Has the perianal abscess that was drained a month ago and is neither painful nor itchy healed?

Written by Yu Xu Chao
Colorectal Surgery
Updated on February 24, 2025
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This situation often shows good post-operative recovery. Whether this situation is completely resolved depends on whether anal fistulas develop later, as most perianal abscesses drained can easily form anal fistulas. This is because drainage of perianal abscesses merely removes pus and secretions as much as possible, but does not completely clear the internal opening of the abscess and infected tissues. Thus, anal fistulas are likely to form later, and the patient needs to continue monitoring. Moreover, it’s important to maintain a light diet, avoiding spicy, irritating, and dry-hot foods as much as possible while also keeping bowel movements smooth. Frequent constipation or diarrhea should be avoided as they can cause wound pain or lead to inflammation and infection of the anal glands, potentially causing recurrence of the perianal abscess or the formation of anal fistulas later. However, the current situation indicates a relatively good post-operative recovery.

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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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How to operate on a perianal abscess

The surgical methods for perianal abscess vary depending on the location of the lesion. If it is a simple ischiorectal fossa subcutaneous abscess, a one-time incision and drainage surgery is generally used. The local wound is debrided and necrotic tissue is removed. After trimming the wound, it is important to maintain clear drainage of the local wound. Local application of gauze strips for compression and drainage treatment can be used. If the abscess is in the ischioanal fossa or the pelvirectal space, considering that the location of the lesion is deep, a one-time incision and seton drainage radical surgery may be required for the perianal abscess. Post-surgery, thorough disinfection and drainage of the local wound are also necessary.

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Written by Chen Tian Jing
Colorectal Surgery
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Can I eat eggs with a perianal abscess?

Patients with perianal abscess can eat eggs, but during the acute onset period of a perianal abscess, besides sticking to a light diet, it is more important to seek surgical treatment as soon as possible. A perianal abscess is an acute infectious disease near the anal sinuses. Typically, it presents with severe local pain in the anus. Once pus forms, it is encapsulated in the abscess cavity and needs to be surgically drained as soon as possible to remove the infection thoroughly. This helps to prevent further enlargement of the abscess cavity and worsening of the condition. Furthermore, in the early postoperative period, patients can consume liquid foods and eat eggs in moderation or other easily digestible foods. However, they should avoid spicy and irritating foods such as chili peppers and seafood.

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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 Chen Tian Jing
Colorectal Surgery
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How to drain pus when a perianal abscess bursts?

If an anal abscess ruptures, it then forms an anal fistula. Both the acute phase of an anal abscess and anal fistula require surgical treatment. If only the local pus is drained, it is generally recommended to open the abscess cavity for local debridement and disinfection, and to further excise the infection focus. During surgery, to protect the function of the local anal sphincter, a seton stitch procedure is also needed. Post-surgery, it is necessary to disinfect and change dressings for the local wound, and ensure normal growth of the granulation tissue to prevent the occurrence of false healing.