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Perianal abscess
How long will it take for the perianal abscess anti-inflammatory medicine to work?
Once a perianal abscess is discovered in clinical practice, it's recommended to undergo surgical treatment as soon as possible, rather than using anti-inflammatory drugs for anti-infection treatment. This is because perianal abscesses are primarily caused by inflammation of the anal glands, leading to swelling and redness around the anus. Treating with only anti-inflammatory medications can temporarily control the condition, but the already infected tissues and the internal opening are not adequately treated. Improper diet or staying up late can lead to recurrence, or even lead to anal fistulas or necrotizing fasciitis. Therefore, for perianal abscesses, it is recommended to promptly undertake procedures such as incision and drainage of the perianal abscess, or a one-time radical surgery for perianal abscesses. However, for a minority of patients with perianal abscesses, such as subcutaneous perianal abscesses, if the area is relatively small, applying ichthammol ointment topically combined with oral administration of anti-inflammatory drugs or antibiotics can generally improve the condition within five to six days. (Please follow the doctor's advice regarding medications.)
Can an anal abscess be left untreated without surgery?
Surgical treatment is required during the acute phase of a perianal abscess. If surgery is not performed, it could lead to an expansion of the abscess cavity or worsening of the infection. Severe cases may lead to a local cellulitis around the anus, forming an inflammation of the cellular tissue. The surgical approach for a perianal abscess primarily involves incision and drainage, complemented by a one-time radical cure. The surgical principle mainly involves excising the infected local lesions altogether, thoroughly disinfecting and dressing the area, accelerating the shedding of the local infection, and ensuring normal growth of granulation tissue. Postoperative dressing changes are also crucial for the recovery from a perianal abscess.
Can you eat fish with a perianal abscess?
Patients with perianal abscesses should avoid eating seafood or consuming excessive amounts of seafood products. Because fish and seafood are considered to provoke symptoms in traditional beliefs, their overconsumption can lead to congestion and swelling of the local mucosa. Along with an acute infection of a perianal abscess, food may exacerbate the infection. Therefore, the diet of patients with a perianal abscess should primarily be bland. Additionally, once a perianal abscess is detected, it is necessary to perform an incision and drainage procedure for the abscess promptly, as well as a one-time debridement and radical surgery to prevent the further expansion of the abscess cavity or recurrent infection leading to the formation of anal fistulas.
Can a perianal abscess that is draining pus heal by itself?
Perianal abscesses cannot heal on their own after they spontaneously rupture and discharge pus, which can lead to the development of anal fistulas. This is mainly due to infection of the anal glands that initially causes swelling and lumps around the anus. Once these rupture and release pus, they can form channels that develop into anal fistulas, causing repeated perianal swelling, pain, and the discharge of pus and blood. In this case, it is advised to visit the proctology department of a hospital as soon as possible for a perianal MRI scan to determine the location of the infection and the direction of the fistula tract, followed by determining the surgical method. After the rupture and discharge of a perianal abscess, a definitive one-time surgical procedure is required to treat the abscess to prevent the potential development of a fistula or a complex, high fistula, which could cause significant damage to the patient and increase the complexity of later surgeries.
Precautions for Perianal Abscess
The precautions for perianal abscess mainly include those during an acute episode and post-surgical measures. If it is clearly an acute onset of a perianal abscess, it is important to seek treatment promptly. Treatment methods, besides incision and drainage, further include debridement to achieve a complete cure through surgery. Generally, simple incision and drainage only alleviate temporary pain symptoms. If not followed by definitive surgery, there is a high likelihood of developing anal fistulas, necessitating a second surgery. Post-surgical precautions for a perianal abscess primarily involve maintaining cleanliness of the local wound, changing dressings, and ensuring that the drainage from the wound remains unobstructed to prevent false healing.
Differences between minimally invasive surgery and traditional surgery for perianal abscess
In clinical practice, perianal abscesses are primarily due to infection and inflammation of the anal glands, which then leads to the formation of red and swollen masses around the anus, causing pain and swelling near the anus. If not treated surgically in a timely manner, it can lead to necrotizing fasciitis or anal fistulas. Minimally invasive surgery for perianal abscesses mainly aims to minimize damage to the anal sphincter during the procedure. Techniques such as loop drainage can be employed to preserve it, whereas traditional surgery generally involves larger incisions, but provides better drainage and has a lower recurrence rate post-operatively. However, leakage or moisture in the anal area can occur after traditional surgery. For minimally invasive surgery for perianal abscesses, there is a relatively higher recurrence rate since the drainage may not be as effective. However, the integrity of the anus post-surgery is better preserved and incidents of leakage are less frequent. The choice of surgical method should still be based on the severity of the perianal abscess.
Can a perianal abscess burst on its own after it forms pus?
After an anal abscess becomes purulent, one should not attempt to rupture it on their own. If purulence occurs, it is advised to perform local disinfection under a doctor's supervision, followed by incision and drainage or pus aspiration to prevent further infection. Attempting to rupture it on your own can easily lead to further aggravation of the local infection. After an anal abscess becomes purulent, the choice of incision location is crucial; once cut, it is necessary to maintain unobstructed drainage to avoid subsequent infection or even necrotizing fasciitis. In clinical practice regarding anal abscesses, it is advised to visit a colorectal surgery department at a hospital as soon as the abscess is detected, to undergo procedures such as incision and drainage or radical surgery of the anal abscess to avoid the later development of anal fistulas or necrotizing fasciitis. Post-surgery, medications such as red oil gauze strips, anal cleansing solutions, and aureomycin ointment are recommended for dressing changes.
How should a perianal abscess be treated effectively?
During the acute phase of a perianal abscess, there is generally severe pain in the anal area, accompanied by redness and throbbing of the skin, and there may be a pus cavity or pus encapsulation under the skin. The treatment of perianal abscess is mainly surgical. The surgical method is incision and drainage, combined with a one-time radical surgery. If the infection involves the local sphincter or has already formed a clear fistula, further incision and ligation surgery may be required. After surgery, it is necessary to thoroughly disinfect and change the dressings of the wound to prevent excessive granulation or the formation of false healing at the local wound. Postoperative diet should consist mainly of light, liquid foods, and spicy and irritating foods should be avoided.
What will happen if a perianal abscess is not treated?
Perianal abscesses are localized abscess formations that occur due to repeated infections in the anal crypts. Typically, under perianal ultrasonography, clear pus chambers and related structures can be observed. If perianal abscesses are not treated promptly, there is a high likelihood of expansion of the local pus chambers and dispersion of the pus, leading to an increase in the size of local anal abscesses, which might involve the sacrococcygeal area or the intersphincteric space. The primary treatment for perianal abscesses is surgical, mainly through incision and drainage to evacuate the pus, followed by thorough debridement of the local wound. Additionally, if there are changes in the local sphincter, thread-lifting therapy may also be performed.
Can a perianal abscess in children heal by itself?
Although they are all perianal abscesses, each child's condition is different. The size of the perianal abscesses varies; some are as small as a grain of rice and may heal on their own, but there are also larger ones the size of a walnut, or even cause the entire buttock area to become swollen and red. Such cases require hospitalization, especially for younger children who also exhibit systemic symptoms like fever. They generally require hospital treatment. Meanwhile, it is recommended that parents take good care of the baby's perianal area, maintain a healthy diet and bowel habits, avoid diarrhea and constipation, ensure cleanliness around the anal area, and use soft, non-irritating wet wipes when cleaning the area to avoid friction injuries that could lead to infections, as the skin of small infants is very delicate.