Causes, Symptoms, and Natural Ways to Treat an Anal Abscess

Although not life-threatening, an anal abscess can be a thorn in a person’s behind. Often associated with pain and discomfort, it happens when mucus-secreting glands in the anus get clogged and infected. These are found near the anus, rectum or perineal region. 

Read on to discover the causes of an anal abscess and treatment options that can help relieve the pain and discomfort.

What are the Causes of Anal Abscess? 

The most common risk factor for the development of anal and rectal abscesses is having a specific type of health condition. These include: 

• Diabetes 
• Diverticulitis 
• Inflammatory bowel disease  
• Human immunodeficiency virus (HIV)  

• Acquired immunodeficiency syndrome (AIDS) 
• Sexually-transmitted infections 

Likewise, smoking, pregnancy, immune-system-suppressing medication like prednisone, and frequent constipation or diarrhoea can also provoke abscess onset.

In Traditional Chinese Medicine (TCM), it’s believed that anal abscesses stem from disorders or imbalances in the Governor Vessel (Du, 督脉), Conception Vessel (Ren, 任脉), and large intestine.

How is an Anal Abscess Diagnosed, and What are Available Treatment Options? 

Most anal abscesses are diagnosed and treated based on clinical findings. These findings can also show the presence of a fistula, a small tunnel that connects the lump to a skin opening around the anus. 

A healthcare provider may use traditional two-dimensional (2D) and three-dimensional (3D) endoanal ultrasounds. These minimally invasive diagnostic methods involve an assessment of the anal canal structure and are effective at: 

• Diagnosing a perirectal abscess 
• Identifying horseshoe abscess (a circumferential spread of lumps around the anus or rectum) 

• Mapping out a fistula path 

A computerised tomography (CT) scan can help diagnose severe infections, such as multiple fistula tracts or Crohn’s disease. Magnetic resonance imaging (MRI) is a reliable way to discover internal openings and detail the fistula tract.

Once diagnosed, the healthcare provider may recommend a surgical drainage procedure to treat the problem. Meanwhile, a TCM practitioner will recommend herbal remedies to calm the accompanying symptoms of an anal abscess and support post-surgery recovery. 

Surgical drainage 

The procedure involves an incision in the skin near the anus to drain pus and fluid from an infection. It’s performed in a clinical physician’s procedure room while a person is under local anaesthesia.

Steps to Help a Person Recover from Anal Abscess Surgery 

Combining healthy habits and pharmaceutical medication use can help promote post-surgery healing. Taking a sitz bath several times daily can soothe pain and swelling. This method requires a person to submerge their anus and genital area in a tub of warm water for a brief period.

A healthcare provider may give antibiotics to stop an infection, which will also help those with a weak immune system. In addition, a person can purchase hydrocortisone over the counter or with a prescription. Increasing fibre and water intake and using laxatives or stool softeners can also help avoid painful bowel movements.

TCM can help keep the surgical wound clean and promote healing. Herbs like pubescent Angelica root (du huo, 独活), Dahurian Angelica root (bai zhi, 白芷), and figwort root (xuan shen, 玄参) are ground into a powder and mixed with sesame oil. The mix is applied externally to the lump to resolve Dampness, relieve pain, and nourish a person’s yin. 

What are the Available Treatment Options for a Fistula? 

Be mindful that fistulas are a complication of an anal abscess and not part of the condition itself. It’s usually suspected in people experiencing pain, bleeding, swelling, or discharge. 

Fistulotomy 

The most common surgical procedure for treating anal fistulas is a fistulotomy. A healthcare provider is required to cut along the entire length of the fistula, enabling it to heal as a flat scar.

A fistulotomy is only suitable for fistulas that don’t pass through much of the sphincter muscles. In doing so, a healthcare provider can lower a person’s risk of incontinence. If a person is likely to develop urinary incontinence, a different surgical procedure may be recommended instead.

Seton insertion 

Surgical insertion of a seton – a thin piece of rubber or suture – may be proposed if an excessive amount of sphincter muscles will be affected during a fistulotomy.

It’ll feature the placement of the seton through the entire fistula tract. The seton will be joined and secured, forming a ring around the anus. It’ll be kept in place for eight to 12 weeks, thus allowing for controlled drainage and the inflammation to subside.

To the same effect, an advancement flap or a ligation of the inter-sphincteric fistula tract (LIFT) procedure may also be considered.

Herbal tonics  

The main objectives of using traditional remedies are to clear Heat, expel toxins, alleviate swelling, avoid recurring infections, and maintain normal anal functions.

“Acute swelling and sudden pain around the anus accompanied with fever, chills, insomnia, and constipation is characteristic of Damp-Heat accumulation in the large intestine. Consuming too many alcoholic beverages and pungent or spicy foods contribute to the syndrome,” explains Eu Yan Sang physician Peh Wei Jie. 

Cooling herbs like forsythia (lian qiao, 连翘), foxglove root (sheng di huang, 生地黄) and garden burnet root (di yu, 地榆) can help correct this body constitution imbalance. To reduce swelling and pain, a person may consume herbs that boost blood circulation and address Stagnation. These include Chinese Angelica (dang gui, 当归) and Szechwan lovage rhizome (chuan xiong, 川芎).  

He adds, “Recurring and prolonged pain in the anus, a dark yet dull swelling of its surrounding skin, and low-grade fever are symptoms of Blood and Qi (vital life force) Stagnation with residual Heat in the blood. Sexual hyperactivity, too much sitting, and physical trauma to the anus are common causes of this syndrome.” 

It can be treated with herbs that cool the blood and remove Stagnation, such as pollen (tian hua fen, 天花粉), red peony root (chi shao, 赤芍) and Danshen root (dan shen, 丹参). Anemarrhena rhizome (zhi mu, 知母) and Japanese catnip (jing jie, 荆芥) can help regulate qi circulation and boost Yin (passive energy) Deficiencies. 

Surgery remains the best treatment option for an anal abscess, and TCM remedies can help fix internal disorders. Speak to a licensed practitioner before using herbal ingredients and avoid self-medicating. Doing so will prevent contraindications, especially if you’re also undergoing clinical treatment or using pharmaceuticals.