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Anal Abscess and Fistula

What is an anal abscess?

An anal abscess is a cavity filled with pus near the anus or rectum. Normal anatomy involves anal glands inside the anus. Occasionally one of these glands can become clogged leading to growth of bacteria, which leads to infection and abscess.

What is an anal fistula?

An anal fistula or fistula-in-ano is an abnormal connection between the anus and skin surrounding the anus. The most common reason for a fistula is clogging of the anal glands of the anus, which results in infection, abscess, and/or fistula.   Other causes include Crohn’s disease, radiation, trauma or cancer. Colorectal surgeons are trained to diagnose and treat anal fistulas while avoiding significant injury to the sphincter muscles.

What causes an anal abscess or fistula?

Normal glands inside the anus can sometimes become clogged leading to overgrowth of bacteria. This leads to an infection and abscess cavity. When the abscess is drained (either on its own or after surgical drainage by a surgeon) the tunnel or fistula may persist between the anus and the skin. A fistula can develop 50% of the time after someone has a perianal abscess.

What are the symptoms of an abscess or fistula?

The most common symptoms of an abscess are pain, swelling, or redness around the anus. Sometimes, an anal abscess can present with fevers or chills, fatigue and malaise. A fistula may present with similar symptoms. If a fistula is present, there may also be continued drainage and leakage from the external opening in the skin.

 What is the treatment of an anal abscess?

Most of the time an anal abscess must be drained surgically. This can be performed by Dr. Zaghiyan in the office with local anesthetic or in the operating room under sedation depending on the size and severity of the infection. Antibiotics are typically a poor alternative to surgical drainage and may be harmful. In patients with a weak immune system due to various conditions, antibiotics may be a necessary adjunct to surgical drainage. A thorough evaluation and exam by Dr. Zaghiyan will allow her to determine if antibiotics are necessary.

What is the treatment of an anal fistula?

Anal fistula typically requires surgery. It is not uncommon to need 2 or more surgical procedures to repair a fistula. Occasionally a temporary drain called a seton is required to allow the inflammation to resolve before the fistula can be repaired. The choice of surgical repair depends on the type, location and cause of the fistula. Dr. Zaghiyan will discuss with you all of the treatment options for your specific condition after a thorough evaluation and examination in her office in Los Angeles.

What to expect after anal abscess or fistula surgery?

You will be provided pain medicine to control your pain. In addition Dr. Zaghiyan recommends a high fiber diet, stool softeners and laxatives to prevent constipation. Warm baths 3 times a day will soothe the area and promote healing. Depending on the type of surgery you may need some time off from work to recover.


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