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WHAT IS A PERIANAL ABSCESS?
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When small glands which open on the inside of the anus become blocked,
the bacteria that live in these glands can multiply, causing an
infection. As pus builds up, surgical drainage is needed so that the
abscess will not rupture inward, which could spread bacteria into the
bloodstream.
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WHAT CAUSES A PERIANAL ABSCESS?
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As is the case in many medical conditions, the cause is not always
known. Contributing factors which may be related to the development of
a perianal abscess include diabetes, granulomatous diseases,
inflammatory bowel disease, immunodeficiency disorders, chronic
constipation, or a thrombosed external hemorrhoidal pile ("thrombosed"
means that bloodflow is obstructed). Sometimes the anatomical
structure of the anorectal area can make abscesses more likely;
perianal abscesses can result from fistulas (abnormal internal
passageways that form tunnel-like connections from one area to
another). Such fistulas can be present at birth, or may develop at a
later date for no apparent reason. It is not likely that your
automobile accident caused a perianal abscess to develop. I have not
heard of any connection between spinal whiplash injury and anorectal
abscesses.
"Perirectal and perianal abscesses are thought to develop from the
glands surrounding the anus. These glands may plug up, leading to
infection. When they fill with pus, they may burst inward, releasing
their infected contents into the spaces around the rectum and anus.
This release of pus causes an abscess, or pus collection, in the
spaces surrounding the rectum. The abscess may enlarge, causing pain,
fever, and difficulty with bowel movements.
Certain people are more likely to develop perirectal and perianal
abscesses, including those with the following medical problems:
Diabetes
AIDS or HIV infection with low white blood cell counts
Crohn's disease
Persons on medications that suppress the body's immune system, such as
steroids (prednisone, methylprednisolone), or those undergoing
chemotherapy for cancer."
eMedicine Consumer: Perirectal Abscesses
http://www.emedicine.com/aaem/topic346.htm
"In 60 percent of cases the pus from the abscess yields a pure culture
of Escherichia coli; in 23 per cent a pure culture of Staphylococcus
aureus is obtained. In diminishing frequency, pure cultures of
Bacteroides, a Streptococcus or Proteus strain are found. In many
cases the infection is mixed. In a high percentage of cases - some
estimate it as high as 90 per cent - the abscess commences as an
infection of an anal gland... Other causes are penetration of the
rectal wall, e.g. by a fish bone, a blood-borne infection or an
extension of a cutaneous boil. Underlying rectal disease, such as
neoplasm and particularly Crohn's disease, may be the cause. Similarly
patients with generalised disorders, such as diabetes and more
recently AIDS, may present with an anorectal abscess... A large
percentage of anorectal abscesses coincides with a fistula in ano. For
this reason, anorectal abscess becomes a highly important subject.
Moreover, as antibiotics cannot reach the contents of an abscess in
adequate concentration, no reliance can be placed on antibiotic
therapy alone...
This usually occurs as the result of suppuration in an anal gland,
which spreads superficially to lie in the region of the subcutaneous
portion of the external sphincter... It may also occur as a result of
a thrombosed external pile. If the haematoma is not evacuated, it may
become infected and a perianal abscess results. This is the most
common abscess of the region. Persons of all ages are affected and the
condition is not uncommon, even in infancy and childhood."
Liaquat University of Medical and Health Sciences: Anorectal Abscesses
http://surgery.4t.com/61.8.htm
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HOW CAN I PREVENT A RECURRENCE?
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Presuming that your colorectal surgeon did not find any structural
abnormalities when he examined the area during your surgery, it is
entirely likely that you will not have a recurrence of the abscess.
The best thing you can do to ensure that the condition doesn't return
is to take gentle care of your anorectal area, and keep your bowel
movements soft and regular so that you won't strain when evacuating
your bowels. It's important to avoid constipation: high-fiber foods
and lots of water may be all you need. Fiber supplements (such as
Metamucil or Citrucel) and stool-softeners like Dulcolax or Colace can
be helpful. Harsh stimulant laxatives are not the best way to go; they
can cause more problems than they solve.
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FURTHER INFORMATION ON PERIANAL ABSCESSES
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Colon & Rectal Surgery Associated, Ltd: Perianal Abscess and Fistula
http://www.colonrectal.org/patientinfo/conditions/perianabscess.htm
University of Bonn: Anorectal Abscesses
http://www.meb.uni-bonn.de/dtc/primsurg/docbook/html/x1411.html
A to Z Health Answers: Anorectal Abscess
http://atoz.iqhealth.com/HealthAnswers/encyclopedia/HTMLfiles/184.html
Surgery Door: Abscess - Perianal
http://www.surgerydoor.co.uk/so/detail2.asp?level2=Abscess%20-%20Perianal
Greater Baltimore Colorectal Specialists: Abscesses
http://www.gbcrs.org/abscess.html
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Google search strategy:
Google Web Search: "perianal abscess"
://www.google.com/search?hl=en&ie=UTF-8&oe=UTF-8&q=%22perianal+abscess
Google Web Search: "perirectal abscess"
://www.google.com/search?hl=en&ie=UTF-8&oe=UTF-8&q=%22perirectal+abscess
Google Web Search: "anorectal abscess"
://www.google.com/search?hl=en&ie=UTF-8&oe=UTF-8&q=%22anorectal+abscess
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Please keep in mind that Google Answers is not a source of
authoritative medical advice; the material I've gathered for you is
intended only as a source of information, and should not be viewed as
a diagnosis nor as a substitute for the services of a qualified
medical professional.
I hope this is helpful. If anything is unclear, or if a link doesn't
work for you, please request clarification; I'll be glad to offer
further assistance before you rate my answer.
Best wishes,
pinkfreud |
