What Is Anus Abscess?

Anus Abscess is a painful disease in the anal region due to infection of the small glands in the anal wall. Internal anal valve ( sphincter ani internus ) serves to prevent infection from the intestinal cavity to the tissues around the anus ( perianal ). However, if an infection of the intestine penetrates this valve, the spread of infection can reach the perianal tissue and cause an anal abscess. Abscesses that occur often appear in the form of blisters filled with pus and swelling in the anal region. If touched, this swelling can feel warm and reddish. But in the abscess that lies within, sometimes can not be seen or palpable.

Based on the location of the abscess due to the spread of infection, anus abscess can be distinguished as follows :

• Perianal abscess (the most common type of anal abscess).
• The ischiorectal abscess is in the postanal cavity.
• Abscess in the supralevator cavity.
• Abscess in the intersphincter cavity.

Symptoms of Anus Abscess
Symptoms of anus abscess that appear in patients vary depending on the location of the appearance of an abscess. If an abscess occurs in the perianal region, the symptoms that appear are:

• The pain in the anus is continuous, feels piercing, and worsens when sitting.
• Skin irritation around the anus accompanied by redness, swelling, and hardening of the skin.
• The discharge of pus from the anus.
• Constipation and pain caused by intestinal movement.

In abscesses that occur in the deeper areas of the anus, such as supralevator abscess, symptoms that may arise include:

• Fever.
• Cold.
• Unwell.

In some cases the anal abscess is deep, sometimes even just show symptoms of fever alone is quite difficult to diagnose and require the help of MRI or CT scan.

Causes Of Anus Abscess
The cause of the appearance of anus abscess in a person may vary. However, this condition can generally be caused by the following:

• Infection of the anal fistula (a small gap that forms on the skin of the anal canal).
• Sexually transmitted infections .
• Obstruction of the anal glands.

A person may be more susceptible to anal abscess if:

• Suffer from diverticulum inflammation .
• Taking anti-inflammatory drugs, such as prednisone .
• Being a recipient of anal sex.
• Have diabetes.
• Suffering from inflammation of the pelvis.
• Suffer from inflammation of the gastrointestinal tract, such as in Crohn's disease or ulcerative colitis .

Diagnosis of Anus Abscess
Anal abscesses, especially perianal abscesses that do not cause systemic symptoms, can be diagnosed by tracing symptoms and examination of anal conditions. To assist with the diagnosis, the doctor will also examine the related conditions, for example:

• STDs are sexually transmitted.
• Inflammatory diseases of the gastrointestinal tract.
• Diverticulum disease.
• Rectal cancer.

In patients suspected of having an internal anus abscess, such as a superelevator abscess, the diagnosis can be performed by a scanning method. Among other things are ultrasound, MRI and CT scan. There are also several cases of anal abscesses that are complex and cause systemic symptoms. To aid in the diagnosis of complex anal abscesses, an endoscopic examination may be performed. The goal is to look at abscesses and fistulas, as well as to determine the location, distribution and size.

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Complications of Anus Abscess
If not treated properly, anus abscess may cause the following complications:

• Fistula.
• Bacteraemia (bacteria enter the circulatory system) and sepsis , as well as the spread of infection from the anus to other organs.
• Fecal incontinence .
• Abscess becomes malignant.

Treatment of Anus Abscess
The presence of an abscess in the anus signifies a severe infection and requires surgical treatment. However, during the preparation stage of surgery, the patient's anal abscess may be given antibiotics. Surgery to treat an anus abscess should be done as soon as possible because postponement of surgery can cause chronic tissue damage.

Surgical methods that can be performed to treat anus abscess include the following:

• Perianal abscess surgery. Abscesses need to be removed surgically before rupture and cause complications. Unlike other surgeries, anal anus surgery does not require emptying of the gastrointestinal tract. Before surgery is done, the patient will be given local anesthesia first. Abdominal surgery is done by making incision in the abscess area, followed by the discharge and draining of pus from the abscess. Incisions made are usually enough with a small incision to reduce the risk of fistula formation. The pineapple removed from the abscess is then analyzed to determine the type of bacteria that causes the infection. After surgery, the incision is covered with an antiseptic gauze containing iodine. After 24 hours, the patient is required to soak the buttocks in water containing the medicine 3 times a day, and once each after defecation.
• Surgical abscess supralevator, ischiorectal , and intersphincter . The third principle of surgery is similar to surgery in the case of a perianal abscess. However, surgical abscess supranevator, ischiorectal and intersphincter require a more complicated process because of its location, and should be done in the operating room. To excrete pus from the abscess, an incision is made in the area with the greatest swelling. After the incision is made, pus is removed through a small tube and is assisted with an emphasis on the abscess to allow pus to exit maximally. For this surgery, the patient may be given local anesthesia or general anesthesia if deemed necessary.
• Surgery and treatment of fistulas. Fistula is one of the complications that can arise due to an abscess. Fistula surgery can be performed simultaneously with an abscess operation. However, sometimes new fistulas appear several weeks to several months afterwards, so surgery for the fistula is performed separately with an abscess surgery.

Some of the complications that can occur after an abscess and fistula surgery include:

• Infection.
• Anal fissure.
• Reappearance of postoperative abscess.
• Scars on the incision area.

To help with post-surgical abscess treatment and reduce the risk of postoperative complications, patients may be given several types of medicines, such as:

• Infection. Patients may be given antibiotics before and after an abscess surgery. Antibiotics are adjusted to the bacteria that cause the abscess that has been diagnosed in advance through bacterial culture. Some types of antibiotics that can be given, among others, are ampicillin (either given alone or in combination with sulbactam ), imipenem and cilastatin, cefazolin, and clindamycin .
• Painkillers. Often before and after an abscess surgery, the patient will experience pain and discomfort in the abscess area. Therefore it can be given anelgesic medicine to relieve the pain. Examples of painkillers that are often given are
• Antiemetics. These drugs may help provide a synergistic effect when administered together with meperidine. In addition, antiemetics can relieve vomiting from arising side effects of treatment. An example of antiemetics that can be given is promethazine .

Post-surgery and treatment, patients are required to perform routine control to the relevant physician for 2-3 weeks. This consultation aims to monitor wound healing surgery and control the possibility of fistula emergence in patients. Deaths from abscesses and complications of abscess surgery are quite rare. However, keep in mind that the fistula may be formed sometime after the abscess is removed. In addition, surgical complications can also occur. Therefore, postoperative control is very important to do.

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