Anorectal Abscesses Caused by Constipation-OUCH!

Anorectal Abscesses Caused by Constipation-OUCH!

The Lumps and Bumps of Anorectal Abscesses Caused by Constipation

 

anorectal abscess of the worst scenerio

There is something called an anorectal abscess located at your rectal -anal region that is a collection of pus.  It can be caused by several different issues (infections) such as the infection from a sexually transmitted disease of the rectum or maybe a blocked anal gland, or possibly that of an anal fissure along with blocked anal glands.

The anatomical sights/types below have been identified for sure:

  • Perianal abscess – it is most common (60%)
  • Ischiorectal abscess – which is next in line as most common at (20%)
  • Intersphincteric abscess – (5%)
  • Supralevator abscess – (4%)
  • Postanal abscess – relevancy was so small that no percentage was even given

Some of the identified risk factors for anal abscesses may surprise you:

  • Crohn’s disease and other inflammatory bowel diseases
  • Ulcerative colitis
  • Colitis
  • Diabetes
  • Diverticulitis
  • If you are the receptive partner for anal sex
  • Pelvic inflammatory disease
  • If you use prednisone or other medications like it

Adults, if you will use condoms during anal sexual intercourse, it could be a huge help in preventing anal abscesses.

With toddlers and infants, make sure to frequently change diapers and clean properly every time at diaper changes as this will be a huge step in preventing perianal abscesses and anal fistulas.

Those who fit into what is considered the high-risk groups such as those with diabetes, people who engage in anal sex, patients who have inflammatory bowel disease, and immunocompromised patients.

There are some that have deep rectal abscesses that can be caused by some intestinal issues like diverticulitis or Crohn’s disease.

The same studies also suggest that most patients fall into the ages groups of 20-60 years old with a mean age of 40.  With men more than twice as likely as women to have the illness.

Symptoms Encountered with These Abscesses:

  • Usually, you will have a constant, throbbing pain in your anal area. It will probably be the first thing that you will notice and believe me it will bring you to attention.  There is pain and swelling in your anal area, and the pain is so much worse when you have a bowel movement.  You might be pretty sure you are going to die or that your insides are going to all come out into the toilet.
  • You will most likely be constipated
  • There will be tenderness and swelling all around your anus. It will hurt!
  • There is almost always bleeding and a discharge of pus.
  • You will be worn out as the fatigue is overwhelming.

You will wonder what in the world is going on with your rectum and you will be able to feel a lump or even a nodule there.  If you can see it, your rectum will be swollen, angry looking, red, and very tender at the rim of your anus.  You will more than likely develop chills and fever that will result from an infection from this little darling you have hatched.

You will probably develop urinary tract symptoms like difficulty urinating and even rectal bleeding.

You will have almost constant perianal pain that nothing seems to relieve and if it does it will not help for long, it is a throbbing pain and much worse when you sit down.

A rectal examination if you can stand it might confirm if you have an anorectal abscess.

A superficial type perianal abscess can also occur in toddlers and infants.  Infants usually have no other symptoms but mild discomfort.

  • Perianal abscesses that are superficial may occur in toddlers and infants. The abscess could appear as a tender lump, that is red and swollen around the edge or rim of the anus. The baby may have no other symptoms but discomfort.

TO DIAGNOSE

As said before, if you can stand it, the digital rectal exam is all it usually takes to diagnose if it is a fistula or an abscess.

To diagnose will all depend on how your case presents itself but it might also be necessary to screen for a sexually transmitted disease or possibly for some inflammatory bowel condition, lower gastrointestinal malignancy, or diverticular disease.

Sometimes a proctosigmoidoscopy will need to be carried out to exclude some diseases.

MRI scan might be required.

And there is a transperineal ultrasound that can be used as well.

Associated diseases

  • You will find that in almost 40% of the cases, patients that have anorectal abscesses will develop a fistula. For some reason, people who do develop anorectal fistulae may also have inflammatory bowel disease, diverticular disease, tuberculosis, malignancy, or actinomycosis.
  • There was one study that has identified that 68% of abscesses that kept reoccurring were associated with a fistula being present.
  • Fistulae can be classified as trans-sphincteric (29.16%), extrasphincteric (12.5%), suprasphincteric (8.33%), intersphincteric (25%) per one study.

How To Manage AnoRectal Abscesses

  • Usually, the most effective way is quick surgical drainage.
  • Pain relief through
  • No antibiotics should be necessary unless the patient has diabetes or they are immunosuppressed.
  • In a review done by Cochrane, it found that with fistula surgery by doing abscess drainage it significantly reduced the persistence or the recurrence of the fistula/abscess, nor did surgery need to be repeated.
  • If it is a low fistula: open it with a fistulectomy or a fistulotomy.
  • If it is a high fistula: it could require a defunctioning proximal colostomy, but there is also a risk of fecal incontinence post op.
  • Sometimes an advancement flap (where a section of mucosa is removed from the lining of the anus) may be what is used to close the defect once the fistula is corrected. There has also been a biosynthetic anal fistula plug made by NIH and the Care Excellence group that recommend its use only as a part of a clinical trial because there has not been enough supporting evidence of efficacy at this point.

Complications That Can Occur

  • Recurrence
  • A fissure in ano that can occur in as many as 30% of patients
  • Infection Systemically
  • Scarring
  • PROGNOSIS
  • Outcomes are usually good if the perianal abscess is addressed
  • In one study it was discovered that there were 31% of those who did have the incision and drainage went on to develop a fistula. Patients without diabetes and under the age of 40 seemed to be highest at risk.  Antibiotics given during surgery appeared to reduce the rate of fistula formation.
  • Fistulas in children seemed to spontaneously resolve so surgical treatment should be withheld to see if this would happen.

PREVENTION

Myself, I am a person who believes in heading things off at the pass if it is possible.  So, I try to prevent something before it happens.  In this case, using an excellent natural Colon Cleanse or a Super Colon Cleanse could only make good sense in several ways.

You would be keeping all your intestines cleaned out, not taking the chance of your anal glands becoming stopped up and lessening your chance of developing an anal abscess.  It is just not worth it if you can take a natural pill and keep you going regularly, keep some weight off and feel better to boot.

 

 

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