Definition Of Abscess Of The Anus
Abscess the anus is a disease that can cause pain in the area of the anus due to infection in the glands-small glands in the wall of the anus. Valves the anus internal (sphincter ani internus) is used to prevent infection of the cavity of the intestine to the tissues around the anus (perianal). However, if the infection of the intestines successfully penetrate these valves, the spread of the infection can reach the perianal tissue and cause an abscess of the anus.
Abscesses that occur often appear in the form of blisters contain pus and swelling in the area of the anus. If touched, this swelling may feel warm and reddish. But in an abscess that is located inside, sometimes not visible or palpable. Based on the location of abscess that occurs due to the spread of infection, abscess of the anus can be distinguished as follows:
- Abscess perianal (is a type of abscess the anus the most common case).
- Abscess ischiorectal namely in the cavity of the postanal.
- Abscess in the supralevator.
- Abscess in the cavity of the intersphincter.
The Symptoms Of Abscess Of The Anus
The symptoms of abscess of the anus which appears on the sufferers vary depending on the location of the abscess. If the abscess occurs in the perianal region, symptoms that appear are:
- Pain in the anus constantly, feels stabbing, and is worse when sitting.
- Skin irritation around the anus which is accompanied by redness, swelling, and hardening of the skin.
- Discharge of pus from the anus.
- Constipation and pain caused by the movement of the intestine.
On abscesses that occur in the area of the anus deeper, like an abscess supralevator, the symptoms of which can appear, among others:
In some cases abscess of the anus which is located in, sometimes even appear only the symptoms of the fever alone so it is quite difficult to diagnosis and requires the help of an MRI or CT scan.
The Causes Of Abscess Of The Anus
The causes of the appearance of an abscess of the anus on a person can vary. However, this condition can generally be caused by the following things:
- Infection in the fistula of the anus (a small gap that is formed on the skin in the anus).
- Sexually transmitted infections.
- A blockage on the gland of the anus.
A person can be more easily exposed to an abscess of the anus if:
- Suffering from inflammation of the diverticulum.
- Taking drugs anti-inflammatory, such as prednisone.
- Be the recipient of anal sex.
- Suffering from diabetes.
- Suffering from inflammation on the part of the pelvis.
- Suffering from inflammation of the gastrointestinal tract, such as in Crohn’s disease or ulcerative colitis.
The Diagnosis Of Abscess Of The Anus
Anal abscess, especially perianal abscesses that do not cause symptoms of a systemic, can be diagnosed through a search of the symptoms and examination of the condition of the anus. To help the diagnosis, the doctor will also conduct an examination of related conditions, for example:
- Diseases sexually transmitted infections.
- Inflammatory diseases of the gastrointestinal tract.
- Of diverticular disease.
- Cancer of the rectum.
In patients suspected of suffering from an abscess of the anus on the inside, as in an abscess superelevator, the diagnosis can be carried out with the scanning method. Between the other is ULTRASOUND, MRI and CT scan. There are also some cases of abscess of the anus which is relatively complex and gave rise to systemic symptoms. To help the diagnosis of abscess of the anus which is complex, can be carried out the inspection with the endoscope. The goal is to see the abscess and fistula, as well as determine the location, spread and size.
Complications Abscess Of The Anus
If not treated properly, abscess of the anus can cause complications as follows:
- Bacteremia (bacteria entering into the circulatory system of the blood) and sepsis, as well as the spread of infection from the anus to other body organs.
- Faecal incontinence.
- Abscess become malignant.
The Treatment Of Abscess Of The Anus
The presence of an abscess in the anus indicates that the infection is quite severe and requires treatment through surgery. However, during the preparation stage of the surgery, the patient’s abscess the anus can be given antibiotics. Surgery to treat an abscess the anus need to be done as soon as possible due to the delay of surgery can cause tissue damage chronic.
The method of surgery that can be done to treat the abscess of the anus, among others, as follows:
- Surgery perianal abscesses.Abscess need to be removed surgically before rupture and cause complications. Different with any surgery, surgery of abscesses of the anus does not require the emptying of the gastrointestinal tract. Before surgery, the patient will be given local anesthesia first. Surgery of the abscess is done by making an incision (incision) in the area of the abscess, followed by dispensing and drying the pus from the abscess. The incision made is usually enough with a small incision to reduce the risk of formation of fistula.The pus secreted from abscesses then analyzed to determine the types of bacteria that cause infection. After the surgery, the incision is closed with gauze antiseptic that contains iodine. After 24 hours, the patient is required to soak the part of her ass in water-containing medicines 3 times a day, and one time each after a bowel movement.
- Surgery abscess supralevator, ischiorectal, and intersphincter. The third principle of this surgery is almost the same with surgery in cases of perianal abscesses. Just, surgery abscess supralevator, ischiorectal , and intersphincter require a more complicated process because it is located in, and should be done in the operating room. To drain the pus from the abscess, and made an incision in the area of experiencing swelling of the most. Having made the incision, pus is expelled through the small pipe and aided by the emphasis on the part of the abscess so the pus can come out with maximum. For this surgery, the patient may be given local anesthesia or general anesthesia if necessary.
- Surgery and fistula treatment. Fistula is one of the complications that can appear due to an abscess. Operation of the fistula can be performed simultaneously with the operation of an abscess. However, sometimes the fistula emerging a few weeks to a few months after, surgery for a fistula be done separately with a surgical abscess.
Some of the complications that can occur after the surgery abscess and fistula, among others, are:
- An anal fissure.
- The reappearance of the abscess after the surgery.
- The scars on the incision area.
To help abscess treatment after surgery and reduce the risk of complications after surgery, the patient can be given several types of drugs, such as:
- Infection. The patient may be given antibiotics before and after surgery abscess. Antibiotics are given customized with the bacteria that cause abscesses have been diagnosed in advance by bacterial culture. Some types of antibiotics that can be given, among others, is ampicillin (either given alone or combined with sulbactam), imipenem and cilastatin, cefazolin, and clindamycin.
- Painkillers. Often before and after surgery abscess, the patient will experience pain and discomfort in the area of the abscess. Therefore it can be given the drug anelgesik to relieve the pain. Examples of pain reliever which is often given is
- Antiemetic. These drugs can help give the effect of synergistic when given together with meperidine. In addition, the antiemetic can eliminate the feeling of wanting to vomit that arises from side effects of treatment that appears. Examples of antiemetics that can be given is promethazine.
After surgery and treatment, patients are required to perform a control routine to the concerned doctor for 2-3 weeks. This consultation aims to monitor the healing of wounds surgically and control the possibility of the appearance of the fistula on the patient. Death due to an abscess and complications of surgery the abscess is quite rare. However, keep in mind that fistulas can be formed some time after the abscess pus issued. In addition, it can also appear complications due to surgery. Therefore, control after surgery is very important to do.