Managing Concerns About Anal Abscess Treatment After Hemorrhoid Surgery

Concerns regarding the management of anal abscesses?

Hello Dr.
Ke, I underwent surgery for internal and external hemorrhoids on January 3, 2018, where two internal hemorrhoids were excised.
The wound has generally divided into two sides; the right side is healing well, but the left side has been experiencing recurrent swelling and discharge of greenish-yellow pus.
I often feel sharp pain and swelling at work.
Recently, I returned to the surgeon for follow-up visits.
During the first visit, the doctor prescribed oral antibiotics and antibiotic ointment, which worked well initially, but after about five days, the symptoms recurred.
On the second visit, the doctor diagnosed it as an anal abscess and recommended surgery on June 1.
The doctor mentioned that he would perform debridement of the anal abscess to remove unhealthy tissue and allow for proper healing, which is expected to take about two hours under local anesthesia.
I am unsure how large the incision will be and how long the recovery period will take, which makes me quite anxious.
I still have to work; I have surgery on June 1, a day off on June 2, and I need to return to work on June 3.
Additionally, I have a trip planned for July 15, and I am uncertain how well I will recover in the next month and a half.
Should I have the surgery before traveling or wait until I return? I would appreciate your advice, Dr.
Ke.
Thank you!

Chen Youyou, 30~39 year old female. Ask Date: 2019/05/28

Dr. Ke Fangxu reply Surgery

The surgical wound from an anal abscess drainage typically takes about a month to heal.
If the surgery is performed on June 1st, it should be healed by July 15th, when you plan to travel abroad.
If you wait to have the surgery until after you leave, there is a risk of complications from infection while you are overseas, which could be more troublesome.
Therefore, I recommend having the surgery before you travel.

Reply Date: 2019/05/28

More Info

After undergoing hemorrhoid surgery, it is not uncommon for patients to experience complications such as anal abscesses. An anal abscess is a painful condition that occurs when a collection of pus forms in the tissue surrounding the anus, often as a result of infection. In your case, it seems that the left side of your surgical site has not healed properly, leading to recurrent swelling and discharge of yellow-green pus, which is indicative of an infection.

The treatment for an anal abscess typically involves surgical intervention to drain the pus and clean the infected area. Your surgeon has recommended a procedure to perform this drainage and remove any necrotic tissue, which is essential for proper healing. The procedure is usually done under local anesthesia, and while the size of the incision may vary depending on the extent of the abscess, it is generally manageable.

Regarding your concerns about recovery time, it is important to understand that healing can vary significantly from person to person. Typically, after an abscess drainage procedure, patients may experience discomfort for a few days, but many are able to return to light activities within a week. However, full recovery may take longer, especially if you have a physically demanding job. It is advisable to listen to your body and not rush back into work if you are still experiencing significant pain or discomfort.

Given your upcoming travel plans, it would be wise to discuss your timeline with your surgeon. They can provide you with a more tailored recovery plan based on the specifics of your surgery and your overall health. It is crucial to ensure that you are fully healed before undertaking any travel, as the risk of complications can increase if you are not adequately recovered.

In terms of managing your concerns about the surgery and recovery, here are some recommendations:
1. Follow Post-Operative Instructions: Adhere strictly to the post-operative care instructions provided by your surgeon. This may include taking prescribed antibiotics, keeping the area clean, and avoiding strenuous activities.

2. Pain Management: Use over-the-counter pain relief medications as recommended by your doctor to manage discomfort. Applying warm compresses to the area may also help alleviate pain and promote drainage.

3. Monitor Symptoms: Keep an eye on your symptoms. If you notice increased redness, swelling, or discharge, or if you develop a fever, contact your healthcare provider immediately.

4. Plan for Recovery: If possible, consider taking additional time off work after your surgery to allow for adequate recovery. This will help reduce stress and facilitate healing.

5. Discuss Travel Plans: Be open with your surgeon about your travel plans. They may recommend postponing your trip until you are fully healed to avoid complications while away from home.

6. Seek Support: If you have concerns about managing your recovery, consider reaching out to a healthcare professional or a support group for advice and encouragement.

In conclusion, while the prospect of surgery and recovery can be daunting, with proper care and communication with your healthcare provider, you can navigate this process effectively. Prioritize your health and recovery, and do not hesitate to seek further clarification from your surgeon regarding any concerns you may have.

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