Anorectal abscess is a group of abscesses caused by infection of the glands in the anus and rectum, causing inflammation. Most can be observed with the naked eye, but some types of abscesses can be so deep in the anus that they are difficult to see. However, this is rare. Most treatments involve draining the pus, because if left untreated and not treated properly, the infection can spread.
Symptoms of anal abscess
If an abscess occurs in the anus, there will be constant throbbing pain in the anus area, swelling, redness, and pain when pressed, and the pain will worsen when defecating, coughing, or sitting down. This is a common symptom, and other symptoms may also occur, such as:
- constipation
- There is blood, pus, or other discharge from the anus.
- Easily tired
- There is a small, swollen, red, inflamed lump or bump around the edge of the anus.
- Have symptoms related to the urinary tract, such as difficult urination.
- Some people may find that the abscess is deep in the rectum, especially those with inflammatory bowel disease (IBD), causing pain or discomfort in the abdominal area, fever, chills, and night sweats.
- In young children, there are usually no symptoms, except for pain or soreness in the anus, which can make the child irritable and may cause small bumps or lumps to be visible around the anus.
When the patient feels severe and continuous pain, has swelling, blood, lymph or foul-smelling fluid flowing from the anus or genitals, has black or bloody stools, has a fever, chills, or in some cases has diabetes and cannot control blood sugar levels, a doctor should be seen to receive proper treatment and prevent further complications.
Causes of anal abscess
An abscess on the buttocks can be caused by many things, such as:
- Anal Fistula, a small opening that connects the inner anus to the outer skin, is commonly referred to as an anal fistula.
- Sexually Transmitted Infections (STI)
- Obstruction of the anal glands, which produce mucus to lubricate the bowel movement. These glands are located at the junction between the anus and rectum and can be located in the submucosal layer or in the sphincter muscle layer.
In addition, other diseases and risk factors that are conducive to the development of anal abscesses are found as follows:
- Colitis
- Inflammatory Bowel Disease (IBD) such as Crohn’s Disease, Ulcerative Colitis
- Diabetes
- Diverticulitis
- Pelvic Inflammatory Disease
- Anal sex
- HIV infection or AIDS weakens the immune system .
- Use of certain medications, such as prednisone or other steroids.
- Are undergoing chemotherapy or have received treatment before
- Constipation or diarrhea
- A tear in the anal sphincter muscle in toddlers and young children, along with frequent constipation, is a more common cause of anal abscesses in adults.
Diagnosis of anal abscess
The doctor will be able to diagnose anal abscess immediately by asking about initial symptoms, examining the anus for abnormalities such as small lumps or polyps, swelling and redness in the anus, pain when touched, and performing a physical examination. However, in cases where abnormalities cannot be observed outside the anus, the doctor will look for abnormalities inside the anus by wearing gloves and using a finger to feel for abnormal tissue.
In addition, the doctor may consider additional tests such as:
- Fistulotomy is an X-ray examination in patients with holes or perforations in various organs to see the depth of the fistula in the rectum area and find the beginning of the hole by inserting a small tube through the skin that is an opening down into the hole until it reaches the inside of the rectum. In some cases, additional dye may be injected to help the doctor see more clearly during the X-ray.
- Anoscopy is a procedure in which a camera is inserted into the anus and rectum, where a contrast dye is inserted into the anus before the examination. The doctor may collect a small sample of stool for further examination in the laboratory.
- Sigmoidoscopy is a procedure in which a camera is inserted into the intestines to examine for possible causes of disease or abnormalities, such as pain or bleeding. The doctor inserts a small tube-like camera through the anus into the intestines. A small sample of tissue may be removed for analysis in a laboratory.
- Transanal ultrasound is a test that uses high-frequency sound waves to create images of internal organs. The doctor inserts a device through the rectum, which emits high-frequency sound waves that hit the organs and tissues before displaying them on a screen.
- Magnetic Resonance Imaging (MRI) is a machine that uses an electromagnetic field to examine various organs in the body. Patients with abscesses in the buttocks will have an MRI scan of the intestines. However, there are some contraindications for this type of examination for those wearing equipment that has metal components because it can cause serious injury.
Treatment of anal abscess
Anal abscesses often do not heal on their own and most require medical treatment. The most common treatment involves draining the abscess along with medication.
General treatment is divided into 2 types.
- In order to drain the abscess, the doctor will inject local anesthesia to help reduce pain. Then, the doctor will make a puncture directly into the abscess or nearby areas to drain the pus before it ruptures or develops into another type of abscess.
- Surgery is used for large abscesses or those deep in the rectum, as well as patients with perforations in the rectum area. Patients will need to stay in the hospital for surgery under anesthesia. The doctor will cut through the pus and clean the skin around the abscess or perforation. Afterwards, the wound will be left open and the skin will heal on its own. After surgery, the doctor will recommend sitting in warm water 3-4 times a day to help reduce swelling of the abscess.
Drug treatment
After surgery or drainage of an abscess, the doctor will prescribe pain relievers to relieve symptoms and antibiotics to prevent infection in patients with weakened immune systems or chronic diseases such as diabetes. However, in healthy people, only pain relievers may be taken. In addition, there are stool softeners to help patients who are constipated have easier bowel movements or prevent constipation.
Complications of anal abscess
During treatment, the abscess may become inflamed, causing continuous pain. If the treatment is not completely cured or the infection is not completely gone, the abscess may spread into the bloodstream. The patient is therefore at risk of developing sepsis, an anal fistula, or a new abscess on the buttocks. In addition, surgery may put the patient at risk of excessive bleeding, infection in other parts of the body, and scarring.
Prevention of anal abscesses
Anal abscesses can be caused by many factors and causes. Some preventive measures can be taken to minimize the risk of developing an anal abscess, such as:
- Always wear a condom before having sex, especially during anal sex, which can reduce the chances of getting infected with other sexually transmitted diseases.
- Maintain cleanliness and hygiene around the anus.
- People who have sexually transmitted diseases or abnormalities in the anus should get them treated completely to prevent complications that may lead to abscesses.
