Post-Surgery Complications: Anal Abscess and Symptoms - Surgery

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Postoperative care for anal abscess?


Hello, doctor.
I underwent extensive drainage surgery for an anal abscess on August 13 of last year, which involved the entire left side of my buttocks.
I continued to have follow-up appointments until November 19, when the surgeon said everything was fine, and I did not return for further visits.
However, in March of this year, I suddenly experienced swelling and pain in my buttocks, along with a significant amount of discharge.
I initially thought I had developed a fistula, so I went back to see the original surgeon.
After the examination, I didn't clearly hear whether the doctor referred to it as a "red nodule" or something else, but the doctor stated it was not a fistula and that surgery was not necessary.
The doctor then scheduled a colonoscopy, which returned normal results, providing me with some relief.
However, on April 20, a pus-filled bump (about 1-2 cm) suddenly appeared above my anus.
It was not painful and soon ruptured on its own.
After that, I experienced similar small pus-filled bumps on May 1, May 5, and May 8, which would also rupture on their own after about 4-5 hours and were not painful.
On May 3, I returned to the surgeon for another examination, and the doctor still could not identify any abnormalities.
A CT scan was arranged to check for any hidden cysts in my buttocks.
Consequently, on May 10, I visited a dermatologist to see if it was a surface skin issue.
The dermatologist suggested that if it was not an internal problem, it could be blisters caused by friction from the wound.
The doctor prescribed an antibiotic ointment and advised that if small pus-filled bumps appeared again, I could apply the ointment to help them resolve on their own.
Interestingly, since May 10, I have not had any small pus-filled bumps.
On May 31, after reviewing the CT scan results, the doctor stated that there were no signs of a fistula or other abnormalities.
I mentioned to the doctor that I still had some discharge from my buttocks, though it was not much—about the amount of a small cotton swab each time.
I also told the doctor that sometimes after using the restroom, I felt some soreness on the right side of my buttocks, which had not undergone surgery, but it was not significant.
The doctor reassured me that it was fine as long as I did not have a fever or feel restless.
However, I would like to ask the doctor the following three questions:
1.
I still have discharge from my anus; is this something that can occur in the general population, or could there be specific reasons for anal discharge?
2.
Sometimes after using the restroom, I experience some soreness in my buttocks, which feels more pronounced when squatting.
Is this normal?
3.
If a colonoscopy shows everything is normal and I have been eating a light diet, what could be the reasons for still experiencing diarrhea?
Thank you very much for taking the time to read my lengthy message, and I appreciate your help with my questions.

Xiao Bo, 20~29 year old female. Ask Date: 2021/06/06

Dr. Ke Fangxu reply Surgery


1.
Is the discharge coming from the anus, an abscess, or the original surgical site? Each of these locations represents different implications, such as a skin infection or a possible anal fistula.

2.
Has this been the case all along? Did it start after the surgery, or is it related to the discharge? These factors will influence clinical judgment; if there is no redness, swelling, heat, or pain, it may be reasonable to continue observation.

3.
This condition is often associated with irritable bowel syndrome (IBS).
If the symptoms significantly impact daily life, a gastroenterologist can prescribe medication for management.

Reply Date: 2021/06/06

More Info


Post-surgery complications, particularly following anal abscess drainage, can be complex and multifaceted. Your experience highlights several important aspects of recovery and potential ongoing issues that can arise after such a procedure. Let's address your questions one by one, while also providing a broader context regarding anal abscesses and their management.

1. Ongoing Anal Discharge: It's not uncommon for patients to experience some degree of discharge after an anal abscess drainage. This can be due to residual inflammation or healing tissue. In general, a small amount of discharge can be normal, especially if it is not accompanied by other symptoms such as fever, increased pain, or a foul odor. However, if the discharge persists or changes in character (e.g., becomes more profuse, changes color, or has an unpleasant smell), it may warrant further evaluation. The presence of discharge can also indicate that the area is still healing or that there may be a small fistula (an abnormal connection between the anal canal and the skin) that has not yet formed a full-blown abscess.

2. Post-Defecation Discomfort: Experiencing some discomfort or soreness after bowel movements can be a normal part of the healing process, especially after surgery in the anal region. The tissues may still be sensitive or inflamed, leading to discomfort when they are stretched during a bowel movement. If the pain is mild and transient, it may not be a cause for concern. However, if the pain becomes severe or is accompanied by other symptoms (such as bleeding or significant changes in bowel habits), it would be advisable to consult your physician for further assessment.

3. Persistent Diarrhea: Diarrhea can have many causes, and if your colonoscopy results were normal, it may be related to several factors. Post-surgical changes, dietary factors, or even stress can contribute to gastrointestinal symptoms. If you have recently changed your diet to a lighter one, your body may still be adjusting. Additionally, certain medications, including antibiotics, can disrupt the normal flora of the gut, leading to diarrhea. If the diarrhea persists, it would be wise to discuss this with your healthcare provider, as they may want to investigate further for conditions such as irritable bowel syndrome (IBS) or other gastrointestinal disorders.

In summary, while some ongoing symptoms can be normal after anal abscess drainage, it is crucial to remain vigilant for any changes that could indicate complications. Regular follow-ups with your healthcare provider are essential to monitor your recovery and address any new or worsening symptoms. If you experience significant changes in your symptoms, such as increased pain, fever, or changes in discharge, do not hesitate to seek medical attention. Your health and comfort are paramount, and open communication with your healthcare team is key to a successful recovery.

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