Perianal Swelling: Causes, Treatments, and When to Seek Help

Perianal issues

There is swelling next to the anus, which has occurred before.
I previously had it drained by a doctor, but it has continued to swell intermittently.
It reduces in size after applying medication, but this time the swelling is different.
I have not experienced diarrhea or irregular sleep patterns.
I consulted a doctor who recommended topical medication and antibiotics.
The doctor informed me that it is currently just red and swollen, without any pus formation.

Today, after applying the medication, it is still swollen and painful.
Can the presence of pus be determined through palpation? Additionally, should I consider changing doctors for a second opinion? I am concerned about the possibility of a fistula forming, as I have not experienced any pus drainage.
Besides applying medication and taking antibiotics, is there a real chance for the swelling to subside? The area feels hard, and the previous drainage procedure resembled a pathway near the anus, but this time the swelling seems to consist of two distinct hard lumps that do not connect to the anus.

Tuzi, 20~29 year old female. Ask Date: 2016/04/20

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, sir.
Please discuss with the surgeon how to handle your current situation.
Changhua Hospital cares about your health.
Chen Shidian

Reply Date: 2016/04/20

More Info

Perianal swelling can be a concerning symptom, and understanding its causes, treatments, and when to seek further medical help is crucial for effective management. Based on your description, it seems that you have experienced recurrent swelling in the perianal area, which has previously required incision and drainage. The fact that you are currently experiencing swelling without diarrhea and that your sleep has been affected adds complexity to your situation.

Causes of Perianal Swelling
1. Abscess Formation: One of the most common causes of perianal swelling is an abscess, which is a collection of pus that can occur due to infection. If the abscess is not fully drained, it may recur, leading to persistent swelling and discomfort.

2. Fistula Formation: If an abscess has formed and drained, it can sometimes lead to the development of a fistula, which is an abnormal connection between the anal canal and the skin. This can cause ongoing issues with swelling and discharge.

3. Inflammatory Conditions: Conditions such as Crohn's disease or ulcerative colitis can also cause perianal swelling and discomfort. These conditions may lead to inflammation and the formation of fistulas.

4. Skin Conditions: Dermatitis or infections of the skin around the anus can also lead to swelling and discomfort.

5. Other Causes: Less commonly, tumors or other growths in the area can cause swelling.

Treatment Options
1. Medications: Since your doctor has prescribed antibiotics and topical treatments, it is essential to follow this regimen. Antibiotics can help manage any underlying infection, while topical treatments can reduce inflammation and promote healing.

2. Warm Sitz Baths: Taking warm sitz baths can help soothe the area and promote drainage if there is any pus formation. This can also help with pain relief.

3. Pain Management: Over-the-counter pain relievers such as ibuprofen or acetaminophen can help manage discomfort. However, if you find that these are ineffective, you should consult your doctor for alternative pain management strategies.

4. Monitoring Symptoms: Keep a close eye on your symptoms. If you notice increased redness, swelling, or the development of a fever, these could be signs of a worsening infection that requires immediate medical attention.

When to Seek Further Help
- Persistent Symptoms: If the swelling does not improve with the current treatment or worsens, it is essential to follow up with your healthcare provider. You may need further evaluation, including imaging studies or a referral to a specialist.

- Signs of Abscess: If you develop a fever, experience severe pain, or notice any discharge, these could indicate an abscess that needs to be drained.

- Concerns About Fistulas: If you suspect that a fistula may have formed (especially if you notice any unusual drainage or a persistent opening), it is crucial to seek evaluation by a colorectal specialist.

- Change in Symptoms: If the nature of the swelling changes (e.g., new lumps or hard areas), this warrants further investigation.

Conclusion
In summary, perianal swelling can arise from various causes, and while your current treatment may help, it is essential to remain vigilant about your symptoms. If you continue to experience swelling and pain despite treatment, or if you have concerns about the possibility of a fistula or abscess, seeking a second opinion or further evaluation from a specialist may be warranted. Your health and comfort are paramount, and addressing these symptoms proactively can help prevent complications.

Similar Q&A

Understanding Perineal Swelling: Symptoms, Treatment, and When to Seek Surgery

There is a hard swelling in the perineal area, currently accompanied by redness, swelling, heat, and pain. I would like to inquire about what symptoms this might indicate. Is surgery necessary? Since I am currently in a quarantine hotel abroad and unable to see a doctor immediate...

Dr. Du Shixi reply Urology
Hello: The information provided here is for reference only and cannot replace a physician's examination, assessment, or diagnostic tests. A hard swelling in the perineum may indicate a urinary tract issue if there are problems with urination. However, if there are no urinary...

Understanding Painful Anal Swelling: Treatment Options and Concerns

Hello Doctor, since June of this year, I have been experiencing swelling and pain about two centimeters to the left of my anus. After the swelling subsided, there is still a hard lump when pressed. I visited the colorectal surgery department at the hospital and saw two doctors. A...

Dr. Ke Fangxu reply Surgery
Answer: Without a personal examination, it is impossible to determine the exact diagnosis. However, at this age, perianal masses are mostly benign conditions. If there is pain or if it affects daily activities, surgical treatment may be a more definitive option.

Understanding Perianal Swelling: When to Seek Medical Attention

Hello, I have an anal fissure and have been taking Laxative for over a year with little improvement. Recently, I noticed a pattern: I take one packet of Laxative every afternoon, and for about half a month, my bowel movements have been normal without blood. However, yesterday I d...

Dr. Xu Kaixi reply Surgery
Based on your description, this lump is more likely to be a thrombosed external hemorrhoid. It is recommended to seek treatment at a local surgical outpatient clinic, as it usually improves with medication and conservative therapy.

Understanding Perineal Swelling: Causes and Treatment Options

Hello: I noticed a lump in the perineal area while showering. It is not painful when pressed, but there is itching nearby. Later, I observed redness and swelling, and the discharge is mostly yellow-green and resembles cottage cheese. I have seen a doctor, but they only mentioned ...

Dr. Chen Zhiyu reply Obstetrics and Gynecology
If you have any questions, it is recommended to actively consult your attending physician during your outpatient visit. If you have already seen a doctor, please follow the prescribed treatment. If you still experience discomfort, please schedule an earlier follow-up appointment....