Anal Abscesses and Fistulas: A Patient's Guide

Anal abscess and fistula?

Hello Dr.
Ke,
I have been troubled by the issue of a fistula for a long time, and it has made me feel sad, depressed, and fearful.
After undergoing a health check-up at my company, which included a colonoscopy and taking two doses of laxatives, I began to experience intense pain and swelling in the lower right side of my buttocks after taking the laxatives the night before the procedure.
Following the check-up, the wound became even more severely swollen and painful.
I later visited Renai Hospital, where I was diagnosed with an anal abscess, and the doctor mentioned that there was a possibility of a fistula forming (though he did not specifically confirm it as a fistula), only stating that there was a lot of blood and pus inside.
I was required to stay in the hospital for treatment.
I spent nine nights in the hospital, during which the doctor administered IV fluids, anti-inflammatory medications, antibiotics, stool softeners, and anti-swelling medications.
I underwent two drainage procedures, where the pus was extracted with a syringe.
After nine days, I was discharged, but I still experienced some swelling and pain, although it was not as severe as on the first day.
The doctor continued to prescribe anti-inflammatory medications for me, but nearly two months later, I am still experiencing intermittent pain and slight swelling.
During my follow-up visits, the doctor did not provide specific instructions on how to manage the situation; I am currently just taking medication to control it.
He mentioned that we would decide on further treatment based on the condition.
Now, due to the medication, I occasionally experience diarrhea, which causes a stinging sensation at the wound site and leads to gradual swelling.

Dr.
Ke, what should I do? I feel helpless and do not know how to proceed.
Could you please provide me with some guidance? Thank you very much.

Y.Y.

Ken, 30~39 year old female. Ask Date: 2016/02/21

Dr. Ke Fangxu reply Surgery

There is a 50% chance that an anal abscess will heal completely, while the other half may develop into an anal fistula.
As for when you will know, a general observation period of two to three months is sufficient.
It is recommended that you focus on treating the anal abscess for now.
Remember to take warm sitz baths regularly and take your medication on time; the swelling and pain will gradually improve.
As for whether an anal fistula will occur, it may take some time to determine that.

Reply Date: 2016/02/21

More Info

Dear Y.Y.,
I understand that you are experiencing significant distress due to your anal abscess and the potential for a fistula. It’s completely normal to feel anxious and overwhelmed when dealing with such a painful and uncomfortable condition. Let’s break down your situation and explore some options for managing your symptoms and improving your overall well-being.

Understanding Anal Abscesses and Fistulas
An anal abscess is a painful condition that occurs when a collection of pus forms in the tissue around the anus. This can happen due to infection of the anal glands, which can become blocked. Symptoms typically include severe pain, swelling, and sometimes fever. If the abscess is not treated properly, it can lead to the formation of an anal fistula, which is an abnormal connection between the anal canal and the skin surrounding the anus. Fistulas can cause ongoing discomfort and may require surgical intervention.

Your Experience
From your description, it seems that your condition began after undergoing a colonoscopy, which can sometimes irritate the anal area, especially if there was any pre-existing inflammation or infection. The pain and swelling you experienced post-procedure are concerning, and it’s good that you sought medical attention. The treatment you received in the hospital, including antibiotics and drainage, was appropriate for managing the abscess.

However, it’s unfortunate that you are still experiencing pain and swelling two months later. This could indicate that the abscess has not fully healed or that a fistula may have developed. The intermittent diarrhea you mentioned could also be exacerbating your symptoms, as it may irritate the area further.

Recommendations
1. Follow-Up with Your Doctor: It’s crucial to maintain open communication with your healthcare provider. If you haven’t already, consider asking for a referral to a colorectal surgeon, who specializes in conditions like yours. They can provide a more thorough evaluation and discuss potential surgical options if necessary.

2. Pain Management: Continue taking any prescribed pain medications as directed. Over-the-counter pain relievers, such as ibuprofen or acetaminophen, may also help manage discomfort. However, consult your doctor before starting any new medications.

3. Dietary Adjustments: Since you are experiencing diarrhea, focus on a bland diet that is easy on your digestive system. Foods like bananas, rice, applesauce, and toast (the BRAT diet) can help firm up stools. Staying hydrated is also essential, especially if you are experiencing diarrhea.

4. Wound Care: Keep the area clean and dry. Warm sitz baths can help soothe the area and promote healing. Avoid any irritants, such as harsh soaps or scented products, which could exacerbate your symptoms.

5. Monitor Symptoms: Keep track of any changes in your symptoms, including the frequency and severity of pain, swelling, and any new symptoms that arise. This information will be valuable for your healthcare provider.

6. Mental Health Support: It’s understandable to feel anxious or depressed about your condition. Consider speaking with a mental health professional or joining a support group for individuals with similar experiences. Sharing your feelings can be therapeutic and help you cope with the emotional aspects of your condition.

Conclusion
Your situation is understandably distressing, but with the right medical support and self-care strategies, you can work towards managing your symptoms effectively. Don’t hesitate to advocate for yourself and seek further evaluations if you feel your current treatment is not addressing your concerns adequately. Remember, you are not alone in this, and there are resources available to help you navigate through this challenging time.

Take care, and I wish you a smooth recovery.

Best regards,
Doctor Q&A Teams

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