Anal abscess
An anal abscess is a pus-filled inflammation in or around the anus or rectum. It is usually caused by an infection of a gland in the anal area and can cause symptoms such as pain, swelling, redness and sometimes fever. An abscess may be superficial, but may also develop deeper into the tissue, which sometimes leaves little visible on the outside.
An acute anal abscess always requires conventional medical assessment. Often, it is necessary to surgically open and drain the abscess. Therefore, Chinese medicine is not a substitute for this treatment. Acupuncture and Chinese herbs may be used in addition, for example during recovery or repeated complaints. In chronic or recurrent abscesses, factors that may make recovery difficult are also considered within Chinese medicine.
Common symptoms
The symptoms depend, among other things, on the location and depth of the abscess.
- pain around the anus, often knocking or persistently present;
- swelling, redness and sensitivity;
- pain that may get worse with sitting or stool;
- pus or moisture from the affected area;
- fever, chills or feeling sick;
- in deeper abscesses sometimes pain in the pelvis or abdomen without obvious external swelling.
A chronic abscess can cause less pronounced symptoms. For example, there may be a recurrent swelling that occasionally fluidizes or separates pus.
Possible causes
An anal abscess is usually caused by a bacterial infection where pus accumulates in the tissue around the anus or rectum. An abscess can sometimes spontaneously break open, but that does not always mean that the infection has completely disappeared.
An important complication is the emergence of an anal fistula: an abnormal passage between the anal canal and skin. This may lead to recurrent inflammation and secretion. Read more about this on the page Anal fistula .
If an abscess does not heal properly or returns regularly, further medical examination may be necessary for an underlying cause.
What can acupuncture do?
In an anal abscess, conventional medical assessment is a priority. Acupuncture may be applied in addition, especially when the acute infection is adequately treated or during further recovery.
Within Chinese medicine, treatment is tailored to the stage of the complaint and the underlying pattern. With acute, red and painful inflammation, the emphasis is different from a chronic abscess that slowly heals or returns regularly.
Possible treatment principles include:
- Reduce heat and inflammatory symptoms
- Supporting local Qi and Blood flow
- Decrease pain and swelling
- In case of chronic complaints, strengthen Qi and Blood
- Support recovery when an abscess slowly heals
- Treat underlying patterns that may contribute to recurring complaints
What can Chinese herbal medicine do?
Chinese herbs are also chosen based on the stage and overall grievance image. In the acute phase traditionally different herbs are used than in a long or recurring abscess.
For example, chronic complaints may have insufficient recovery potential, while other people retain signs of persistent Heat or Dampness. Herbal treatment is adapted accordingly.
Possible treatment principles include:
- Reduce heat and so-called toxic Heat
- Reduce Dampness-Heat from the lower part of the body
- Reduce swelling and local irritation
- In case of chronic complaints, supplement Qi and Blood
- Support Yin or Yang when there are clear signs of it
- Supporting the recovery of affected tissue
Chinese herbs should not be used in acute abscess as a substitute for necessary drainage, antibiotics or other regular treatment.
How does Chinese medicine view an anal abscess?
In an anal abscess, Western medicine mainly looks at the infection, the location of the abscess and the need for drainage. In the traditional Chinese Medicine (TCM), it also looks at the underlying imbalance associated with the complaint.
For example, an acute, red, warm and painful abscess often talks about Dampness-Heat and toxic Heat. Dampness within TCM is a term for an accumulation that may include swelling and discharge. Heat refers to symptoms such as redness, heat and inflammation.
In chronic abscesses, the picture can be different. For example, when someone is tired, has low appetite and slowly recovers, a shortage of Qi and Blood can play a role. In long-term dryness complaints and night sweats, a shortage of Yin can be at the forefront.
Especially the TCM organ systems Spleen, Large Intestine and Kidneys can be relevant. A TCM organ system is not the same as the anatomical organ from Western medicine, but describes a whole of body functions.
A recognizable combination of signs and symptoms is called a TCM pattern within Chinese medicine.
Read more at TCM basics Organ Systems .
Read more at TCM basics • TCM patterns .
Only the most common patterns in an anal abscess are described below. Other patterns are possible and multiple patterns may occur at the same time. Moreover, you do not need to have all of these symptoms to fall within a particular pattern. The pattern is determined by the overall picture of complaints.
Most common TCM patterns
Dampness-Heat and Toxic Heat
This is mainly a pattern of an acute anal abscess. Within TCM, a strong local accumulation of Heat and Dampness is seen as a situation in which normal flow is hindered and swelling and pus can occur. In severe acute inflammation is talked about toxic Heat.
Common symptoms: a sudden onset, painful and swollen area around the anus, redness, warmth and throbbing pain. Pus may develop. A deeper or more severe abscess may also prevent fever, chills, nausea, decreased appetite and general feeling sick. Constipation and dark or concentrated urine may also be present.
Examples of Western disorders: acute perianal or anorectal abscess.
If an acute anal abscess is suspected, conventional medical assessment is necessary. Especially fever, increasing pain, rapid swelling or a clear feeling of illness require prompt assessment.
Qi and Blood deficiency with a residual pathogenic factor
This pattern occurs especially in chronic or slow healing abscesses. According to TCM, the body does not have enough Qi and Blood to complete the recovery completely. Therefore, a remainder of the original inflammation may remain present.
Common symptoms: prolonged or recurrent abscess with low redness or pain, mild swelling and sometimes thin or aqueous secretion. In addition, fatigue, weakness, low appetite, spontaneous sweating and loose stools can be avoided.
Examples of Western disorders: chronic or recurrent anal abscess and prolonged wound healing after an abscess.
When an abscess persists or recurs, medical assessment is important because of the possibility of a fistula.
Yin-deficiency with residual Dampness or Heat
With this chronic pattern, the nourishing and moistening functions called within TCM Yin are weakened, while at the same time a remainder of Dampness or Heat remains present. As a result, inflammation can remain dormant for a long time.
Common symptoms: chronic abscess with mild swelling, warmth or pain and sometimes recurrent watery or punctual discharge. In addition, night sweats, afternoon or evening heat, restless sleep, dry mouth or throat and tendency to constipation may occur.
Examples of Western disorders: prolonged or recurrent anorectal abscesses.
This pattern is particularly apparent when a complaint exists for a long time and in addition to local inflammatory symptoms there are clear general signs of dryness and relative heat.
Yang-deficiency with Cold
This is a chronic pattern in which TCM does not provide sufficient heating and activating force. This allows moisture to accumulate and recovery can be slow. The local image is usually much less inflamed than at Dampness-Heat.
Common symptoms: prolonged, firm swelling without obvious redness or warmth and often little pain. In addition, crookedness, cold hands and feet and sometimes more frequent urination or nocturnal urination can occur.
Examples of Western disorders: chronic, slow-healing anorectal abscesses.
A little painful abscess is not automatically innocent. Also a deeper abscess can give relatively few external phenomena and needs to be assessed regularly.
Outlook
The prognosis strongly depends on the location and depth of the abscess and on whether a fistula or other underlying condition is present. An acute abscess requires regular medical treatment in the first instance; if drainage is necessary, it cannot be replaced by acupuncture or herbs.
In supplementary treatment, the course of treatment depends on the severity, duration and underlying TCM pattern. Chronic or recurrent symptoms may require a longer course, including factors that may maintain recovery.
If an abscess is re-emerging after treatment or prolonged pus or fluid continues to emerge from an opening, further research into an anal fistula is important.
When to contact a doctor?
Always have a possible anal abscess medically evaluated. In particular, contact a doctor immediately if:
- severe or rapidly increasing pain and swelling;
- fever, chills or feeling clearly ill;
- pus or persistent secretion;
- an abscess that does not heal or keeps coming back;
- symptoms that re-emerge after drainage.
In the case of diabetes, reduced defences or use of anti-depressant medication, special caution is important.
Contact
Do you have an anal abscess or recurrent symptoms after a previous abscess and do you want to know whether acupuncture or Chinese herbal medicine can be of additional benefit to you? Please feel free to contact us. The intake will look at your complaints, medical treatment and the underlying pattern according to Chinese medicine. In an acute abscess, conventional medical assessment and treatment are always paramount.