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 8.
On June 14, I experienced sharp pain and bleeding during bowel movements, which I believe was due to an anal fissure.
After a week, it improved.
I have been diligently following the sitz bath routine and applying the ointment.
However, recently I have noticed a hard area less than one centimeter 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 between the wound and the anus.
The wound itself does not hurt or feel particularly sensitive, but the hard area is very uncomfortable.
It is located near the anal opening, and pressing on it causes pain, along with a sensation as if I need to have a bowel movement, which makes me anxious about possibly developing another issue.
During my recovery period, I have smoked, consumed alcohol, and eaten barbecued food.
Can you tell me what kind of problem this might be?

Li Jiaxiang, 10~19 year old female. Ask Date: 2020/06/25

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 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 for further evaluation.

Reply Date: 2020/06/25

More Info

Post-surgery discomfort, particularly after an anal abscess drainage procedure, can be concerning, especially when new symptoms arise. Based on your description, it seems that you are experiencing hardness near the site of your previous surgery, which is causing discomfort. Let’s break down the potential causes and considerations regarding your symptoms.

Possible Causes of Hardness Near the Surgery Site
1. Scar Tissue Formation: After any surgical procedure, including an abscess drainage, scar tissue can form as part of the healing process. This scar tissue can sometimes feel hard or firm to the touch and may cause discomfort, especially if it is near sensitive areas like the anal region.

2. Residual Infection or Abscess: Although you have undergone drainage, there is a possibility that some infection remains, or a new abscess could be forming. This could lead to localized swelling and hardness. If there is any discharge, increased pain, or fever, it would be essential to seek medical attention promptly.

3. Hemorrhoids or Anal Fissures: Given your history of pain during bowel movements and bleeding, it is possible that you may have developed hemorrhoids or anal fissures. These conditions can cause localized pain and discomfort, especially when pressure is applied.

4. Inflammation: Post-surgical inflammation can also lead to a feeling of hardness or swelling in the area. This is typically part of the normal healing process but should be monitored for any signs of worsening.

Recommendations for Management
1. Continued Care: It’s great to hear that you are taking steps to care for the area, such as sitz baths and applying ointments. Continue these practices, as they can help soothe the area and promote healing.

2. Avoid Irritants: Smoking and alcohol can impair healing and increase inflammation. It would be beneficial to avoid these substances during your recovery period.

3. Dietary Considerations: Ensure that your diet is rich in fiber to prevent constipation, which can exacerbate discomfort during bowel movements. Staying hydrated is also crucial.

4. Monitor Symptoms: Keep an eye on your symptoms. If the hardness increases, if you experience significant pain, or if you notice any discharge or fever, it’s important to contact your healthcare provider.

5. Follow-Up Appointment: If the discomfort persists or worsens, it would be wise to schedule a follow-up appointment with your surgeon or a gastroenterologist. They may perform a physical examination and possibly imaging studies to assess the area for any complications.

Conclusion
While some discomfort and changes in the area around the surgical site can be expected, it is essential to differentiate between normal healing and potential complications. The hardness you are feeling could be due to scar tissue, inflammation, or other factors, but it is crucial to monitor your symptoms closely. If you have any concerns or if your symptoms change, do not hesitate to reach out to your healthcare provider for further evaluation and guidance. Your health and comfort are paramount, and addressing these concerns early can help ensure a smoother recovery.

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