If pus is draining from a perianal abscess, does that mean it's getting better?

Written by Yu Xu Chao
Colorectal Surgery
Updated on December 13, 2024
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The discharge of pus from a perianal abscess does not indicate improvement. This situation is due to the spontaneous rupture of the perianal abscess, which can easily lead to the formation of an anal fistula. Since a perianal abscess is caused by an infection of the anal glands and can infect the surrounding tissues, the simple discharge of pus without clearing the internal opening and infected tissues will not resolve the problem. Furthermore, there is a risk of recurrent episodes that may even result in more severe swelling. Therefore, it is necessary to seek early treatment at a hospital's colorectal surgery department for a definitive one-time surgical resolution of the perianal abscess, removing the internal opening and infected tissues. Post-surgery, medications like anal washes and potassium permanganate solutions should be used for dressing changes. Additionally, medications like erythromycin ointment strips and mupirocin ointment can be used to promote healing of the local surgical site. Patients should also maintain perianal hygiene, ensure smooth bowel movements, and avoid dry, hard stools that may irritate and cause pain or bleeding at the wound site.

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Written by Yu Xu Chao
Colorectal Surgery
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Has the perianal abscess that was drained a month ago and is neither painful nor itchy healed?

This situation often shows good post-operative recovery. Whether this situation is completely resolved depends on whether anal fistulas develop later, as most perianal abscesses drained can easily form anal fistulas. This is because drainage of perianal abscesses merely removes pus and secretions as much as possible, but does not completely clear the internal opening of the abscess and infected tissues. Thus, anal fistulas are likely to form later, and the patient needs to continue monitoring. Moreover, it’s important to maintain a light diet, avoiding spicy, irritating, and dry-hot foods as much as possible while also keeping bowel movements smooth. Frequent constipation or diarrhea should be avoided as they can cause wound pain or lead to inflammation and infection of the anal glands, potentially causing recurrence of the perianal abscess or the formation of anal fistulas later. However, the current situation indicates a relatively good post-operative recovery.

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Written by Chen Tian Jing
Colorectal Surgery
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Can I eat eggs with a perianal abscess?

Patients with perianal abscess can eat eggs, but during the acute onset period of a perianal abscess, besides sticking to a light diet, it is more important to seek surgical treatment as soon as possible. A perianal abscess is an acute infectious disease near the anal sinuses. Typically, it presents with severe local pain in the anus. Once pus forms, it is encapsulated in the abscess cavity and needs to be surgically drained as soon as possible to remove the infection thoroughly. This helps to prevent further enlargement of the abscess cavity and worsening of the condition. Furthermore, in the early postoperative period, patients can consume liquid foods and eat eggs in moderation or other easily digestible foods. However, they should avoid spicy and irritating foods such as chili peppers and seafood.

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Written by Chen Tian Jing
Colorectal Surgery
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Can a perianal abscess heal by itself?

During the acute phase of a perianal abscess, there is significant local redness, swelling, heat, and pain around the anus. Generally, this condition is caused by an infection of the anal crypts, and the possibility of self-healing is very low, so the main treatment for a perianal abscess is surgery. The surgical approach usually involves incision and drainage of the perianal abscess, combined with a one-time curative surgery. If the abscess ruptures and forms an anal fistula, surgical treatment is also required. During the outbreak of a perianal abscess, due to the severe local pain, it is advisable to undergo surgery as soon as possible to prevent further spread of the abscess. Simple topical medications can only relieve the symptoms of local inflammatory infection and cannot achieve a cure.

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Written by Chen Tian Jing
Colorectal Surgery
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Which is more serious, perianal abscess or hemorrhoids?

Perianal abscesses and hemorrhoids are two different types of anorectal diseases. During the acute phase of a perianal abscess, the urgency of the condition is greater than that of hemorrhoids. If active surgical intervention and incisional drainage and debridement are not carried out for a perianal abscess, it can lead to further enlargement of the pus cavity, increasing the size of the infected wound and the focus of infection, causing more severe pain and symptoms of systemic infection in the patient. Hemorrhoids, on the other hand, can be managed with conservative medication to alleviate symptoms. Surgical treatment is considered only when there are recurrent flare-ups, severe pain, significant prolapse, and worsening bleeding.

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Written by Chen Tian Jing
Colorectal Surgery
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Can conservative treatment be effective for perianal abscesses?

Conservative treatment of perianal abscesses can only relieve temporary inflammatory symptoms and cannot achieve a curative effect. There is also the potential for conservative treatment to delay the condition, leading to an increase in the size of the abscess cavity or the rapid expansion of pus, thereby exacerbating the condition. Once a perianal abscess is identified, surgical treatment should be carried out as soon as possible. First, the abscess cavity needs to be opened, and the enclosed pus drained completely, and then either a local incision with suture or debridement surgery chosen for treatment. Additionally, it is necessary to maintain the normal function of the anal sphincter. If only conservative medication is used for a perianal abscess, it can only temporarily relieve the current symptoms and does not benefit the healing of the disease or its long-term development at all.