Should You Return to the Doctor After Experiencing Anal Discharge?

Should I return for a follow-up if there is pus coming from the anus?

Hello doctor, two weeks ago I visited a colorectal surgeon due to severe anal pain.
The doctor diagnosed me with mild inflammation and prescribed oral pain relievers and anti-inflammatory medication, as well as a suppository.
When my mother assisted me with the suppository, she noticed a small white object about the size of a grain of rice.
A week ago, I was still in pain, and the doctor mentioned that an external hemorrhoid had ruptured, so he prescribed more anti-inflammatory and pain relief medication along with an ointment.
After two or three days, my symptoms improved, but yesterday the pain returned (it feels like the small grain is the source of the pain, and it feels hard and very painful to touch).
Today, while resting at home, I noticed yellow discharge in the anal area on my underwear when I went to the bathroom in the afternoon, which feels like pus.
At this point, the pain has significantly decreased.
Could this be an anal abscess? If there is pus draining on its own, should I just wait for it to heal, or do I need to return for a follow-up? I am very concerned about the possibility of an anal fistula (is this something I should be worried about?).
Thank you.

Xiao A, 30~39 year old female. Ask Date: 2016/07/19

Dr. Ke Fangxu reply Surgery

Based on your description, it is indeed possible that you have an anal abscess or a fistula.
If the pus has drained and your symptoms have improved, it is likely not serious.
However, to obtain a definitive diagnosis, it is best to return for a follow-up appointment with your physician to determine if surgical intervention is necessary.

Reply Date: 2016/07/19

More Info

It sounds like you are experiencing a concerning situation with your anal health, and it's understandable to feel anxious about it. Based on the symptoms you've described, including the pain, the presence of a small hard lump, and the yellow discharge that resembles pus, it is advisable to return to your doctor for further evaluation.

Why You Should Return to the Doctor
1. Persistent Symptoms: You mentioned that despite initial treatment, your symptoms have persisted and even worsened. The presence of a hard lump that is painful, along with the discharge, suggests that there may be an underlying issue that needs to be addressed.
2. Possible Anal Abscess: The yellow discharge you observed could indicate the presence of an anal abscess, which is a collection of pus that can occur due to infection. While some abscesses can drain on their own, they often require medical intervention to ensure complete drainage and to prevent further complications.

3. Risk of Fistula Formation: If an abscess is not treated properly, it can lead to the formation of a fistula, which is an abnormal connection between the anal canal and the skin. This can result in chronic drainage and infection, leading to more significant health issues.

4. Need for Further Investigation: Your doctor may want to perform a physical examination or imaging studies to determine the exact nature of the lump and the discharge. This can help rule out other conditions such as hemorrhoids, fissures, or more serious issues.

5. Treatment Options: Depending on the diagnosis, your doctor may recommend different treatment options. If it is an abscess, it may need to be drained surgically. If it is a hemorrhoid or another condition, there may be other treatments available to alleviate your symptoms.

What to Expect During Your Visit
When you return to the doctor, be prepared to discuss your symptoms in detail, including:
- The duration and intensity of your pain.

- Any changes in your bowel habits.

- The characteristics of the discharge (color, consistency, odor).

- Any other symptoms you may have experienced, such as fever or changes in appetite.

Your doctor will likely perform a physical examination, which may include a digital rectal exam to assess the area more thoroughly. They may also ask about your medical history and any previous treatments you've undergone.

Conclusion
In summary, given your symptoms and the potential for complications, it is important to seek medical attention promptly. Do not wait for the symptoms to resolve on their own, as this could lead to more serious issues down the line. Your health is paramount, and addressing these concerns with your healthcare provider will ensure that you receive the appropriate care and treatment.
If you have any further questions or concerns, do not hesitate to reach out to your healthcare provider. They are there to help you navigate these issues and ensure your well-being.

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