Perianal Abscess
Everything about the causes, symptoms, risk factors, and treatment of pus accumulation in the area between the anus and the genitals.
Symptoms and causes
A perianal abscess is the formation of a pus collection in the perineum, the area between the anus and the genitals. This accumulation results from a bacterial infection originating in the anal secretory glands, which produce mucous substances to facilitate lubrication during defecation.
The prognosis for a perianal abscess is usually good if detected early and properly treated with Surgical drainage. Nevertheless, there is a high risk of fistula formation, especially in patients with underlying diseases.
Symptoms
The most common symptoms of a perianal abscess are:
- Dull, continuous pain.
- Red, warm swelling.
- Fever.
- Chills.
- Presence of pus.
Causes
The most frequent cause of a perianal abscess is the obstruction of one of the glands responsible for producing lubricating fluid in the anal canal. This blockage occurs due to accumulation and subsequent infection by bacteria that make up the fecal microbiota and are usually harmless.
Occasionally, it may result from other conditions (tuberculosis, inflammatory bowel disease, cancerous tumors), trauma, or treatments with chemotherapy or radiotherapy.
Risk Factors
The risk of developing a perianal abscess increases in the following cases:
- Crohn’s disease or ulcerative colitis: The chronic intestinal inflammation caused by these diseases extends to anal tissue, facilitating glandular infection.
- Weakened immune system: The body’s defenses cannot effectively fight infections.
- Diabetes: When blood sugar levels are poorly controlled, the immune system may be compromised.
- Sexually transmitted infections: These often cause sores in the anal area, increasing infection risk.
- Anal sexual activity: Can cause small injuries that promote infections.
- Chronic constipation or persistent diarrhea: Damage or irritation of anal tissues makes them more vulnerable.
Complications
The most common complication of a perianal abscess is fistula formation, which is the creation of an abnormal tract connecting the anal canal with the perineal skin. These lesions do not heal spontaneously and require surgical intervention to repair.
Prevention
Perianal abscesses cannot be easily prevented, but the following measures can reduce the risk:
- Maintain a balanced diet and exercise regularly to strengthen the immune system.
- Prevent constipation with a fiber-rich diet and adequate hydration.
- Address episodes of diarrhea promptly.
- Keep diabetes under control.
- Use lubricants during anal sex.
Which doctor treats a perianal abscess?
Perianal abscesses are diagnosed and treated by specialists in General and digestive system surgery.
Diagnosis
Diagnosis of a perianal abscess is primarily clinical:
- Medical history: Patient history, lifestyle habits, and reported symptoms are reviewed.
- Physical examination: The perianal area is examined for swelling, redness, and pus accumulation.
To identify the causative bacteria and determine the most appropriate treatment, a culture of a sample from the affected tissue is performed.
Treatment
Treatment of perianal abscesses should be initiated as soon as possible to reduce the risk of complications. In addition to administering antibiotics to fight the infection, pus must be drained. Surgical intervention is the only effective approach in these cases. The procedure is as follows:
- Local or regional anesthesia is administered.
- The patient is positioned on their side or prone.
- An incision is made in the inflamed area.
- Surrounding tissue is pressed to ensure all pus is expelled; a probe may be used to drain completely if necessary.
- A sterile solution is applied to clean the now-empty cavity.
- The wound is left open (covered with a gauze) to continue draining and heal naturally, thus preventing reinfection.
