Anal Abscess: Symptoms, Treatment, and Recovery

Anal abscess

Hello, doctor.
This week, I developed a cyst the size of a ping pong ball near my anus.
It was so painful that I went to the emergency room on Friday night.
The inflammation markers were very high, and the cyst was large, so the emergency physician decided to perform an incision and drainage.
After that, a colorectal surgeon came to drain the pus, and after receiving antibiotics, I was sent home.
However, after returning home, I still have a fever, and the cyst has not reduced in size; I can still feel the cyst when I touch it.
I need to take anti-inflammatory and pain relief medication to manage the discomfort.
I would like to ask if this is normal, doctor?

Nina, 20~29 year old female. Ask Date: 2022/03/27

Dr. Zhang Shuhao reply Surgery

If an anal abscess causes a significantly elevated inflammatory index, it indicates a systemic infection.
If fever persists after returning home, it may suggest incomplete drainage or a severe infection, necessitating intravenous antibiotics.
It is advisable to return for a follow-up appointment as soon as symptoms persist, and hospitalization or a second drainage procedure may be required.

Reply Date: 2022/03/27

More Info

An anal abscess is a painful condition that occurs when a collection of pus forms near the anus, often due to an infection. The symptoms you are experiencing, including the presence of a large cyst-like swelling, fever, and persistent discomfort, are common indicators of an anal abscess.

Symptoms of Anal Abscess
The symptoms of an anal abscess can vary but typically include:
- Pain and tenderness: This is often the most prominent symptom, especially when sitting or during bowel movements.

- Swelling: The area around the anus may appear swollen and may feel warm to the touch.

- Fever: An elevated temperature can indicate an infection.

- Discharge: There may be pus or other discharge from the abscess if it has ruptured.

- Difficulty sitting: The pain can make it uncomfortable to sit or engage in normal activities.

Treatment of Anal Abscess
The standard treatment for an anal abscess involves:
1. Incision and Drainage: As you experienced, the abscess is often surgically drained to remove the pus. This is typically done under local anesthesia.

2. Antibiotics: After drainage, antibiotics are usually prescribed to help clear the infection. It's essential to complete the full course of antibiotics as directed by your healthcare provider.

3. Pain Management: Over-the-counter pain relievers or prescribed medications can help manage discomfort.

Recovery and Follow-Up
Recovery from an anal abscess can take time, and it is not uncommon for the swelling to persist for a while after drainage. Here are some points to consider regarding your recovery:
- Persistent Swelling: It is not unusual for the abscess site to remain swollen for several days or even weeks after drainage. The body needs time to heal, and the inflammation may take a while to subside.

- Fever: If you continue to have a fever after the procedure, it may indicate that the infection has not fully resolved or that there is a complication. It is crucial to monitor your temperature and report any persistent fever to your healthcare provider.

- Follow-Up Care: It is essential to have a follow-up appointment with your healthcare provider to assess the healing process. They may perform a physical examination to ensure that the abscess is healing properly and that there are no signs of complications, such as a fistula (an abnormal connection between the anal canal and the skin).

When to Seek Further Medical Attention
You should seek immediate medical attention if you experience:
- Increased pain: If the pain worsens significantly after the procedure.

- Persistent fever: A fever that does not improve with medication or lasts more than a few days.

- Redness or warmth: Increased redness or warmth around the incision site, which may indicate a spreading infection.

- Changes in bowel habits: Any new or worsening bowel symptoms, such as bleeding or severe constipation.

In conclusion, while some discomfort and swelling are expected after an anal abscess drainage, persistent fever and significant pain warrant further evaluation. It is essential to maintain communication with your healthcare provider and attend follow-up appointments to ensure a complete recovery.

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