Therapy for an anal abscess
Smaller anal abscesses can be treated with ointments that are applied to the affected area and are designed to extract the contents. The ointments usually contain tar and have the property of attracting fluids. This is used in this case.
Larger anal abscesses can be punctured with a sterile needle or cannula. This causes the usually purulent contents to be emptied and the anal abscess to shrink. In many cases, the anal abscess will reappear in the same or adjacent area.
Stubborn anal abscesses and very large forms must be surgically removed in general surgery. In this case, the abscess cavity is cut out extensively under general anesthesia. In most cases the wound site is left open or only treated with a sterile wound dressing.
The patient is usually instructed to shower the area after each visit to the toilet to prevent the corresponding infections. The healing of wounds after abscess operations can be very long. The patient can often only sit properly after 4-6 weeks.
Often surgery is the only effective treatment for patients with anal abscesses. The decision whether surgery is necessary depends on various factors. Consequently, the size, location, accompanying symptoms and causative pathogens are particularly relevant.
Especially in the case of a large anal abscess, surgery is in most cases the only possibility to relieve the pain and remove the pus completely from the body. In case of an anal abscess, the surgical procedure is usually performed under general anesthesia or at least under regionally limited partial anesthesia. During the actual surgery, the attending physician cuts through the epidermis and the tissue underneath it layer by layer.
In this way the abscess cavity can be opened. Most of the purulent secretion usually drains off already during the opening. The remaining pus can then be drained off via a drainage.
The biggest advantage of anal abscess surgery is the fact that the causative bacterial pathogens do not infect the surrounding area and no emptying to the inside takes place. In this way, the risk of the bacteria entering the bloodstream and causing blood poisoning is minimised. After the successfully initiated drainage of secretion, the abscess cavity should be cleaned and the inflamed tissue removed during the operation.
If the anal abscess is particularly large, there is a possibility that purulent secretion will form again and another operation will have to be performed. After the operation, the wound is usually not sutured, but an open wound healing method is chosen. This measure prevents remaining fluid and bacterial pathogens from re-encapsulating.
Within the first few days after anal abscess surgery, the wound cavity must be cleaned and sanitised at regular intervals by the treating physician. In addition, the dressing must be changed at least once a day. Since in most cases an open wound healing method is chosen, a regular wound cleansing must be carried out even after the inpatient stay.
The affected patients should clean the open areas daily until the wound cavity is completely closed and also change the dressings themselves. In addition, sitz baths after the successful performance of an anal abscess operation can have a positive influence on the healing process and accelerate healing. Although the surgical opening of the abscess cavity is in many cases the only effective treatment method in the presence of an anal abscess, certain risks must be considered.
As the operations are usually performed under general anaesthesia, there are general risks. During general anesthesia, problems in the cardiovascular system may occur. In addition, important anatomical structures in the throat area can be injured during intubation.
Following anal abscess surgery, there is also the risk of a blood clot (thrombus) forming. This blood clot may come loose and block vessels in the area of the heart, lungs or brain. As a result, it can lead to a heart attack, pulmonary embolism or stroke.
In addition, a patient with anal abscess is at risk of wound healing disorders even after successful surgery. It may be necessary to place a drainage if the anal abscess cannot be completely removed during surgery or if surgery is not possible. A tube is inserted and placed in the abscess with the help of a guide wire.
A drainage is a plastic tube through which pus and accumulated secretion can drain to the outside. This prevents further inflammation of the abscess cavity. In the case of large anal abscesses, surgical treatment is usually preferred to conservative (non-surgical) therapy.
In this way, an inwardly directed bursting of the abscess and the release of bacterial pathogens into the bloodstream can be prevented. In addition, after surgical opening of the abscess cavity, a strip placed in an anti-inflammatory ointment can be inserted into the wound, thus improving the healing process. However, in patients who only have a small anal abscess, conservative treatment with the help of an ointment can be carried out for the time being.
Especially the application of ointment and/or cream, which has analgesic active substances, is very popular with most of the affected patients. In this context, however, it must be urgently noted that the temporary relief of the discomfort caused by the anal abscess is only due to the effectiveness of the analgesic ointment. If its effectiveness diminishes, the complaints also return with the same or even increasing intensity.
For this reason, the application of an analgesic ointment in the presence of an anal abscess should only be used to bridge the period until the next possible visit to the doctor. In the case of an immature anal abscess, surgical opening of the abscess cavity is often not advisable. In such cases, treatment of the anal abscess can be carried out by regular application of an antibiotic ointment.
Ideally, the antibiotic ointment is applied to the anal abscess three to four times a day for a period of five to seven days. Since an anal abscess is in most cases caused by the bacterium Staphylococcus aureus, the antibiotic ointment typically contains an active substance directed against this pathogen. When applying the ointment, however, it is essential to pay attention to hygiene.
The anal abscess should never be touched with the fingers, otherwise there is a risk of the causative bacterial pathogens spreading. Ideally, the affected patients use disposable gloves when applying the ointment and wash their hands thoroughly afterwards. In addition, a small anal abscess can be treated with the help of combination ointments.
These ointments contain both analgesic and anti-inflammatory agents. After applying the ointment superficially, the active ingredients are absorbed through the skin and thus reach the inside of the abscess cavity. After only a few applications, the discomfort caused by the anal abscess is noticeably relieved.
In this context, however, it should be noted that even this combined ointment is not an effective treatment method. In addition, there are various ointments and creams which are intended to stimulate the spontaneous opening of an anal abscess. In this way, the surgical opening of the anal abscess should be manageable in many cases.
The best known ointments contain active ingredients that thin the outer wall of the abscess cavity. The pressure inside the anal abscess then tends to cause a spontaneous opening that is directed outwards. However, this treatment method should be questioned critically, especially in patients with a large anal abscess.
Thinning of the outer wall of the abscess cavity reduces the probability of internal voiding, but does not completely eliminate it. In the worst case, the bacterial pathogens may still enter the bloodstream and cause blood poisoning (sepsis). Small anal abscesses do not have to be surgically removed, but can be treated with a pulling ointment.
Inflammatory ointments have an antibacterial and anti-inflammatory effect. The application of the pulling ointment additionally promotes the blood circulation, so that the melting of the pus is accelerated by the body’s own immune system. As a result, the abscess breaks open to the outside and the accumulated pus can be emptied through the skin.
In most cases an abscess is removed surgically. To completely combat the bacteria, antibiotic therapy is then given for several days. The administration of antibiotics is important because otherwise there is a risk that the inflammation will spread and lead to life-threatening blood poisoning (sepsis).
Since an abscess is an encapsulated pus cavity with poor blood supply, it is difficult for drugs to reach the inflamed tissue. Therefore, the administration of antibiotics alone is not sufficient to treat the anal abscess effectively. In most cases, anal abscesses must be surgically removed.
If an abscess or anal fistula is suspected, a doctor should always be consulted to discuss the further procedure with him. The patient can also observe some important points and use home remedies to speed up the healing process. Most importantly, under no circumstances should the abscess be self-expressed, as this can lead to dangerous infections and in the worst case to blood poisoning.
Abscesses are caused by bacteria and occur mainly in people with a weakened immune system. A strong immune system supports the body in fighting the inflammation. A balanced diet and plenty of exercise in the fresh air help to strengthen the body’s defences.
Sufficient sleep and little stress promote physical well-being and help the anal abscess to heal. An anal abscess causes severe pain, which is exacerbated by hard bowel movements. A lot of liquid (drink enough) and a low-fibre diet help the stool to take on a soft consistency.
Regular physical exercise also stimulates bowel activity and helps against hard stools. Other household remedies for anal abscesses are nettle tea and chamomile tea. Nettles have an anti-inflammatory effect and drinking three cups of freshly brewed nettle tea a day speeds up wound healing.
Compresses soaked with chamomile tea can be placed on the abscess and help to pull out the pus. Tea tree oil is a popular natural remedy, which consists of the essential oils of the tea tree. Tea tree oil can be used to treat an anal abscess.
A few drops of Tea Tree Oil are applied to a damp cloth or washcloth and placed on the affected area for several hours. The Tea Tree Oil helps to fight the infection and dissolve the pus. Tea Tree Oil should not be used on open wounds and does not help in the treatment of large abscesses.
In case of doubt, it is essential to consult a doctor, otherwise the infection may spread and complications may occur. How quickly an anal abscess heals depends on its size and location. In general, however, it takes a relatively long time until an anal abscess is completely healed.
The treatment method of first choice is surgical splitting of the abscess. This involves removing the skin over the inflammation and allowing the pus to drain away. This operation is usually a routine procedure that is performed without complications.
The removal of the inflamed tissue results in a relatively extensive wound up to several centimetres deep, which is not sutured but remains open. This prevents the formation of a new anal abscess. The wound must be cleaned conscientiously by the patient and the dressings must be changed regularly.
The operation is followed by a therapy with antibiotics to completely eliminate the bacteria that caused the abscess from the body. Usually operated anal abscesses heal completely. However, it can take a long time until the wound is completely closed and one has to reckon with several weeks until the healing is complete.
How well the wound generally heals depends on many factors, including age, nutritional status, previous illnesses and medication. Smoking worsens the blood circulation in the body, which has a negative effect on wound healing. Therefore, patients should refrain from nicotine after surgical removal of the abscess in order not to unnecessarily delay the healing of the wound.
The duration of an anal abscess varies from person to person and depends on various factors such as the location, size of the abscess and the form of treatment. Small abscesses can usually be treated conservatively, i.e. they do not need to be surgically removed, but can be treated with pulling ointment over several days. Larger anal abscesses, on the other hand, must be removed surgically.
This involves cutting out the entire abscess cavity and the surrounding tissue. The patient must remain in hospital for three to four days. In the case of simple abscesses, the removal can also be carried out on an outpatient basis.
Several weeks or even months can pass before the wound has completely healed. An anal abscess is an encapsulated accumulation of pus in a cavity caused by the inflammation near the anus. In many cases the chronic inflammation of an anal abscess results in the formation of an anal fistula. An anal fistula is a tubular connection between the abscess and the anal region through which the purulent secretion is drained to the outside.