ANAL ABSCESS

• Anal abscesses are the acute manifestation of a purulent infection in the perirectal area. It is a pus filled cavity that most commonly develops from an infected anal crypt gland following obstruction and bacterial overgrowth
• An anorectal abscess may heal spontaneously following drainage into the anal canal. In 40-50% cases, it progress into fistula
• Patients complain of painful swelling around the anus associated with discharge of pus occasionally and the pain increase on continuous sitting or during defecation

• Acute inflammation of anal gland
• Infection of a thrombosed external pile
• Injury to anorectum
• Extension of cutaneous boil
• Fissure in ano

Perianal Abscess

• Severe pain , throbbing in nature
• Perianal discomfort and pruritus
• Rectal examination – tender, boggy, swelling under the anal mucosa
• Complications: If untreated, perianal abscess may rupture into the canal, rupture to the exterior causing fistula-in-ano or may pass laterally through the external sphincter to form ischio-rectal abscess

Ischio rectal abscess

• Severe throbbing pain is characteristic
• Induration in the ischiorectal fossa
• Pain exacerbation with sitting and defecation
• High grade fever with chills and rigor
• Per Rectal examination- painful and bogginess can be appreciated on the side of the lesions

• Ultrasonography
• CT/ MRI - for deeper abscesses

• Incision and drainage of pus
• Followed by antibiotic cover

Ayurvedic Treatment

Internal medicines

• Guggulutikthaka Kashaya
• Trayantyadi Kashaya
• Nimbadi Kashaya
• Manjishtadi Kashaya
• Kaishora guggulu
• Triphala guggulu
• Gorochanadi Gutika
• Guggulu panchpala choorna
• Gandhaka Rasayana
• Avipathi Choorna – monthly Virechana (to reduce recurrence)
• Manibhadra guda

Procedure

• Avagaha - Kashaya of Tamarind leaves, Nalpamaradi Kashaya

On becoming pakwa

• Do vidarana ( I & D )
• Jathyadi Thaila (E/A)