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Anal glad cyst, infected cyst, painful - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Cancer
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
User :   I went to the dr today and he said that I have a anal glad cyst. They stated that one of three things will likely happen. The cyst will get infected and become very painful. The cyst will go away on its own or it will remain as is and then surgery is necessary to remove it.
I have noticed the cyst for about a week and the size seems to be getting smaller. And unless I apply direct pressure there is no pain.
How long would one wait to see if it goes away prior to surgery? Is this a cyst that would benefit from Clydamicin? I am also extremely active, swimming, biking and running. Is there any reason to stop these activities?
Doctor :   Hi
User :   Hey there Dr....
Doctor :   let me read ur query
User :   Great
User :   What is your background as well?
Doctor :   I am a general surgeon with 10 yrs of experience
Doctor :   can u give me the size of the swelling ?
User : a relative size how do you typically size them?
User :   Maybe the size of a pea?
Doctor :   ok
Doctor :   in that case, it will certainly resolve within 2 weeks
Doctor :   and antibiotics include augmentin and clindamycin
User :   The Dr actually have a hard time finding it
User :   As he thought I was describing a hemroid
User :   But he did an internal DRE and said it was a cyst.
User :   He did not perscribe any antibiotic
User :   Is that odd?
Doctor :   if there is a pain, redness, and tenderness, then antibiotics are prescribed
Doctor :   if there is no symptoms and the cyst is very small as mentioned, then antibiotics are usually withheld and the swelling is observed
User :   You can not see the cyst it is not external it seems to be below the skin does that make sense. It only hurts if you squeeze it or apply direct pressure. Which does not occur unless I try and find it.
User :   At what size is it no longer small?
Doctor :   in that case, it is very insignificant
Doctor :   the size less than 1cm diameter is not needed to be worrried about
User :   I am not sure of the size and I am not sure how big a 1cm is if it is double that size would you be worried? I guess the question is at what size would your feeling change?
Doctor :   since you mentioned that the cyst is reducing, it might be followed for a week or two
User :   As well is the surgery for this very involved?
User :   Surgery has me very scared.
User :   Is an option to just leave it if it stays this same size?
Doctor :   surgery not needed for small cysts like yours
Doctor :   they will subside in about 85% cases and in the rest just stay as it is
Doctor :   you can just leave it as it is
Doctor :   and observe for 2 weeks
User :   The dr left me with the impression that if I just left it would eventually get infected so he would not leave it.
Doctor :   it will certainly subside on its own
User :   Should I start the antibiotic?
Doctor :   since it does not cause any symptoms by its own, , no need for any form of intervention
Doctor :   no need for antibiotics too
User :   And should I stop my training? He said let the pain be the guiide.
User :   Would riding a bike or running or swimming make it worse?
Doctor :   riding a bike might worsen it
Doctor :   running or swimming will not affect it in any way
User :   It seems that when I squeeze it and generally touch it get inflamed and painful does that make sense?
User :   Being paranoid I am always checking it to see if it is getting bigger or smaller.
Doctor :   yes it does , this seems to be a sebaceous cyst
User :   Is that a cyst in the anal glad?
Doctor :   yes
User :   At what size does this not longer become insignifcant?
User :   Double the size or much much larger?
Doctor :   less than 1 cm diameter, - no need to worry about
Doctor :   more than 2 cm, needs to be surgically removed
User :   That size will not reduce?
Doctor :   yes 2cm and larger, increase in size and get infected more common
Doctor :   but size of 1cm , most resolve
User :   I see, so the best sign is if it is staying the same size or smaller.
Doctor :   yes , that is right
User :   Great is there any way to actually measure this?
User :   Is there anything that can be done to ensure it reduces?
User :   Advil, warm bathes?
Doctor :   yeah, take some advil, to reduce the inflammation
Doctor :   other than that nothing is needed
Doctor :   just patience and time will be enough
User :   OK, and would the antibotic help even more?
User :   Patience ;)
User :   That is what I do not have as I am so scared of the surgery.
Doctor :   antibiotics will help, only in case of severe infection , not in uninfected cysts
User :   OK, thank you!
User :   You have been wonderful. Anything else that I should know?
Doctor :   you are most welcome,
User :   Last question, the surgery how long of a procedure is that?
Doctor :   just relax and then , observe
User :   And how involved is that?
Doctor :   you will definitely feel better once the swelling reduces
Doctor :   surgery will take just less than 1 hour
Doctor :   as this is very basic and easy procedure
User :   The swelling from poking and prodding?
User :   That is my last question :)
Doctor :   it will reduce with cold packs and advil
User :   Great! Have a great weekend!
Doctor :   you too
Doctor :   take care
Doctor :   bye for now
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