ANAL ABSCESS / FISTUALA

What is an anal abscess?
An anal abscess is an infected cavity filled with pus found near the anus or rectum. A patient who feels ill and complains of chills, fever, and pain in the rectum or anus could be suffering from an anal abscess.

What is an anal fistula?
An anal fistula, almost always the result of a previous abscess, is a small tunnel connecting the anal gland(sweat gland) from which the abscess arose to the skin of the buttocks outside the anus.

What causes an abscess?
An abscess results from an acute infection of a sweat gland which opens into the anal canal, when bacteria or foreign matter enters the tissue through the gland.

What causes a fistula?
After an abscess has been drained, a tunnel may persist connecting the inner opening of the gland from which the abscess arose to the skin. If this occurs, persistent drainage of pus from the outside opening may indicate the persistence of this tunnel. If the outside opening of the tunnel heals, recurrent abscess may develop.

What are the symptoms of an abscess ?
Painful Swelling around the anus, associated with fever and chills . A typical symptom of an abscess is difficulty to sit because of pain. Fistulas tunnel -a probe passed through the tunnel.

Does an abscess always become a fistula?
No. A fistula develops in about 50 percent of all abscess cases, and there is really no way to predict if this will occur. All patients whose abscess got drained either by a surgeon or on its own, should remember that there is a possibility of developing a fistula

How is an abscess treated?
An abscess is treated by draining the pus from the infected cavity, making an opening in the skin near the anus to relieve the pressure. Often, this can be done as an out patient procedure using a local anesthetic. A large or deep abscess may require hospitalization and use of a general anesthetic. Hospitalization may also be necessary for patients prone to more serious infections, such as diabetics or people with decreased immunity.

What are the symptoms of a fistula?
Persistent or recurrent oozing of pus or watery like liquid from a wound around the anus. It may be associated with itching. Some may notice passing gas and faecal matter through the wound. Generally pain is not a significant feature, unless the wound closes and develops into an abscess or tunnel gets severely infected.

What about treatment for a fistula?
Non operative - procedure include
1.plugging the tunnel with a special material
2. Passing a seton(thread) and tying it so that it serially cuts tunnel

Operative procedure- Fistula surgery usually involves laying open the tunnel by cutting open from outer opening till the inner opening, converting the tunnel into a wide groove. Such a groove heals from within outwards, there by eliminating the tunnel. This procedure requires hospitalization for a day

How long does it take before patients feel better?
Discomfort after fistula surgery can be mild to moderate for the first week and can be controlled with pain pills. The amount of time lost from work or school is usually minimal.