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Suggest Treatment For A Perianal Abscess
Question: I have a painless swelling, about walnut shaped. This is a change to previous symptoms (which I had about 6, 7 years ago where there was no swelling but a hole through which my partner was able to squeeze some clear fluid out. That alleviated some associated lower back pain. At the time I saw a rectal specialist who said to leave it alone since it didn't cause further pain. Now with the swelling there is no pain. What do you suggest? I have tried epsom salt sitzbaths, castor oil packs, tumeric packs, to make the walnut go away. My only success is getting a small area to open up, like a sore the size of a dime, but nothing coming out.
Brief Answer:
Anoscopy, DRE, biopsy to determine if poor response to empiric treatment
Detailed Answer:
Hello and Welcome
I appreciate your concern
The description of the lesion you described most likely could be a perianal wart or a perianal abscess. Though a physical exam by a general surgeon that includes general inspection, anoscopy and a DRE ( Digital Rectal Exam) would be required to be more sure and to look for additional disorders such as hemorrhoids, anal fissure or a fistula. In case of recurrent lesions accompanied by local lymphadenopathy, malignant lesions of the anus like squamous cell carcinoma must be ruled out by doing a biopsy of the swelling/growth. Please consult a general surgeon in this regard. If the swelling / growth persists despite the various treatments you mentioned then a biopsy should be done to determine the nature of the swelling and to rule out any serious cause. Please fix an appointment with a General surgeon in this regard.
Please consult your doctor before deciding on any further course of action
wishing you best of health
thanks
Dr. M.S. Khalil
Anoscopy, DRE, biopsy to determine if poor response to empiric treatment
Detailed Answer:
Hello and Welcome
I appreciate your concern
The description of the lesion you described most likely could be a perianal wart or a perianal abscess. Though a physical exam by a general surgeon that includes general inspection, anoscopy and a DRE ( Digital Rectal Exam) would be required to be more sure and to look for additional disorders such as hemorrhoids, anal fissure or a fistula. In case of recurrent lesions accompanied by local lymphadenopathy, malignant lesions of the anus like squamous cell carcinoma must be ruled out by doing a biopsy of the swelling/growth. Please consult a general surgeon in this regard. If the swelling / growth persists despite the various treatments you mentioned then a biopsy should be done to determine the nature of the swelling and to rule out any serious cause. Please fix an appointment with a General surgeon in this regard.
Please consult your doctor before deciding on any further course of action
wishing you best of health
thanks
Dr. M.S. Khalil
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Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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