If you have got pain in the anal region with tenderness at a particular point with fever this may be due to an abscess. Abscess is a collection of pus due to an infection. It can be extremely painful or may only cause a discomfort during passage of stools.
Most of the time this happens due to a blockage of an ‘anal gland’. Anal glands are found in the anal canal and they secrete a lubricant to keep anal canal moist. They can get blocked due to hard faeces. Once they are blocked bacteria can grow in them and form an abscess. In addition various other conditions also can cause perianal abscesses eg. Inflammatory bowel disease, Tuberculosis, Cancer, Lymphoma, trauma, surgical interventions, radiation etc.
These abscesses can point through skin close to the anus or away from it. If not treated properly it can rupture spontaneously and pus will drain out. This will give rise to a condition called a ‘fistula’. Before the burst of the abscess it can spread to various directions to various degrees leading to give rise to complex fistula at the end.
Perianal abscess should be treated only by a surgeon as it should not be treated with antibiotics. Antibiotic treatment will give rise to complex fistula formation and may even lead to incontinence i.e inability to control passage of flats (gas) or faeces due to damage to anal ‘sphincter’ (muscular structure which control the anal function).
Your doctor will order some blood investigations and examine you from outside or internally to make the diagnosis. You will be referred to a surgeon for surgical management of the condition. The surgeon may carry out a camera test or may differ it and proceed to operate on you. The surgery would be called ‘incision and drainage of the abscess’ where abscess will be opened up surgically and pus will be removed. This should settle the pain and fever.
The remaining wound will take a variable time to heal depending on patients general condition (3 to 12weeks).
Following surgery, patient may be advised to take daily baths, wash the wound with soap and water about 2-3times a day. It is not necessary or may cause complications if tried to do daily change of dressings. Do not use any strong antiseptics on the wound.
Forty to fifty percent of these will give rise to fistula formation and recurrence which need proper surgical management.