Anal Abscess

ANAL ABSCESS pain

Last Updated December 20th, 2021

Overview

Since the anus is one of the orifices of the body communicating directly with the external environment, it is particularly vulnerable to infection. The glands, ducts, and lining of the anal canal are the usual sites of infection. An anal abscess usually develops when the anal glands get blocked or plugged with fecal matter, bacteria or foreign material which then collects in a cavity-causing irritation and inflammation.

These can easily appear in infants and young children if sufficient care is not taken to maintain hygiene during diaper changes. Among adults, sexually transmitted infections are also, at times, responsible for this often painful condition. Anal abscesses are not uncommon but since they are often spontaneously resolved, not all patients seek medical intervention.

 

Definition

Anal abcess dischargeAn anal abscess is a pus-filled cavity that is caused by infection of the cryptoglandular tissue of the anal canal. Externally, these manifest as tender, often painful reddish boils or lumps located around the rim of the anus. Less often, these are situated deeper in the tissue and do not present externally except in the form of fever.

The infectious agents usually implicated in this condition are a variety of common bacterial flora found in the gut and on the skin. Abscesses initially arise in the intersphincteric space of the anal canal and then spread outward from there, the infection spilling into one or more of the spaces surrounding the anal canal. They may drain spontaneously. Otherwise surgical incision and drainage is the preferred mode of treatment.

 

Causes

The primary cause of the anal abscess is an infection which may be contracted in a number of different ways including sexual intercourse or postoperative infection. Common aerobic and anaerobic bacteria such as Escherichia coli, Clostridium, Bacteroides fragilis, Staphylococcus aureus, and Streptococcus are usually responsible.

  • Blockage of anal glands can lead to infection and abscess formation.
  • Sexually transmitted infection.
  • Anal fissures are breaks in the skin surrounding the anus. These can be infiltrated by bacteria and become infected, developing into abscesses.
  • In rare instances, appendicitis can lead to supralevator abscesses. There are also certain risk factors that can increase the likelihood of an individual developing anal abscess:
  • Taking certain immunosuppressant medications.
  • Chemotherapy.
  • Constipation, since it can result in anal fissures.
  • Anal intercourse which can lead to anal fissures and infections if adequate protection is not used.
  • Inflammatory bowel disorders such as Crohn’s disease or ulcerative colitis.
  • Weakened immunity due to diseases such as HIV or AIDS.
  • Pregnancy.
  • Diarrhea.
  • Obesity.
  • Tuberculosis.
  • Anorectal or blood cancers.
  • Diverticulitis.

 

Symptoms

The telltale externally noticeable boils are usually easy to identify. However, when an abscess is located deeper within the tissues, as in the case of the supralevator variety, fever may be the only sign. The general symptoms of this condition are as follows:

  • Painful, reddish swelling in the area adjacent to the anus. This may be warm to the touch.
  • Rectal discharge that may be accompanied by bleeding.
  • Persistent throbbing pain in the anal region. The pain may be exacerbated by movement or by sitting.
  • Fever and chills.
  • Fatigue.
  • The difficulty with bowel movements or urination.
  • Sciatica and acute lower back pain may present in some cases of the supralevator abscess.
  • Infants may show signs of discomfort and irritability.

 

Types of Anal Abscess

ANAL ABSCESS painDepending on its specific location within the anal region, an abscess can be of four main types. Those that are located more superficially, such as the perianal kind, are by far more common. The ischiorectal variety is the next most common, followed by the intersphincteric and supralevator varieties.

  • Perianal: This accounts for nearly 60% of anal abscesses and results from the spread of infection to the area directly below the surface of the skin surrounding the anus. Tender, reddish lumps are externally noticeable and may be accompanied by some itching.
  • Ischiorectal: Infection spreads into the ischiorectal space of the anal region, with minimal external indications apart from some reddening of the skin surface and hardening of the underlying tissue. Symptoms such as fever, chills and severe pain are more common.
  • Intersphincteric: Infection remains confined to the intersphincteric space.
  • Supralevator: These account for only about 3-4% of the incidence of the anal abscess. They may be caused by the spreading of infection from intersphincteric or ischiorectal abscesses. They may even occur as a result of Crohn’s disease or diverticular disease.
  • Submucosal: 1% of all diagnosed cases are of this variety. Sometimes the abscess spreads in such a way as to partially encircle the area around the anus and this form is known as a horseshoe abscess.

 

Clinical Complications

Nearly half of all cases of anal abscess are found to progress into a chronic condition known as an anal fistula. A fistula is an abnormal tunnel connecting the abscess itself with the skin surrounding the anus. In the event of incomplete drainage of infected material during surgical treatment, the abscess can reappear soon afterward. Recurrent abscess formation commonly leads to the development of an anal fistula.If untreated or inadequately treated, infection from the abscess can spread to other locations and cause a systemic infection.

 

Diagnosis

A physical examination usually reveals the presence of the painful lump or boil characteristic of a perianal abscess. When they are more internally located, abscesses may be difficult to detect solely by means of physical examination. Anesthesia administered prior to examination aids the process by minimizing the patient’s pain and discomfort.

Digital rectal examination helps identify ischiorectal abscesses although intersphincteric and the rarer supralevator varieties generally only become apparent through diagnostic imaging. A computerised tomography (CT), magnetic resonance imaging (MRI) and anal ultrasonography help locate the abscess. associated fistulae if any and possible adverse effects on the anal sphincters or other internal structures. Screening for sexually transmitted diseases, inflammatory bowel diseases or other conditions such as cancer might be required to establish whether there is a causative relationship.

 

Treatment and prevention

Treatment – if it is a minor case if abscess, a local aesthesia can be given; and the abscess drained. In severe cases, a more intensive form of treatment may be needed –

  • Surgical drainage of the abscess and repair of the fistula.
  • Antibiotic treatment.
  • Placement of steton if continuous drainage is needed.

Preventions 

  • Manage diabetes.
  • Use a condom if you are partaking in anal sex.
  • In the cases of inflammatory bowel diseases such as Crohn’s, medication is usually provided to prevent abscess.

 

Dos and Don'ts

Dos
  • Sit in an 8-10 centimeter sitz bath 3 times a day and after a bowel movement. This helps with the pain and itching.
  • If you are prescribed with antibiotics, take them as directed.
  • Follow the doctors’ instructions if you are sent home with a drain or a package of the abscess.
Don'ts
  • Consume high-fiber foods; increase your fiber intake slowly.
  • Partake in any strenuous activity.
  • Skip your pain medications. If they do not work ask your doctor for different ones.

 

 

 

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Heartburn: What are the exact symptoms and the best home remedies? There are easy home remedies for heartburn, which not only acts as a first aid when you experience…
Barium-enema
Barium Enema Barium enema is also known as colon x-ray. Here, the patient is asked to consume small amount of…
GGt test
GGT – Gamma-Glutamyl Transferase Test GGT or gammaglutamyl transferase test is a liver function test that is used to detect the extent of…
blood elements analysis
Blood Element Analysis Test A blood element analysis is a blood test performed to measure the level of toxic elements such as…
fructosamine test
Fructosamine Test A fructosamine test measures blood sugar glucose content. Fructosamine level can indicate blood sugar level in past 2-3…
anoscopy
Anoscopy Anoscopy is an invasive diagnostic procedure where a small device known as anoscope will be inserted in the…
iron deficiency profile
Iron Deficiency Profile An iron deficiency profile is a battery of blood tests which are performed in order to determine the…
Diabetes blood test
Diabetic Profile The diabetic profile is a set of tests used for testing and monitoring the various kinds of Diabetes…
oral hygiene tips
6 shocking consequences of bad oral hygiene (and how to avoid them) Did you know bad breath is not just turning off, but also harms your body in ways you…
Dragon Fruit – Blessing from Nature’s Basket Dragon fruit is packed with nutrients but low on calories. It is the dream food that can help…
xylitol gum
Xylitol : Is this the right sugar substitute for you? Discovered during World War 2 owing to sugar shortage, xylitol has become a common name in pharamaceutical industry.…
avocado benefits
Avocado: 15 reasons why this fruit should be a staple in your diet Did you know that the word avocado literally means "testicles". Don't get grossed out as this power-packed fruit…
ashwagandha brain
Ashwagandha: The best-kept secret of Ayurveda now revealed! Ashwagandha literally means "smell of horse". Don't get bogged down by that one tiny detail because this ayurveduic…
black seed oil benefits
Black Seed Oil: What secret benefits could it bestow on your health? Black seeds or nigella seeds are tiny packets of health brimming with amazing benefits. Find out why should…
Cayenne: The remarkable benefits of these red hot chili peppers These may make you rush for a glass of water, but cayenne pepper is actually a healthy additive…
Kava: Is it the healthy substitute for alcohol you have been waiting for? Native to the beautiful South Pacific islands, Kava is a famous beverage rooted in the local culture. It…
How can berberine supplements help you live longer and healthier? Berberine is a turmeric look-alike herbal extract that is credited with numerous health benefits ranging from diabetes cure…
glucose-tolerance
Oral Glucose Tolerance Test – GTT Glucose tolerance test (or Oral GTT) is used to detect the onset of diabetes or prediabetes conditions. It…
ASTtest-liver
AST- Aspartate Aminotransferase Test AST test is a blood test that is used to measure the level of a particular liver enzyme…
ANTIPHOSPHOLIPIDANTIBODY(APL)_IgG
Antiphospholipid (APL) antibody-IgG The Antiphospholipid Antibody testing is a blood test used to determine an autoimmune disorder called Antiphospholipid syndrome linked…
vdrl test syphilis
VDRL Test The VDRL test is a blood test that is used to diagnose sexually transmitted or venereal diseases, primarily…
malarial antigen test
Malaria Antigen Test A malaria antigen test is a rapid diagnostic test (RDT) that can detect malarial antigens (proteins) in your…
Okra: How can this nutrient-dense vegetable help you fight diabetes? Okra is a food which is rich in nutrients and minerals which are extremely essential for a healthy…
Hepatitis A virus infected liver
Hepatitis A Virus (HAV) Total Blood test to look for IgM antibodies to know if you are infected with Hepatitis A virus (HAV),…
stress depressed anxiety
Are you depressed or just stressed? Know when to see a doctor Why are some people more anxious than others? Is being depressed the same as feeling sad? Have you…
sugar toxic health
Sugar: 7 new shocking truths revealed about the sweet poison Can drinking soda bring you closer to death? Is sugar slowly poisoning you and your family? You would…
L-theanine attention
L-Theanine: Better sleep, higher focus, and many other benefits Did you know that L-theanine found in green tea can make you sleep better and be focused at…
aspartame or sugar
Aspartame – Hidden truths about this storm in a teacup Aspartame, the artificial sweetener, has gone under the scanner on several occasions for allegedly doing more harm than…
High Fiber Diet – Fire up your fiber intake for these health benefits! Regular bowels, healthy detox, higher immunity, and guaranteed weight loss - a high fiber diet can bring all…
gallbladder diet tomato
Gallbladder surgery :Tips on post-operative care and diet What to eat post a gallbladder surgery? What are the key things to avoid if you had a…
DHEA wrinkles
DHEA: Now get unbelievable age defiance with this wonder hormone! DHEA is known popularly as the age-defying hormone. This supplement is widely used to slow down aging and…
Oil of Oregano: The one-stop essential oil you’ve been looking for Are you plagued by a weak immune system? High body inflammation accompanied by pain and infections? Why not…
Love tea, hate tannins? Rooibos tea is just what you need The market is brimming with a multitude of herbal teas. But what makes rooibos tea (or red bush)…
How seitan proved to be a blessing in disguise for vegans worldwide Can only meat-eaters enjoy delicious juicy steaks and burgers? With seitan, the best meat substitute available today,even vegans…
Pescatarian Diet 101: What are the inherent health advantages of this diet? People opt to become a pescatarian in order to enrich their bodies with the essential health benefits that…
Mood swings
The real reasons for your mood swings and how to overcome them Are you prone to heated moods frequently? Do you also feel bouts of depressive feeling creeping up on…
shakeology woman
Meal replacement or protein drink? Learn all about Shakeology and its claims Shakeology from Beachbody claims to be the most suitable shake that can aid in weight loss, regulate blood…
hemoglobin variant analysis
Hemoglobin Variant Analysis Hemoglobin variant analysis is a blood test that is used to detect the presence of hemoglobin variants which…
cystatin C
Cystatin C Test Cystatin C is a specific single-chain protein that is found in body fluids and is a biomarker for…
piles fissure fistula
Allopathy vs homeopathy vs ayurveda treatment for piles, fissures, and fistula Read to know the best form of treatment among allopathy, homeopathy,or ayurveda for piles, fissures, and fistula
liver detox facts
7 liver detox facts and why ignoring these could kill you! Are you taking care of this organ that handles over 500 different vital functions in your body? Your…

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