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Drainage of Abscesses
You have either a perianal abscess, an infection around your anus that
began in a mucous-secreting gland in the anal canal, or a pilonidal abscess,
an infection in a hair follicle trapped under the skin overlying the tailbone.
In either case, you did nothing to cause the infection and you could have
done nothing to prevent its development.
Treatment
Drainage is the most reliable way to treat these abscesses. First the
doctor injected a local anesthetic around the abscess to allow the drainage
to be as painless as possible. The doctor made an incision into the abscess
to drain the pus and removed a portion of the skin and fat to allow drainage
while your body heals the abscess. A gauze dressing was then applied.
Antibiotics in addition to drainage are sometimes given to diabetics,
patients with artificial heart valves or joints, or those who have decreased
immunity.
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After Treatment
Symptoms and Care
You will have some pain after the local anesthetic wears off. It may be
moderately strong. Your doctor will prescribe something for you. Do not
take aspirin or products containing aspirin for at least seven days as
they promote bleeding. You may take acetaminophen (Tylenol®) or ibuprofen.
It takes two to four weeks for the wound to heal. Don't worry if some
bleeding, discharge, pus, or itching occur during this time; they are
part of the normal healing process. You may apply gauze, cotton dressings,
or minipads to the wound as needed.
Anal hygiene is important. Take a bath or shower at least twice a day.
(A hand-held sprayer is helpful if you are taking a shower.)
You have been asked to return to the office in 7 to 14 days for a check-up.
Most patients with perianal abscesses will need no further treatment.
If you develop a chronic fistula, surgery may be necessary. Pilonidal
abscesses typically come back, possibly requiring further surgery.
Diet
It is important to keep your bowel movements soft and regular. Eat foods
high in fiber and drink lots of water (6-8 glasses a day). If you are
constipated, take a fiber supplement like Metamucil® or Konsyl®. Prune
juice or small doses of milk of magnesia may also be used.
Activity
Avoid strenuous activity for the rest of the day. Tomorrow you can go
back to your normal activities.
Causes for Concern
Call your doctor if you have any of the following problems:
- Excessive pain unrelieved by your pain medication
- Increasing pain several days after treatment
- Fever or chills
- Difficulty urinating
- Severe bleeding that won't stop with direct pressure using Kleenex
or gauze
- Severe constipation (no bowel movement for three days)
- Diarrhea (more than three watery bowel movements within 24 hours)
- Nausea or vomiting
If your own doctor is unavailable, the doctor on call is available 24
hours a day, every day of the year. After hours, call any of our offices
and the answering service will locate one of our doctors on call. In an
emergency try to contact us for advice before you go to the hospital.
A telephone call may save you a lot of time, discomfort, and expense.
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