Anal Abscesses and Fistulas: Symptoms and Treatment Options

Anal abscess or anal fistula?

Two weeks ago, after my menstrual period ended, I developed a lump near my anus that resembled a boil.
I suspect it might be an anal abscess.
A few days later, after applying medication, it healed within a day.
I have a history of constipation, so my anus may have been injured before my period.

1.
Is it possible for the first occurrence of an anal abscess to develop into an anal fistula?
2.
After the anal abscess healed, I experienced a high fever for several days, accompanied by cold symptoms.
Could this indicate an anal fistula?
3.
However, I do not have any pain in my anus.
Could this still be an anal fistula?
4.
If it is an anal fistula, would surgery be necessary?

Jessica, 10~19 year old female. Ask Date: 2022/01/04

Dr. Zhang Shuhao reply Surgery

There is approximately a 40% chance that an anal abscess may develop into an anal fistula.
Deeper anal abscesses may sometimes present with subtle surface symptoms, but they can still cause fever.
To confirm the diagnosis, an examination in an outpatient setting is necessary.
If an anal fistula is confirmed, early surgical intervention is recommended to prevent recurrent inflammation and to reduce the complexity of the fistula.
General colorectal surgeons are typically equipped to handle these issues.
Wishing you a speedy recovery.

Reply Date: 2022/01/04

More Info

Understanding anal abscesses and fistulas is crucial for anyone experiencing symptoms related to these conditions. An anal abscess is a painful condition that occurs when a collection of pus forms near the anus, often due to an infection. It can arise from various causes, including blocked anal glands, trauma, or inflammatory bowel disease. On the other hand, an anal fistula is a small tunnel that forms between the end of the bowel and the skin near the anus, often resulting from an untreated anal abscess.

1. Can an anal abscess evolve into an anal fistula?
Yes, an anal abscess can potentially develop into an anal fistula if the abscess is not adequately treated. When an abscess forms, it can create a channel that connects the anal gland to the skin surface. If this channel remains open after the abscess has drained, it can lead to the formation of a fistula. It is essential to monitor any symptoms following an abscess, as the development of a fistula may require further medical intervention.

2. Could the fever and cold symptoms indicate a fistula?
While fever and cold symptoms can occur after an anal abscess, they are not definitive indicators of an anal fistula. A fever may suggest that there is still an infection present, either in the area of the abscess or elsewhere in the body. If the abscess has resolved but you are experiencing systemic symptoms like fever, it is crucial to consult a healthcare provider to rule out any complications or other infections.

3. Is it possible to have a fistula without anal pain?
Yes, it is possible to have an anal fistula without experiencing significant pain. Some individuals may have a fistula that does not cause discomfort, especially if it is not infected or inflamed. However, many people do report symptoms such as discharge, itching, or irritation around the anus. If you suspect you have a fistula, even in the absence of pain, it is advisable to seek medical evaluation.

4. Will surgery be necessary if a fistula is present?
The treatment for an anal fistula often involves surgical intervention, especially if it is symptomatic or causing complications. Surgery aims to close the fistula and prevent recurrence. The specific type of surgery will depend on the fistula's location, complexity, and any associated conditions. In some cases, a simple procedure may suffice, while more complex fistulas may require advanced surgical techniques.

In conclusion, if you suspect you have an anal abscess or fistula, it is essential to consult a healthcare professional for a thorough evaluation. They can provide a proper diagnosis and recommend appropriate treatment options. Early intervention can prevent complications and improve your overall health. Additionally, if you have ongoing issues such as constipation, addressing those can also help reduce the risk of future anal problems.

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