Perianal abscesses can cause several painful symptoms for patients, but the good news is that they’re easily treated. For most patients initial treatment is successful - they can move on with their lives and be symptom free! For some, however, the abscess will continue returning. If you have a perianal abscess that keeps coming back, it’s usually a sign that there’s more going on that meets the eye.
What Is A Perianal Abscess?
A perianal abscess is a raised bump around the rectum or anus. Many people confuse these bumps with hemorrhoids, but the difference between a perianal abscess and a hemorrhoid is that the perianal abscess contains fluid (pus) and needs to be drained.
If your perianal abscess keeps returning even after treatment, it could be an indicator that you’re dealing with a complication called an anal fistula. An anal fistula is a tunnel that forms under the skin connecting the infected glands to the abscess. These glands can become infected even without a perianal abscess. Sometimes bacteria, fecal matter, or other foreign substances clog the gland and create an infection, resulting in an anal fistula.
What are Some Anal Fistula Symptoms?
So how do you know if you have an anal fistula? Common symptoms of an anal fistula include pain, swelling, and redness in the area surrounding the anus. In more severe cases, the patient may also feel lethargic, fever, and chills. The abscess or surrounding area may have discharge as well.
Your doctor may use an ultrasound, CT scan, or MRI to diagnose an anal fistula.
How To Prevent Perianal Abscesses From Returning: Anal Fistula Surgery
A recurring perianal abscess is often an indicator of an anal fistula, so out first recommendation is to treat the anal fistula through surgical drainage of the fluid. Although that can sound scary, this is actually a routine surgery that’s very minimally-invasive! Patients typically require the use of a local anesthetic, and the surgery can be performed in an outpatient setting.
During the procedure your colorectal surgeon will make a small incision near the anus, draining the fistula. Antibiotics are prescribed post-surgery to help fight the infection after drainage. Some patients may require additional surgeries to treat and completely eliminate the infection.
In very severe cases, your doctor may recommend another type of surgery called a fistulotomy. Another way a doctor prevents anal fistulas and perianal abscesses from returning is by inserting material into the fistula tract to obstruct it or surgically close it.
After any of these surgeries, your doctor may prescribe pain medication and the use of sitz baths to avoid constipation.
Although there is no guarantee that either the anal fistula or perianal abscess won’t return, these treatments are quite effective in preventing a reoccurrence. Talk to your colorectal doctor if you have questions!