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Abscesses
When an infection does not heal properly, it frequently will create
an abscess, which is a cavity of pus formed by tissue degeneration.
Its importance should not be underestimated because once it forms,
an abscess will continue to worsen.
A chronically neglected abscess
will often grow into a fistula
or cryptitis, a larger
cavity that may have many openings, and involve
extreme pain, loss of control of the bowels,
or massive tissue degeneration. They are quite common in the region
of the anal opening and buttocks.
Abscess usually begins with a tender swelling somewhere near the
anal opening. As it progresses there is heat, redness, and
a dull steady ache which later becomes a throbbing pain. Chills and
fever may also be experienced. The cavity may extend to the surface
and then break, exuding pus and blood. This causes immediate relief
from the pain, but if the abscess cavity is not then carefully cleaned
out, it will remain infected and not heal properly. So even
if it breaks a fistula might still form, in which case the ‘relief’ marks
the beginning of serious trouble rather than the end of it.
Abscesses in this region are caused by anything from the outside
penetrating the skin and soft tissues of the buttocks or anus (such
as cuts, bruises, abrasions); or through the rectum by way of crypts,
papillae, fissures, infected sweat glands or hair follicles, and
many other causes. Any infection runs the risk of absessing
if not properly treated.
A particular type I see often is a post-sphincter abscess, which
means literally an abscess in the rectum, behind the sphincter muscle. It’s
a condition which can cause the patient considerable frustration
because standard methods rarely can find it or cure it. This
kind of abscess may linger for years, while the patient is told he
has neuralgia, coccygodynia, or arthritis of the coccyx (tailbone),
and frequently will use prescribed creams and salves, but to no avail.
The patient will complain of backache at the end of his spine (tailbone
ache), and even have difficulty rising after sitting for awhile. He
will often unconsciously sit on one side of his buttocks instead
of sitting evenly on both. There will be pain during bowel movement
and a dull aching sensation afterward.
Because of the deep location of a post-sphincter abscess, routine
examination will often fail to identify it.
However, once the abscess located, treatment
is straightforward and brings quick relief
as the abscess cavity is drained and cleaned.
Fissures
Hemorrhoids
Fistulas
Cryptitis
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