An abscess is a pocket of infection creating pus. It is very painful. Many abscesses can occur when a gland / pore becomes clogged. The gland cannot drain and becomes plugged with sweat/mucus/oil build up. Infection can set in. The body forms a response & pus can form. Most abscesses get better when the pus can drain out. If it cannot drain, the infection can grow, spreading into deeper tissues to cause a deep abscess, a fistula tunnel, fasciitis/gangrene that kills deep tissues and can even threaten life.
Antibiotics are helpful in treating the infection & prevent new abscesses from forming elsewhere. Antibiotics are often not enough to cure an abscess. If an abscess is larger than a grape, it will not heal with antibiotics alone & requires drainage of the pus to allow the infection to drain.
Abscesses can form near the anus, often just inside where an anal crypt gland gets plugged & and abscess can form. Patents with certain health conditions (smoking, diabetes, inflammatory bowel disease, immunosuppressed on steroids of chemotherapy) are more likely to get more severe infections & worsening abscesses. These can be extremely painful given their sensitive location that the abscess can form.
The board certified surgeons at Central Carolina Surgery specialize in diagnosing and treating perirectal abscess in Greensboro, NC. Learn about perirectal abscesses, the types of surgeries available, and call Central Carolina Surgery today at (336) 387-8100.
How an Anal Fistula Forms
When anal glands become clogged, they can lead to infections within the tissues that exist around the anal cavity. Bacteria will continue to collect in the gland until it becomes a larger mass of infected tissue that is known as an anal abscess. If these infections are not treated properly, more and more pressure will build to the point that the body will form an anal fistula in order to expel the infection from the anal gland.
Although a large majority of anal fistulas are the result of anal abscesses, other potential causes can include:
- Sexually transmitted diseases (STDs)
- Crohn’s disease
- Trauma to the area
- Radiation exposure (usually from treatments for cancer)
Symptoms of an Anal Fistula
Many individuals who are diagnosed with an anal fistula will report significant swelling and redness near the anus in addition to moderate to severe amounts of pain. It is also common for patients to notice bleeding, pain during urination or defecation, and foul-smelling discharge from a hole located near the anus.
It is advised for persons to seek medical care right away if they experience any of the symptoms mentioned above. If a fever is also present, it may be a sign that the infection has worsened considerably, which necessitates more urgent treatment. Ideally, patients will be able to have their anal fistula diagnosed early on to avoid more serious complications and a difficult recovery.
Types of Anal Fistulas
Anal fistulas are classified based on the where they form in relation to the anal sphincter complex. These various categories include:
- Suprasphincteric fistula
- Superficial fistula
- Transsphincteric fistula
- Intersphincteric fistula
- Extrasphincteric fistula
Diagnostic Testing & Evaluation
Once a patient contacts Central Carolina Surgery to discuss their abnormal anorectal symptoms with a specialist, a physical examination is typically given to determine if the fistula is in fact visible on the superficial skin around the anus.
While many cases of an anal fistula will be identifiable to the naked eye, there are many instances in which further testing is required to accurately determine the patient’s condition. Such tests may also be performed to help establish the particular cause of the individual’s anal fistula formation. For example, an individual may be unaware that they suffer from Crohn’s disease until unwanted side effects such as an anal fistula occur.
For additional diagnostic testing, your physician may order one or more of the following tests:
- Ultrasound imaging
- CT scan
- Blood paneling
Treatment for Anal Fistulas in Greensboro, NC
Surgery is often required to effectively treat an anal fistula. This procedure is typically performed by a colon and rectal specialist who has many years of experience in treating conditions that are specific to this region of the body. It is important for patients to seek care from an experienced colorectal surgeon because inefficiency during surgery could easily result in permanent damage to the anal sphincter muscles, which can lead to problems of urinary incontinence.
If the anal fistula is deemed to be mild, it can often be treated with a fistulotomy. This procedure involves cutting the thin tissue over the tunnel of the fistula. By opening the tunnel, the infection is able to be cleared away from inside the tissues and then proceed to heal naturally over the course of several weeks.
In the case of a severe anal fistula, more complex surgical methods will be needed. Before any procedure is performed, it is best to first drain the fistula using a specialized device called a seton. The seton remains in place for approximately six weeks until the patient is determined to be ready for an operation to repair their anal fistula. Your physician may recommend the following methods once it is time for surgery:
- A fistulotomy
- An advancement flap procedure
- A lift procedure
To learn more details about these procedures and which one may be best to resolve your individual case, please contact Central Carolina Surgery at (336) 387-8100 today to schedule an appointment!