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Anal abscess

An anal abscess is a pus-filled lump that forms in the anus. This condition generally occurs due to a bacterial infection in the anal area. Anal abscesses are painful, especially when sitting or having a bowel movement. 

An anal abscess is generally characterized by a small, reddish lump in the anal canal. In some cases, an abscess can also appear at the end of the large intestine where it connects to the anus (rectum). 

If not treated immediately, an anal abscess can cause the formation of an abnormal channel in the anus (anal fistula). This condition will make the pain worse, even causing difficulty controlling bowel movements. 

Causes of anal abscesses

An anal abscess occurs when the glands around the anus become infected with bacteria. As a result, the gland enlarges and fills with pus. Some of the causes of anal abscesses include:

  • Blocked glands in the anus
  • infected sores or tears in the anus (anal fissures). 
  • Anal injury
  • Sexually transmitted disease

Risk factors for anal abscess

Anyone can have an anal abscess, but this condition is more at risk for people who:

  • Suffer from inflammatory bowel diseases, such as ulcerative colitis and Crohn's disease.
  • Suffering from pelvic inflammation, diabetes, diverticulitis, diarrhea, or constipation
  • have a weak immune system, for example due to suffering from HIV/AIDS.
  • Taking corticosteroid or chemotherapy drugs
  • Having sex through the rectum (anal)
  • Smoke
Anal abscesses are also more likely to occur in pregnant women, as well as in babies and toddlers who are still wearing diapers. 

anal abscess symptoms

The common symptom of an anal abscess is pain in the anus or rectum that feels stabby. This pain is continuous and gets worse when sitting, coughing, or defecating. 

Other symptoms that can appear as a result of an anal abscess are:

  • Constipation
  • The body gets tired easily.
  • Difficulty urinating
  • Fever and chills
  • Pain in the lower abdomen
  • Irritation, swelling, and redness around the anus
  • Pus or blood discharge from the rectum

When to see a doctor

Check with your doctor if you experience the symptoms mentioned above. An anal abscess that is left unchecked can develop into an anal fistula, which is an abnormal channel that forms in the rectum. Anal fistulas must be treated with surgery and usually take a long time to heal. 

Immediately go to the emergency room if you have a high fever accompanied by vomiting, chills, difficulty defecating, and unbearable pain around the anus. These symptoms can indicate that the infection has spread to the bloodstream. If not treated quickly, sufferers can experience sepsis, shock, and even death. 

Diagnosis of an anal abscess

The doctor will start the diagnosis by asking about the patient's symptoms and medical history. Next, the doctor will perform a physical examination of the patient's rectal area. Through a physical examination, the doctor can distinguish whether a lump in the patient's rectum is an abscess or hemorrhoids. 

The doctor will also carry out a supporting examination to determine the cause of the abscess that has formed in the anus. The examination includes:

  • Blood tests are used to detect diabetes, colitis, or HIV/AIDS.
  • Endoscopy or colonoscopy to see the condition of the anal canal and rectum
  • scanning with ultrasound, CT scan, or MRI to detect deeper abscess locations not visible during physical examination.

Treatment of an anal abscess

An anal abscess cannot heal with antibiotic therapy alone. The treatment that needs to be done to treat this condition is surgery, the type of which depends on the location of the abscess. 

If the abscess is located in an area that is not very deep, the patient will undergo minor surgery and can usually go home after recovering. However, if the abscess is located in a deeper part of the body or is large, the patient needs to be hospitalized. 

Anal abscess surgery can be performed under local anesthesia or general anesthesia. The operation is performed by making an incision in the abscess area and removing pus from the rectum. 

After surgery, the doctor will prescribe antibiotics to treat the infection and drugs to relieve pain, such as paracetamol. Patients are also advised to soak the anus in warm water or a sitz bath 3–4 times a day. 

To help the healing process, patients can eat soft foods that contain high fiber and drink lots of water to facilitate bowel movements. Patients can also use stool softeners to relieve pain during bowel movements. 

Anal abscess complications

If left untreated or not routinely examined after anal abscess surgery, it can cause a number of complications listed below:

  • Anal fistula
  • persistent (chronic) pain in the area of the abscess
  • Difficulty controlling bowel movements (fecal incontinence)
  • The abscess recurred after surgery.
  • infection that spreads to the bloodstream (sepsis)

Prevention of anal abscess

There are several things you can do to prevent anal abscesses from forming, including:

  • Prevent sexually transmitted infections, one of which is by using a condom when having sex.
  • Seek immediate treatment if you have a sexually transmitted infection.
  • Treating diseases that can increase your risk of developing an anal abscess, such as diabetes and colitis,
  • Do not have sex through the rectum (anal).
  • Maintain genital and anal hygiene.
  • Change the child's diaper regularly.

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