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Perianal abscess and anal fistula: Treatment, symptoms, advice and help

About perianal abscess and anal fistula

A perianal abscess is a collection of pus in a cavity surrounding the anal canal. This may occur as a result of an infection of the surrounding soft tissues. The severity and depth of the abscess is quite variable, and is often associated with formation of a fistulous tract.

Perianal abscess and anal fistula: Incidence, age and sex

Men have a higher incidence than women. Anal fistula occurs in at least 40 to 50% cases of perianal abscess. The incidence of such conditions is higher in individuals staying in unhygienic environments.

Signs and symptoms of perianal abscess and anal fistula: Diagnosis

The perianal abscess drains either inside or outside the body by travelling in a path of least resistance. Such a condition results in formation of anal fistula. Anal abscess mostly presents itself as a tender swelling in or around the anus and may be associated with throbbing pain. It is more commonly occurs in individuals with piles or anal fissure.

Anal fistula also present with a feeling of lump near anus, associated with stabbing/throbbing pain. There may be leakage of foul smelling pus or mucous or faecal matter from the fistula’s external opening. This may lead to soiling the inner garments. The anal pain usually subsides when the pus gets discharged outside.

Perianal abscess and fistula can be diagnosed easily by physical examination of anal region by a specialist. Investigations like proctoscopy, sigmoidoscopy and fistulography may help in corroborating the diagnosis and also give more details about the abscess or fistula including its tracts and openings.

Causes and prevention of perianal abscess and anal fistula

Anus, the aperture from where the faeces get expelled and its surrounding areas are more vulnerable to bacterial or fungal infection due to increased moisture content and folding of the skin. Poor hygiene may also lead to such conditions. Piles and fissures, if left untreated may lead to abscess formation. Some other causes of perianal abscess followed by anal fistula, are Crohn’s disease, colon cancer, and constipation.

Such conditions can be prevented by maintaining adequate personal hygiene and avoidance of straining during defecation.

Perianal abscess and anal fistula: Complications

Any untreated perianal abscess may continue to expand and finally become a serious systemic infection.

Perianal abscess and anal fistula: Treatment

The first and foremost step is to increase the intake of liquids. Drink plenty of water and fruit juices to avoid constipation and maintain good hygiene around the anal area. Affected individuals are advised to take Sitz bath as frequently as possible. Sitz bath involves sitting in a shallow bath tub filled with antiseptic lotions or warm salted water for 10 minutes. Antibiotic medications may be prescribed if the infection has spread to other areas. Heat therapy also can be employed which enhances blood circulation to the anal area for diluting the infective toxins and healing faster. Abscess can be incised and laid open for it to drain and antibiotics to avoid secondary infection. Fistula too can be surgically treated.