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15 Nov 2016

Ano-Rectal Abscess


An anal abscess is a painful pus filled cavity, which develops as result of an infection and forms near the anal ano-rectal portion. 90% of the absecesses arise due to acute infection of the anal glands in the cryptoglandular epithelium, lining the anal canal. These pus filled cavities can infect various parts of the anus and rectum. The internal anal sphincter acts as a barricade between the lumen of the gut and the peri-rectal space, protecting from infection. Sometimes, the bacteria from the faecal mass or from other foreign sources block the cryptoglandular epithelium that in turn leads to pus formation in the anal and rectal tissues, later affecting the anal sphincter too. Based on the depth, severity and location, anal abscesses are divided into four types, named after the anatomical part they form cavity in. Perianal abscess is the most common type, formed below the anal skin, mostly visible from outside in the form of a swollen boil causing pain. Deep tissue anal abscesses are rarer and cannot be seen from outside. The extent of infection differs in every case and if the infection spreads deeper into the peri-rectal spaces, the chances are high that the abscess will result in the formation of a fistula.

Causes

There are a number of factors that increase the risk of developing an ano-rectal abscess like those indulging in anal sex, HIV positive patients, cancer patients undergoing chemotherapy, individuals using corticosteroid drugs, diabetics or people with colic ulcers or any other bowel conditions. Infants using diapers are also at a risk of developing an anal abscess, especially if they had fissures in the past. The common reasons for a person to develop anal abscesses can be attributed to infection of anal glands, anal fissures or if they are already suffering from infections that have been sexually transmitted to them. Those anal abscesses that are deep seated are mostly caused due to inflammatory bowel conditions like Crohn’s disease.

Symptoms

Perianal abscesses are quite painful, red and swollen with pus oozing out. The skin around the anal region is tender along with palpitation due to the infection with constant irritation, more so in the seated position. A person feels constipated with huge discomfort while emptying the bowels. For anal abscesses that are deeper, like the supraelevator abscess, the symptoms are even more: a person might develop fever and feel fatigued with chills and sweats besides being constipated.

Current Treatment

Anal abscesses need clinical intervention and do not heal on their own. A thorough rectal examination confirms the presence of an anal abscess, followed by advice of a course of treatment. Local anaesthesia would suffice to drain out the pus of a perianal abscess. Surgical procedure is required for larger and deeper abscesses like the intersphincteric and supralevator abscesses. Generally pain relief medicines are prescribed after the drainage procedure in order to reduce mild discomfort, which lasts for a few days. Diabetics who have had anal abscess treatment are given antibiotics to curtail infection due to lower immunity levels. The pus has to be drained out from the abscess cavity before it erupts, and allows the infection to spread into other anal and rectal parts, causing secondary infection or other deep tissue ano-rectal abscesses. In case an abscess recurs, immediate clinical intervention is needed. If an anal abscess is not treated properly or if it recurs in the same area, there is a chance that a fistula may be formed.

Koya Stopilesin Hyderabad, and now in Bangalore, is an exclusive clinic for the diagnosis and treatment of ano-rectal problems. The team of doctors and surgeons at the facility have extensive experience in treating ano-rectal conditions and are aided by experts who monitor the cases from UK and other countries. The techniques used for the treatment are latest, US-FDA approved, minimally invasive and designed specifically to suit a patient’s need, lifestyle and symptoms. Patients visiting the clinic are successfully treated for their ano-rectal problems, including anal abscesses, fissures anal fistulas.

Classification of Anal Abscesses: fascrs.org




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