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Is Surgery Necessary To Cure Anal Abscess?

Posted on Sat, 26 Apr 2014

Question: Hello Dr., I had Anal fissure two month back and now after two month I went to specialist(colonrectal surgeon) and he said I have Anal abscess and need to do surgery (fistulotamy and sphicnterotamy). I am confused. Is the surgery really required? I dont have much pain but a slight discomfort. sometimes I have pus discharge.

Answered by Dr. Anshul Varshney (10 minutes later)

Brief Answer: Indication of surgery is there in anal abscess. Detailed Answer: Dear Friend. Hi , I am Dr Anshul Varshney , I have read your query in detail , I understand your concern. If you simply have an anal fissure, that can be treated well with: 1. Sitz bath 2. Laxatives 3. Local creams like Diltiazem you have been using. But if your doctor is saying that you have developed Anal abscess, that treatment of choice would be a surgical intervention with a good antibiotic cover. I feel if you are comfortable with your doctor, you should go ahead with the surgery. Fistulectomy would be done, and decision of Sphincterotomy would be taken by your doctor. Usually it is done with fistulectomy. This is my personal opinion based on details available here. If you still have any query you may please ask me. Stay Healthy. Dr Anshul Varshney , MD

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Anshul Varshney (2 days later)

Hello Dr, Thaks for your opinion, I just received the report and it says this, I have the following condition, Anal fissure and Periannal Abscess. Treatment insisted by surgeon: Surgery with Anal abscess and Fistula with sphincterotomy and DIS ( In one sitting). My question : The surgeon is insisting on doing all these three procedures together. Why he cant drain the abscess first and do the fistulectamy and sphincterotomy later if it reoccurs. Actually I used to have normal bowel movements regularly, this was just an onetime accident I had, why we need to do sphincterotomy(which has longtime side effects)?

Answered by Dr. Anshul Varshney (10 hours later)

Brief Answer: Detail Follows Detailed Answer: Dear Friend. Actually, decision of doing all these things depends on findings on local examination of that site by the doctor. In case you are not sure that your treating doctor is advising you correctly, you can take a second opinion. It is difficult to comment perfectly here because this problem requires direct clinical examination to diagnose and to treat. In general, perianal abscess is resistant to conservative treatment, so is preferably managed by surgery. If you have any further query, please ask me.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Anshul Varshney (6 hours later)

Thanks Doctor for your opinion. As you said I have set up for a second opinion with another doctor, but that appointment I got is after 4 weeks from now. I am not sure whether I can wait till that time or can I go to an Emergency hospital and get an opinion from there.

Answered by Dr. Anshul Varshney (2 hours later)

Brief Answer: You should not wait Detailed Answer: Dear Friend, I would say that you should not wait for 4 weeks, as if it is an abscess, it might get worse and might cause more complications. Any disease, if there should be treated immediately. So, you should consult an other doctor at the earliest and should take the treatment as advised. Waiting for 4 weeks is not a good idea! If you don't have any further query, you may please close the discussion and rate it! Stay Healthy.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar