Located at the bottom of the rectum, the anus is the final part of the digestive tract. It is lined with two separate sphincters and controls the expulsion of feces — waste from the digestive process. As important as it is, however, it can succumb to infections such as anal abscesses, which can easily result from infected anal glands. Abscesses are extremely painful; they develop when pus collects adjacent to the anus. Unfortunately, they typically do not go away without treatment. With that said, it is possible to treat them with relatively simple drainage procedures.
Anal abscesses develop when pus fills cavities near the rectum or anus—often as a result of infected anal glands. Classified by their location, the abscesses typically form in the perianal area surrounding the anus. This embarrassing condition often leads to extreme pain which rarely subsides without surgical intervention.
Anal abscesses are most common among individuals between the ages of 30 and 40. While the condition affects both genders, it is twice as common in men. In addition to affecting adults, the condition is also relatively common in young children. More specifically, it is frequently observed in male infants under one year old.
Physically, a red, tender nodule will develop at the rim of the anus. One of the most common symptoms is constant pain, which typically aggravates during bowel movements. More often than not, people also experience throbbing and swelling in the anal area, and possibly rectal bleeding. In some cases, anal abscesses cause fever, fatigue, constipation, and chills.
Blocked anal glands are the most common cause of anal abscesses. Other possible causes include sexually transmitted infections, anal sex, and anal fissures—the last of which occurs when there is a tear in the anal canal. On occasion, abscesses may also develop from infected skin adjacent to the anus. Frequently, e. coli or staphylococcus bacteria cause the underlying infections.
Diabetes, inflammatory bowel diseases such as ulcerative colitis or Crohn’s disease, HIV or AIDS, colitis, hemorrhoids, appendicitis, pelvic inflammatory disease, and diverticulitis can all increase the risk of developing anal abscesses. In many cases, medical practitioners note increased risk from the use of medications such as corticosteroids or chemotherapy agents.
Physicians diagnose anal abscesses with digital rectal exams. The relatively simple procedure involves the insertion of a lubricated finger into the rectum. For most individuals, this will be sufficient for diagnosis. Other patients may require CT scans, MRIs, or ultrasounds. Physicians may also order additional tests to screen for other conditions such as sexually transmitted infections, rectal cancer, or inflammatory bowel disease.
Anal abscesses can result in fistulas—tube-like passages between the skin and the muscular opening of the anus. These typically occur in 50% of people with abscesses. If left untreated, fistulas will continue to grow—potentially to the outside of the skin. Ultimately, they require surgery to fix. In addition to fistulas, abscesses can lead to continuous pain, scars, fissures, and sepsis, the last of which can be life-threatening.
Individuals should go to the doctor if they suspect they have an anal abscess. At the clinic, the medical practitioner will perform the necessary tests for diagnosis. If at any time one experiences chills, a high fever, significant pain, painful bowel movements, inability to have a bowel movement, or persistent vomiting, he or she should seek emergency medical attention.
Surgery is the main treatment for anal abscesses. More specifically, physicians will surgically drain the abscesses, often to prevent an eruption. Minor abscesses are often treated at the clinic using local anesthesia while more serious cases may require hospitalization. If fistulas exist, the surgeon will remove them at the same time.
Pain is common following the surgical procedure. Depending on the individual’s condition, the physician may prescribe antibiotics and analgesics. If there is packing in the wound (abscesses are often left open to drain, to accelerate healing), the doctor will remove it after a few days. To help with the discomfort of bowel movements during recovery, some people take stool softeners.
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