How long will it take for the perianal abscess anti-inflammatory medicine to work?

Written by Yu Xu Chao
Colorectal Surgery
Updated on December 02, 2024
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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.)

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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.

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Anal abscess tight skin tendon pain for a few days

If a perianal abscess undergoes a rubber band ligation surgery, the rubber band may fall off within a week to ten days. If the local rubber band is too loose or takes longer to fall off after surgery, the doctor can further tighten the local rubber band to promote its earlier detachment and ensure the function of the local sphincter around the anus. After tightening the rubber band, the local wound may experience significant pain and minor bleeding due to the pulling of the rubber band. The pain usually lasts about one to two days and will gradually subside as the local wound heals.

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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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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.

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How many days of antibiotic injections are needed to treat a perianal abscess?

During the acute phase of a perianal abscess, the main focus is on the nature of the local abscess. If it is a hard swelling without pus formation, anti-inflammatory injections or antibiotics can be used for symptomatic treatment. Generally, a five to seven-day course of antibiotic and anti-inflammatory treatment can reduce the local swelling, but it cannot guarantee a 100% chance of non-recurrence in the future. If a local pus cavity or swelling has already formed, and there is pus formation, simply using anti-inflammatory injections for symptomatic treatment will not be curative. Surgery is also required, mainly involving opening the local pus cavity, cleaning out the pus thoroughly, and removing local infection foci to promote normal growth of fresh granulation tissue, which could then lead to the healing of the local wound.