The anorectal abscess, also known as abscess anal, is an infection of skin and soft tissue consisting of an agglomerate of pus which together produce a local inflammatory reaction, represent a very troublesome infectious disease area anus or rectum. This accumulation of purulent matter can form a bulge in the anorectal region and its contents can drain towards the nearby skin in the perianal region or in the rectal mucosa.
The anal abscesses are a common reason for consultation because it is a condition that creates discomfort and inconvenience to the patient, being more common in men after the third decade of life.
One of the most feared complications of anorectal abscess is rectal fistula, which means a pathological communication between two spaces or cavities (usually between the skin and the rectal mucosa), which can cause the infection to perpetuate in the time and is more difficult to heal completely.
Symptoms of anorectal abscess
Pain is the main symptom of anal abscess. This pain is persistent, can be of mild, moderate or strong intensity, is exacerbated when sitting or wearing tight clothing, is stabbing and may be accompanied by other symptoms such as:
· Sensation of mass or weight.
· Redness of the skin.
· Increased temperature of the affected area.
· Shaking chills.
· Loss of appetite
· Fear when evacuating.
If it progresses over time, the anorectal abscess can grow in great magnitude, encompassing the genital and perineal area. In other cases, the purulent contents may drain spontaneously, which you perceive as a thick whitish liquid, in most cases with an unpleasant odor. In almost half of cases there is a risk of developing an anal fistula.
If another comorbidity is present in the patient that causes immunosuppression (decrease in their defenses) such as diabetes mellitus, HIV infection without anti-retroviral treatment, use of steroids or treatment with chemotherapy, this infection can generate serious symptoms of systemic inflammatory response and reach a state of sepsis, especially in elderly patients.
Causes of anorectal abscess
The perianal and anal regions are areas that harbor a high content of bacteria, due to their proximity to the feces found in the rectum, they are also areas of high humidity. On the edge of the anorectal canal there are glands, which secrete mucus that improve the consistency of the stool during evacuation. When these glands are colonized by enteric bacteria, an inflammatory reaction occurs, which triggers a local immune response that promotes the generation of pus and plasma fluid. As it accumulates, a rectal abscess forms.
The causes for this colonization to occur are: the presence of prolapsed internal hemorrhoids, anal fistulas and traumatic injuries (shaving, aggressive hygiene, among others).
Although rectal abscess is an annoying pathology that makes the patient go to the doctor, there are a large number of patients who present recurrent rectal abscesses that, sometimes by draining their contents, improve the symptoms and make the patient, one or more Otherwise, learn to live with this condition. Although this scenario is not recommended, since in this type of patient there is a high probability of developing anorectal fistulae.
The only way to know if a painful mass in the anal region corresponds to a rectal abscess is to go to the doctor, since he must make the differential diagnosis between internal hemorrhoids, anorectal fistulas, Fournier's gangrene or rectal prolapse, which have another management therapeutic.
What should be done in case of rectal abscess symptoms?
If you have any of these symptoms, you should see a doctor, since the perianal abscess should be treated as soon as possible. A large number of perianal abscesses must be surgically drained, in view of the risk of increasing in size, presenting an anal fistula, and recurring over time.
When the abscesses are very large or deep and the patient has a condition that affects their immune defenses, in addition to considering the surgical approach, broad-spectrum antibiotic treatment should be started.
The doctor who specializes in this subject is the coloproctologist, who is in charge of the diagnosis and treatment of diseases of the colon, anus and rectum. If an anorectal abscess occurs, it should be treated by a Coloproctology Specialist, in order to prevent complications, including injury to the anal sphincter after drainage surgery for the anorectal abscess.
Environmental factors that influence skin aging and carcinogenesis fall into the following major categories: sun radiation (ultraviolet radiation, visible light, and infra-red radiation), air pollution, tobacco smoke, nutrition, some less well-studied factors, and cosmetic products. Hydracellum