Most perianal abscesses develop spontaneously in completely healthy children. Many naturally start to drain and heal, but some may need treatment with frequent baths and antibiotics. Others may need to be treated with a small operation. Some perianal abscesses may not heal completely, with or without surgery. Antibiotics are often not enough to cure an abscess. If an abscess is larger than a grape, it will not heal with antibiotics alone & requires drainage of the pus to allow the infection to drain. Abscesses can form near the anus, often just inside where an anal crypt gland gets plugged & and abscess can form.
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Febrile, neutropenic, or diabetic patients or those with marked cellulitis should also receive antibiotics (eg, ciprofloxacin 500 mg IV every 12 hours and metronidazole 500 mg IV every 8 hours, ampicillin/sulbactam 1.5 g IV every 8 hours). Antibiotics are not indicated for healthy patients with superficial abscesses.
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Surgical incision and drainage is the most common treatment for all types of anal abscesses and is usually successful. About 50% of patients with an anal abscess will develop a complication called a fistula. A fistula is a small tunnel that makes an abnormal connection between the site of the abscess and the skin.
Your abscess can be treated by draining the pus from the infected cavity. This is performed under a general anaesthetic in the operating theatre. The surgeon can check where the abscess is, drain it effectively and prevent it returning
Surgery is often the only way to treat the abscess and remove all the infected tissue. However, some may spontaneously drain by themselves and not need any surgery. Your surgeon will discuss the options with you.
An anal abscess can have many different causes. These include:
Risk factors for anal abscesses include:
For adults, using condoms during sexual intercourse, including anal intercourse, can help prevent anal abscesses. For infants and toddlers, frequent diaper changes and proper cleaning during diaper changes can help prevent anal fistulas and perianal abscesses.
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Anal abscesses rarely go away without treatment. The most common and simple treatment is for your doctor to drain the pus from the infected area. This can usually be done in the doctor’s office. Your doctor will use medicine to numb the area. Place a maxi pad or gauze in your underwear to absorb drainage from your abscess while it heals. Sit in 8 to 10 centimetres of warm water (sitz bath) for 15 to 20 minutes 3 times a day. Do this as long as you have pain in your anal area. Apply ice several times a day for 10 to 20 minutes at a time.
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