The symptoms of perianal abscess include initially feeling a small hard lump or swelling around the anus, followed by increased pain, redness, swelling, fever,坠胀不适, restlessness, inability to sleep at night, constipation, and dysuria with a sense of urgency, which are rectal irritation symptoms. Accompanied by systemic discomfort, fatigue, elevated body temperature, decreased appetite, chills, and high fever, which are systemic toxic symptoms.
1. Subcutaneous anal abscess: It is an abscess formed under the skin around the anus, with local redness, swelling, heat, and pain. If the abscess has formed, there is a significant fluctuation in the local area, while the systemic symptoms are generally not obvious. 2. Ischiorectal abscess: An abscess formed in the ischiorectal fossa, with a wider and deeper infection area than the subcutaneous abscess. Initially, there is only a feeling of anal discomfort or mild pain, which gradually is accompanied by fever, aversion to cold, headache, loss of appetite, and then more severe local symptoms appear, such as burning or jumping pain in the anus, which intensifies during defecation, coughing, and walking. Digital rectal examination can palpate a fullness on the affected side, with significant tenderness and fluctuation.
3. Pelvic rectal space abscess: Located above the levator ani muscle and below the peritoneum. This type of abscess is deep and hidden, with not very obvious local symptoms, and sometimes only a feeling of rectal descent. However, the systemic symptoms are relatively severe, and digital rectal examination shows infiltration, hardening, tenderness, swelling, and fluctuation on the affected side of the rectal wall.
4. Rectal posterior space abscess: The main symptoms are the same as those of the pelvic rectal space abscess. There is a significant feeling of weight in the rectum, and there is dull pain in the sacrum. The pain can radiate to the lower limb, and there is a significant deep tenderness between the coccyx and the anus. Digital examination shows tenderness, swelling, and fluctuation on the posterior wall of the rectum.
In addition, according to the nature of the pathogenic bacteria of perianal abscesses, they can be classified as:
1. Acute suppurative abscesses: Most are caused by Staphylococcus, Streptococcus, and Escherichia coli infections.
2. Chronic suppurative abscesses: Most are caused by Mycobacterium tuberculosis infection.
1. What are the causes of anal abscess?
The causes of anal abscess include the following:
5. Anal gland infection. The anal glands open into the anal sinuses at the junction of the anal canal and rectum. The anal sinuses open upwards in a funnel shape, which are prone to injury and bacterial invasion, causing infection. Once the anal sinuses become infected, it can lead to suppurative infection, and the inflammation spreads to the spaces around the anal area. Because the perianal spaces have poor resistance to bacterial infection, infection is easy to spread in these spaces, forming abscesses in different locations.
4. Weakened systemic resistance. Conditions such as diabetes, old age, frailty, overexertion, and decreased resistance in patients with tuberculosis and AIDS are prone to perianal abscesses, and rectal cancer patients can also develop perianal abscesses.
3. Local stimulation and injury of the anal canal. Regular consumption of spicy foods such as chili peppers and alcohol can lead to local congestion and decreased resistance in the anal canal and rectum, thus causing infection. In addition, the rough and hard fecal mass can cause abrasions to the anal canal skin and mucosa, the loose stools of diarrhea patients can fall into the anal sinuses causing obstruction of the anal glands, as well as anal and rectal trauma or bone spurs from chickens, ducks, and fish bones swallowed with food can cause injury to the anal canal and rectum, all of which can lead to infection around the anal canal and rectum, and develop into perianal abscess.
Secondly, it can also be analyzed according to the factors affecting perianal abscess:
(I) Infectious factors: Modern medicine believes that infection is the main cause of this disease.
(Two) Iatrogenic factors: Clinically, iatrogenic causes of perianal abscesses are also not uncommon.
(Three) Postoperative factors: Clinically, it is also possible to see that anal and rectal surgery can cause infection, leading to perianal abscesses, as well as postoperative infection of the urethra, perineal postoperative infection, postpartum perineal dehiscence suture infection, and postoperative infection of sacral bone marrow abscess.
(Four) Other causes: such as gunshot or knife wounds, infection after damage to the rectum by foreign bodies, lymphogranuloma venereum, actinomycosis, rectal diverticulitis infection, rectal and anal malignant changes, ulceration or deep infection involving the rectum, and physical weakness, low resistance, or chronic consumptive diseases, or malnutrition, are all causes of perianal abscesses.
4. How to prevent anal abscess
For perianal abscesses, many people suffer greatly, with persistent and recurring abscesses that fluctuate in severity, torturing each patient. The experts of Nanning Gantai Anal Rectal Hospital point out that perianal abscesses can cause great harm to the human body, and if not cured for a long time, they can lead to anal fistula. However, if everyone takes appropriate measures in daily life, they can prevent the occurrence of perianal abscesses or reduce the severity of the abscesses.
1. Adjust defecation: Whether constipation or diarrhea occurs frequently, both can lead to anal cryptitis and cause perianal abscess. When constipation occurs, the feces stored in the rectum is prone to block the anal crypt, causing anal cryptitis and forming a perianal abscess. At the same time, dry and hard stools can cause skin abrasions on the anal canal or anal crypt, also leading to perianal abscess. Prolonged diarrhea can allow loose stools to enter the anal crypt, stimulate inflammation, and thus trigger infection.
2. Develop good hygiene habits:养成每日便后洗洁局部的习惯，防止感染。
3. Proper dietary adjustment: Do not eat too refined food and avoid eating刺激性 strong foods, which is conducive to the defecation.
4. Actively treat anal cryptitis and anal papillitis: Use sitting bath, suppository insertion, oral antibiotics, or traditional Chinese medicine therapy to prevent the inflammation from spreading and even forming perianal and rectal abscesses.
5. Actively treat systemic diseases: Actively treat systemic diseases such as intestinal tuberculosis, Crohn's disease, ulcerative colitis, etc.
6. Exercise and strengthen the physique: Prolonged sitting and standing can easily lead to obstructed local blood circulation in the anal area, reducing the local resistance to disease and increasing the risk of infection. Therefore, people who sit for a long time should actively participate in sports to increase the anal area's resistance to disease.[1]
7. Avoid sitting on damp ground for a long time: Sitting on grass or damp soil for a long time can cause the anal area to be cooled and dampened, reducing the body's resistance to disease, and it is easy for pathogenic factors of cold and dampness to invade the anal area, causing infection.
5. What laboratory tests are needed for anal abscess
(1) Compression and pus drainage: This involves exposing the anal crypts at the abscess site with a double-leaf anoscope or dilator, then compressing the abscess and carefully observing the site of pus drainage, which is the location of the internal orifice. This method is the simplest and most reliable means to determine the primary lesion.
(2) Bimanual palpation: Insert the index finger into the anal canal, with the thumb on the skin, to touch the most obvious fluctuation of the abscess, and the thinnest area of the skin and mucosa, which is the position of the internal and external orifices.
(3) Anoscopy: Generally, there is cryptitis at the primary lesion site, with local congestion being obvious, and the crypts deepening to form concavities, with purulent discharge or anal papillitis visible.
(4) Needle examination: Generally, a hook-shaped round-tipped probe is used to examine the anal crypts at the abscess site under a double-leaf anoscope. The infected crypts are often concave and deepened, making it easy for the probe to enter. If pus oozes out, it is the internal orifice. It is also possible to probe from the abscess cavity after incising the abscess, using the index finger to feel inside the anal canal, with the probe tip being the thinnest, only separated by a layer of mucosa, which is the internal orifice. However, it is important to avoid blind probing, which can人为 cause false orifices and lead to surgical failure.
6. Dietary taboos for patients with anal abscess
When eating fruit, patients with perianal abscess should be selective and choose fruits like watermelon, apple, pineapple, orange, pear, etc., as they all have the effect of moistening intestines and promoting defecation.
High-fiber vegetables, such as spinach, celery, winter melon, luffa, pumpkin, mung beans, soybeans, rapeseed, cauliflower, mushrooms, kelp, radish, and lotus root, are very light and contain a lot of fiber. They can clear heat and detoxify. Regular use of these vegetables can alleviate local swelling and pain, as well as symptoms of pus and discharge.
Patients with perianal abscess should avoid eating spicy foods, such as alcohol, chili, ginger, garlic, cinnamon, etc., as they can stimulate local inflammation and worsen the condition of perianal and rectal abscesses.
When taking medication for perianal abscess, some drugs and some foods should not be eaten at the same time. For example, when taking heat-clearing and detoxifying agents, it is forbidden to eat fish, shrimp, lamb, coriander, chive, bamboo shoots, dog meat, seafood, and other things that can cause internal heat. When taking blood and Qi tonifying agents, it is forbidden to eat radish, peach, plum, and other foods, otherwise they will affect the efficacy of the medicine.
The above dietary methods are only for the treatment after the patient has undergone surgical treatment, and the patient must not use the above content as the basis for treatment. After symptoms appear, the patient should still go to a regular professional hospital for treatment.
