Should You Consider Surgery for Recurring Anal Issues?

Should I undergo surgery to resolve the issue in one go?

I have a habit of constipation and irregular bowel movements.
However, since last year, I have noticed that whenever I experience constipation and cannot pass stool, small hard lumps appear near my anus.
I researched online and suspect it might be an anal fistula.
I experience pain while sitting and walking.
The worst incident involved an abscess in the groin and two hard lumps near the anus, which was extremely painful.
I tried to puncture it with a needle, but it didn't burst.
A few days later, it ruptured due to external pressure.
I want to see a doctor, but as a woman, I feel embarrassed about having to undress and show my buttocks and anus.
Now, whenever I notice the lumps, I try to endure it for a few days to let it resolve on its own.
I would like to ask if this condition is likely to recur and whether I should go to the hospital to have the fistulas surgically removed for a permanent solution.
Otherwise, every time I experience constipation and struggle to pass stool, I feel a significant risk of developing hard lumps, and each occurrence leads to several days of pain.
Generally, if I can pass stool, my constipation is manageable.

Niming, 30~39 year old female. Ask Date: 2018/05/15

Dr. Ke Fangxu reply Surgery

Self-administering injections to treat anal lesions is very dangerous and could lead to sepsis due to bacterial infection.
It should not be attempted lightly.
Based on your description, it seems more like an anal fistula infection with an accompanying abscess.
A proper diagnosis can only be made by a physician, so please seek medical assistance as soon as possible to prevent the condition from worsening and endangering your life.

Reply Date: 2018/05/15

More Info

When it comes to recurring anal issues, particularly those related to constipation and the formation of hard lumps near the anus, it is essential to approach the situation with a comprehensive understanding of the potential underlying causes and treatment options. Based on your description, it seems you may be experiencing symptoms consistent with anal fissures, abscesses, or possibly an anal fistula, especially given the recurring nature of the hard lumps and the pain associated with bowel movements.

Firstly, it is important to recognize that constipation can significantly contribute to anal problems. When stool becomes hard and difficult to pass, it can lead to straining during bowel movements, which may cause or exacerbate fissures or lead to the formation of lumps. These lumps could be indicative of an abscess, which is a collection of pus that can occur when there is an infection in the anal glands. If these abscesses are not treated, they can develop into fistulas, which are abnormal connections between the anal canal and the skin.

Regarding your concern about surgery, it is crucial to consult with a healthcare professional who specializes in gastrointestinal or colorectal issues. Surgery may be considered if you have recurrent abscesses or fistulas, as these conditions often require surgical intervention to prevent further complications. The surgical procedure typically involves draining the abscess and possibly removing the fistula tract if one is present. This can provide a long-term solution and alleviate the pain and discomfort you are experiencing.

However, before considering surgery, it is advisable to explore non-surgical options as well. Here are some steps you can take:
1. Dietary Changes: Increasing your fiber intake can help soften your stool and make bowel movements easier. Foods rich in fiber include fruits, vegetables, whole grains, and legumes. Additionally, staying hydrated is crucial.

2. Regular Bowel Habits: Establishing a regular schedule for bowel movements can help reduce the incidence of constipation. This may involve setting aside time each day to sit on the toilet, even if you do not feel the urge to go.

3. Over-the-Counter Remedies: Laxatives or stool softeners can be used occasionally to help relieve constipation. However, these should not be relied upon long-term without consulting a healthcare provider.

4. Pain Management: If you experience pain during bowel movements, topical treatments such as hydrocortisone creams or anesthetic ointments may provide relief.

5. Medical Evaluation: It is essential to have a thorough evaluation by a healthcare provider. They can perform a physical examination and possibly imaging studies to determine the exact nature of your condition. This evaluation can help rule out more serious issues and guide appropriate treatment.

6. Addressing Anxiety: It is understandable to feel embarrassed about discussing anal issues, but healthcare providers are trained to handle such situations with professionalism and confidentiality. Open communication with your doctor is vital for effective treatment.

In conclusion, while surgery may be a viable option for recurrent anal issues, it is essential to first explore conservative management strategies and consult with a healthcare professional. They can provide a tailored approach based on your specific symptoms and medical history, ultimately leading to better management of your condition and improved quality of life.

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