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Dr. Andrew Rynne

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How can a rectal abscess be treated?

Answered by
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Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 1956 Questions

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Posted on Tue, 4 Apr 2017 in Liver and Gall Bladder
Question: Hello, 


My name is XXXXXXX and I am 22 years old. A week ago I noticed that I have a wound/rounded spot outside the rectum/anus, it was tiny at first but after week, now, it has become a little bit bigger. It is near the anus. At first I felt a little pain when I sit our touch it, there was moments when I did not feel the pain at all and now the pain came back. 
The spot feels hard and painful when I touch it.  

What may it be? 

Thank you, XXXXXXX
doctor
Answered by Dr. Ramesh Kumar 1 hour later
Brief Answer:
All possibilities mentioned in detailed answer.

Detailed Answer:
Hello XXXXXXX
Thanks for posting your query on this forum.

As per the description given by you there are three possibilities,

1)It can be a peri anal or rectal abscess.It is a painful condition in which wound develops near the anus. Most anal or rectal abscesses are a result of infection from small anal glands. The most common type of ana abscess is a perianal abscess.

2) It can be a Anal fistula,it is a chronic abnormal communication between the epithelialised surface of the anal canal and the perianal skin,In a lay mans language it is breach of external skin and this breach results in direct communication of your anal canal with external enviroment and pathogens.It can be a potential source of infection if left untreated.Its just like a open wound where skin is breached this break in the skin provides a route for the germs to travel from the outside to the inside.

3)A pilonidal sinus is a small hole in the skin near anus.Most commonly located near anus. More than one hole may develop, and often these are linked by tunnels under the skin.More common in people with lots of hairs around anual hole.

However for a better professional advice please attach 2,3 High resolution clear pictures,Because to give a exact diagnosis without physically examining the patient is very difficult.I hope you understand the intensity of problem.

General treatment
Antibiotic cream should be used twice daily locally over the area.
Proper hygiene should be maintained,Any oozing pus etc should be cleaned up immediately.Betadine lotion can be appliede over affected area.
Any broad spectrum antibiotic like Cefixime should be taken in low prophylactic doses as adviced by your gastroenterologist.
Try to take a healthy diet,Immune booster and natural anti oxidants should be taken regularly to boost immunity.
For pain analgesics like diclofenac can be taken as and when required.
Take vitamin C and folic acid supplements they promote wound healing.

Advice
Physical examination by atleast a Surgeon should be done.
Test advice
MRI of Anal and rectal area.
Fasting and PP blood sugar.
I hope i answered your query well,Feel free to follow up.

Waiting
Regards.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Ramesh Kumar 3 hours later
Hello Dr. XXXXXXX XXXXXXX Thank you for your answer.

I have uploaded 2 photos of the area, I am sorry for showing you such ugly images
:(

another thing: there is also near the area a white spot, I noticed it just now.
Can you tell what you see there?

thank you very much.
doctor
Answered by Dr. Ramesh Kumar 8 hours later
Brief Answer:
Hemorrhoids.

Detailed Answer:
Hello again XXXXXXX
Sorry for a bit late reply.

Have gone through your photos,They are Hemorhoids.
Let me just give you a briefing about hemorrhoids initially.

Usually Hemorrhoids come due to in take of heavy, spicy, non veg foods. These foods get lot of time for digestion and one gets dull for prolonged time.In non medical language, the Liver gets hang, causing improper metabolism and gets congested. This causes to pooling of blood in the rectal vein, engorged and protrudes to anal canal. While on passing stool, it gets friction and ruptured resulting bleeding.These engorged veins are termed as hemorrhoids.

First step in management is-
Drastic life style change.
Maintain your food habits. Take simple and easily digesting veg. Food, daily. Cut shot spicy, oily bakery foods and junk foods. Include fiber rich food in diet.Proper exercise, walking helps to maintain physical fitness. Avoid heavy and late night foods, cut shot all stimulants if any. Be to bed in proper time. Take 8 glass of water daily morning.

Don't Strain during bowel movements,Can take Metamucil daily before going to bed to add mucous to stool and make it soft.
Don't Sit for long periods of time on the toilet,Maintain proper posture while defaecating.
Drink one glass XXXXXXX warm water 10 minutes before going to washroom.Water lubricates stools and assist in easy passage.

Advice
A proper physical examination should be done by a general surgeon.
Digital and proctoscopic examination of rectal canal should be done to look for exact positions of piles.

General measures
-Take warm baths. Soak in a bathtub filled with a few inches of warm water for about 15 minutes at a time.
-Rub cream containing Calcium Dobesilate, Hydrocortisone, Lignocaine, and Zinc once daily before going to bed.
-Don't scratch.

I hope i answered your query well feel free to ask for any professional advice.

Regards,
Kumar.


Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Ramesh Kumar 5 hours later
Thank you very much doctor. So, Do I need a surgical procedure?
can this be treated at home? It is possible to use creams? or some medicine?
It is possible to cure this area without any surgical processes?

Thanks.
doctor
Answered by Dr. Ramesh Kumar 6 hours later
Brief Answer:
Follow up answer.

Detailed Answer:
Hi again XXXXXXX

As you are young I would advise you initially to go for Noninvasive procedure's like-

Sclerotherapy-An injectible chemical would be injected into hemorrhoid to kill the tissue.It's a relatively painless and out patient procedure.

Band ligation-Small bands will be ligated to base of hemorrhoid, this will cut off the blood supply resulting in shrinkage of hemorrhoid.

Laser or Infrared therapy can be use to coagulate the hemorrhoid.
All three procedures are equally effective. If recurrence occurs, you can go for surgery.

Yes it can be managed medically also, whether to go for noninvasive procedure or not depends on intensity of your symptoms and problems.

However, Calcium dobesilate can be tried initally twice daily for 21 days followed by once for 3 months along with application of cream containing Calcium Dobesilate, Hydrocortisone , Lignocaine and Zinc once daily at bed time. It is effective in about 60% patients.Strict dietary restrictions are to be followed if you opt for medical management.

Absolute cure is not possible but control of symptoms is possible medically. For cure either go for non-invasive procedures or surgery.

In case you need any other professional assistance I would be glad to help you XXXXXXX

Regards,
Kumar.


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Ramesh Kumar 1 hour later
Thank you very much. You're the best!
doctor
Answered by Dr. Ramesh Kumar 9 minutes later
Brief Answer:
Get well soon XXXXXXX

Detailed Answer:
Your welcome XXXX!

Well, what have you decided?
Medical management or Non-invasive?

In case you need details about diet to be followed, I would be happy to provide you with details.


Regards!

Above answer was peer-reviewed by : Dr. Arnab Banerjee
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