What is causing the stabbing pain in the wound half a year after perianal abscess surgery?

Written by Chen Tian Jing
Colorectal Surgery
Updated on March 27, 2025
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Six months after surgery for a perianal abscess, if there is local pain at the wound site, it is first necessary to rule out the presence of local infection and recurrence. To differentiate between infection and recurrence, it is necessary to conduct a digital rectal examination and a perianal ultrasound to confirm the diagnosis.

If infection and recurrence are ruled out, consider the possibility that the pain may be due to contraction and softening of the scar tissue at the site of the perianal abscess surgery, leading to painful stinging at the wound. Local application of anti-inflammatory ointments or gels can be used to treat the inflammation. If the pain or discomfort is severe, Chinese herbal washes or dilute salt water can be used for fumigation and hot compresses on the local scar.

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Written by Chen Tian Jing
Colorectal Surgery
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How to find the internal opening of a perianal abscess?

The internal opening of a perianal abscess is mainly identified through digital rectal examination and with the aid of a probe and perianal ultrasonography. Typically, during the onset of a perianal abscess, there is noticeable redness, swelling, heat, and pain around the anus. Inside the anal canal, digital rectal examination and anoscopy reveal swollen mucosa at the anal crypt, accompanied by the discharge of pus. Using a probe for exploration can clearly identify the presence of the internal opening locally. Once the internal opening of a perianal abscess is located, prompt surgical treatment is necessary. Surgery for perianal abscesses generally involves a one-time radical procedure complemented by incision and drainage. If an internal opening exists and involves the sphincter, further surgery involving incision, drainage, and seton placement may be required.

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Written by Chen Tian Jing
Colorectal Surgery
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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.

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Written by Chen Tian Jing
Colorectal Surgery
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Can you drink alcohol with a perianal abscess?

Patients with perianal abscess should not drink alcohol. Long-term or excessive alcohol consumption, due to the effects of evaporation or sublimation, can cause local congestion and edema at the anus, and may also increase the risk of infection. As perianal abscess is a local infectious disease of the anus, not only should alcohol be avoided during the acute phase, but prompt surgical treatment is also necessary. If a patient with a perianal abscess does not undergo timely surgical intervention, the pus cavity may expand and the abscess may further spread and rupture, potentially forming an anal fistula. Excessive drinking could lead to worsened local inflammatory symptoms, resulting in an increase in pus and possibly enhancing pain or infection, leading to a more extensive infection in the anal area. Therefore, patients with a perianal abscess should not consume alcohol.

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Written by Chen Tian Jing
Colorectal Surgery
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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.

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Written by Xiao Zhi Guo
Colorectal Surgery Department
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How to treat perianal abscess?

Perianal abscesses generally have two treatment options. Initially, if the abscess is not very large and the swelling and pain are not particularly severe, conservative treatment with antibiotics can be used temporarily. If conservative treatment is ineffective and the swelling worsens, surgical treatment may be necessary. In cases of severe abscesses, incision and drainage can be considered first, followed by antibiotic treatment. Surgical definitive treatment can then be performed 3-5 days later.