Post-Surgery Discomfort: Hardness Near Anal Abscess Site

There is a hard lump after the anal abscess surgery?

I underwent an anal abscess drainage surgery on June 8th.
On June 14th, I experienced sharp pain and bleeding during bowel movements, which I suspect was due to an anal fissure.
However, after a week, it improved.
I have been diligently following the sitz bath routine and applying ointment.
Recently, I have noticed a hard area less than an inch from the 6 o'clock position of my anus, which is quite uncomfortable.
The drainage wound is also located at the 6 o'clock position, and the hard area is situated between the wound and the anus.
The wound itself does not hurt or feel particularly sensitive, but the hard area is bothersome.
It is near the anal opening, and pressing on it causes pain, along with a sensation similar to having a bowel movement.
This makes me anxious about potentially developing further symptoms.
During my recovery period, I have smoked, consumed alcohol, and eaten barbecued food.
Could you please advise me on what the issue might be?

Li Jiaxiang, 10~19 year old female. Ask Date: 2020/06/24

Dr. Ke Fangxu reply Surgery

If the area of tenderness is the same as the surgical site, it is more likely that the abscess has not completely resolved.
If the tenderness is in a different location from the surgical incision, then anal fissure should be considered.
In the former case, it is advisable to have the surgeon evaluate the situation.
In the latter case, warm sitz baths can be beneficial, and over-the-counter hemorrhoid suppositories can be used.
If symptoms persist without improvement, it is best to consult a physician.

Reply Date: 2020/06/24

More Info

After undergoing an anal abscess drainage surgery, it is not uncommon to experience discomfort or unusual sensations in the area surrounding the surgical site. Your description of a hard area near the anal region, particularly at the 6 o'clock position, raises several considerations that we can explore.

First, it is essential to understand that the healing process after such a surgery can lead to various changes in the tissue. The hardness you are feeling could be due to several factors, including:
1. Scar Tissue Formation: After surgery, the body naturally forms scar tissue as part of the healing process. This tissue can sometimes feel firmer than the surrounding areas and may cause discomfort, especially if it is located near sensitive structures like the anal sphincter.

2. Residual Swelling or Inflammation: Even after the initial healing phase, some swelling or inflammation can persist. This can create a sensation of hardness or fullness in the area, which may be exacerbated by activities such as straining during bowel movements.

3. Possible Infection or Abscess Formation: Although you mentioned that the wound does not hurt significantly, it is still important to monitor for signs of infection. If the hardness is accompanied by increased pain, redness, warmth, or discharge, it could indicate a recurrence of the abscess or a new infection.

4. Anal Fissure: Given your history of pain and bleeding during bowel movements, an anal fissure could also be a contributing factor. Fissures can cause significant discomfort and may lead to muscle spasm in the anal sphincter, which can create a sensation of tightness or hardness.

5. Hemorrhoids: Sometimes, the stress of surgery and changes in bowel habits can lead to the development of hemorrhoids, which can also cause discomfort and a feeling of fullness in the anal area.

Regarding your concerns about smoking, drinking alcohol, and consuming spicy or fatty foods during your recovery, these factors can indeed impact healing. Smoking can impair blood flow and delay tissue repair, while alcohol and certain foods can irritate the gastrointestinal tract, potentially leading to more straining during bowel movements.

Recommendations:
1. Follow-Up with Your Surgeon: It is crucial to have a follow-up appointment with your surgeon or healthcare provider. They can perform a physical examination to assess the hardness and determine if any further intervention is necessary.

2. Maintain Good Hygiene: Continue with sitz baths and proper wound care as you have been doing. This can help soothe the area and promote healing.

3. Dietary Adjustments: Focus on a high-fiber diet to prevent constipation and reduce straining during bowel movements. Staying hydrated is also essential.

4. Avoid Irritants: If possible, avoid smoking and limit alcohol consumption, as these can hinder your recovery.

5. Pain Management: Over-the-counter pain relievers may help alleviate discomfort, but consult with your healthcare provider before taking any medications.

6. Monitor Symptoms: Keep an eye on any changes in symptoms, such as increased pain, changes in bowel habits, or any new symptoms that arise.

In conclusion, while the hardness you are experiencing may be a normal part of the healing process, it is essential to consult with your healthcare provider to rule out any complications. They can provide tailored advice and treatment options based on your specific situation. Your proactive approach to your recovery is commendable, and addressing these concerns with a professional will help ensure a smoother healing process.

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