Anal Abscess: Symptoms, Causes, and Treatment Options

External anal lump

Hello Doctor,
In March, I discovered a lump near my anus, which is painful to the touch, but I have not experienced any fever or discharge.
After researching, I suspect it might be an anal fistula.
I consulted a colorectal specialist who performed a digital examination and said it is unlikely to be a fistula.
However, the pain has persisted for over a month, and in the past two days, there has been noticeable swelling in my buttocks.
Since I live in a remote mountainous area, it is difficult to visit a hospital, so I would like to ask you:
1.
If it is an anal fistula, what other symptoms can I look for to assess it myself?
2.
Given that I do not have fever or discharge, is it still likely to be an anal fistula?
3.
I have read that surgery is required for anal fistulas.
Since I will be traveling abroad for three months, how long does recovery from the surgery typically take?
4.
What are the causes of anal fistulas? I wash with water after using the toilet, so I am unsure why I suddenly developed this swelling and pain.

Niming, 30~39 year old female. Ask Date: 2017/04/25

Dr. Yu Mingchang reply Surgery

Hello; when you have time, please take a look at the colorectal diagnosis from the Ministry of Health and Welfare Changhua Hospital.
We care about you.

Reply Date: 2017/04/25

More Info

Understanding Anal Abscess: Symptoms, Causes, and Treatment Options
Anal abscesses are painful collections of pus that can develop near the anus or rectum. They often arise from infections in the anal glands, which can become blocked, leading to inflammation and pus formation. Here’s a detailed overview of the symptoms, causes, and treatment options for anal abscesses, particularly in the context of your situation.

Symptoms of Anal Abscess
1. Pain and Swelling: The most common symptom is localized pain and swelling near the anus. This pain can be sharp and may worsen with movement or sitting.

2. Tenderness: The area around the abscess is usually tender to the touch. You may notice increased sensitivity when applying pressure.

3. Fever: While you mentioned not having a fever, it’s worth noting that some individuals may experience a low-grade fever as the body responds to the infection.

4. Discharge: In some cases, there may be a discharge of pus if the abscess ruptures. This can provide temporary relief from pain but requires medical attention to prevent further complications.

5. Changes in Bowel Habits: Some individuals may experience discomfort during bowel movements, leading to changes in their regular habits.

Causes of Anal Abscess
Anal abscesses can be caused by several factors, including:
1. Blocked Anal Glands: The most common cause is the blockage of the anal glands, which can lead to infection.

2. Infections: Bacterial infections, particularly from E. coli or other bacteria that normally reside in the intestines, can lead to abscess formation.

3. Inflammatory Bowel Disease: Conditions like Crohn's disease can increase the risk of developing abscesses.

4. Trauma: Any injury to the anal area can predispose an individual to infections.

5. Poor Hygiene: While you mentioned using water to clean after using the toilet, inadequate cleaning or excessive moisture can also contribute to infections.

Diagnosis and Self-Assessment
1. Self-Assessment for Fistula: If you suspect a fistula (an abnormal connection between the anal canal and the skin), look for additional symptoms such as persistent drainage of pus or stool from the skin, recurrent abscesses, or pain that persists even after the abscess has drained.

2. Likelihood of Fistula: The absence of fever and pus does not rule out the possibility of a fistula, but it may lower the likelihood. A thorough examination by a healthcare professional is essential for an accurate diagnosis.

Treatment Options
1. Medical Evaluation: Given that you have had persistent pain for over a month, it is crucial to seek medical evaluation. A healthcare provider can perform a physical examination and possibly imaging studies to assess the situation accurately.

2. Surgical Intervention: If an abscess is confirmed, surgical drainage is often necessary. This procedure typically involves making an incision to allow the pus to escape, which can provide immediate relief.

3. Recovery Time: Post-surgery, recovery can vary. Generally, individuals can expect to return to normal activities within a few days to a week, but complete healing may take longer, especially if a fistula is involved.

4. Home Care: In the meantime, you can manage discomfort with warm sitz baths, over-the-counter pain relievers (like ibuprofen or acetaminophen), and maintaining good hygiene.

Conclusion
While it may be challenging to access healthcare in a remote area, it is crucial to prioritize your health and seek medical attention as soon as possible. Delaying treatment can lead to complications, including the spread of infection or the development of a fistula. If surgery is necessary, discuss your travel plans with your healthcare provider to ensure that you receive appropriate care before your trip.

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