A person who feels ill, has chills, fevers, and/or pain in the anal and rectal area could be suffering from an anal fistula or abscess.
WHAT IS AN ANAL ABSCESS?
An anal abscess is an infected-pus filled cavity near the anus or rectum.
WHAT IS AN ANAL FISTULA?
An anal fistula is usually the result of a previous abscess. The abscess forms a tunnel from the inside of the anus to the outside skin on the buttocks. That tunnel is a fistula.
WHAT CAUSES AN ANAL ABSCESS?
An abscess forms when a gland, on the inside of the anus, gets clogged with bacteria or feces. An infection forms causing the abscess. (see “a” in picture to the right)
WHAT CAUSES AN ANAL FISTULA?
When the anal abscess ruptures, or is drained, it may leave behind a tunnel from the inside of the anus to the outside buttock skin. Although the outside opening may close, the inside opening remains. When bacteria or feces enters the inside opening, the abscess may reform. Persistent anal abscess are usually formed by fistulas.
WHAT ARE THE SYMPTOMS OF AN ANAL ABSCESS OR FISTULA?
Pain, fevers, and swelling may be a sign of an anal abscess or fistulas. In addition, drainage of pus and skin irritation are also signs.
DOES AN ASBCESS ALWAYS LEAD TO A FISTULA?
No. About 33-50% of the time an abscess can lead to a fistula. Usually there is no way to predict it.
HOW IS AN ABSCESS TREATED?
The main treatment is to lance, or drain, the abscess. If small, this can be done in the office under local anesthesia. If large, hospitalization may be required and the assistance of an anesthesiologist may be helpful. Antibiotics are a poor alternative to draining an abscess because the antibiotics to not penetrate the fluid within the abscess.
HOW IS A FISTULA TREATED?
Surgery is needed to cure a fistula. The surgery is usually done as an outpatient under anesthesia. It is performed about 6 weeks after the drainage of the abscess to allow a decrease in the inflammation.
Due to the potential for complication, fistula surgery is preferably done by a colon and rectal surgeon. Complications include injury to sphincter muscles and fecal incontinence.
Surgical techniques include opening up the fistula tunnel or filling the tunnel with a specific substance that obliterates the tract.
HOW LONG IS THE RECOVERY?
The recovery is mild to moderate pain for the first week which can be controlled with pain pills. The time lost form work or school is minimal.
WHAT ARE THE CHANCES OF RECURRENCE?
If properly healed, the chance of recurrence is small. However, new abscesses or fistulas may form.
WHAT CAN I DO TO AVOID ABSCESSES OR FISTULAS?
Very little. The important issue is to seek a professional opinion when those symptoms arise.