Which is more serious, anal abscess or anal fissure?

Perianal abscess and anal fissure both have their own severity, and perianal abscess is often more serious than anal fissure and needs to be treated first. If perianal abscess is not treated in time, it will cause pus to spread and even develop into a complex anal fistula; while anal fissure, although painful, is usually not life-threatening and can be relieved through self-care or medication. For perianal abscess, it is recommended to see a doctor as soon as possible, and for anal fissure, severe cases also require medical intervention. The following will analyze the differences and treatment methods of the two from the aspects of cause, symptoms and treatment to help everyone make the right choice.

1. Characteristics and treatment of perianal abscess

Perianal abscess is an inflammatory condition in which pus forms locally due to infection of the anal glands or perianal tissues. Its causes include anal gland infection, low immunity, trauma or constipation. The main symptoms are redness, swelling, heat, pain and tenderness around the anus. Some cases may experience symptoms of poisoning such as fever and fatigue. If the condition worsens, the bacterial infection may spread to nearby tissues or enter the blood, endangering life.

In terms of treatment, perianal abscesses usually require surgical drainage.

- Small abscess or early stage: The doctor can perform local incision and drainage to clean out the pus.

-Large abscesses: Deep drainage under local or general anesthesia can be used.

- Severe infection: Antibiotics, such as cephalosporins, are required before or after surgery. Sitz baths can be taken after surgery to reduce the risk of wound infection.

Early intervention is the key to controlling perianal abscesses. If severe local pain, lumps or fever occur, you should seek medical attention immediately without delay.

2. Characteristics and treatment of anal fissure

Anal fissures are tears in the skin or mucous membrane of the anal canal, mostly caused by hard, dry stools or excessive force. The main symptoms are severe stinging pain during defecation, accompanied by a small amount of bright red bleeding. The pain may last for several hours, causing great trouble to daily life. Compared with perianal abscesses, anal fissures are usually not accompanied by infection. For acute anal fissures, treatment is mainly self-care and medication; but chronic anal fissures have hardened the wound and may require surgical intervention.

Treatment options include:

-Self-care: Increase dietary fiber in the diet and keep bowel movements smooth; local hot water sitz baths twice a day for 10 minutes each time can effectively relieve pain and promote healing.

-Drug treatment: Topical ointments such as nitroglycerin ointment can improve local blood circulation and promote healing; lidocaine ointment can also be used to relieve pain.

-Chronic anal fissure: If conservative treatment is ineffective, surgery such as internal sphincterotomy can be performed to improve anal pressure and promote wound recovery.

Compared with perianal abscesses, anal fissures usually develop slowly and can be improved with regular care. Patients who experience significant pain during defecation should try to avoid sitting for long periods of time and exerting force for long periods of time.

3. How to decide what to do?

Perianal abscesses are treated first because they may cause more serious infections, while anal fissures are mostly mild, with obvious symptoms but less harm. The common point between the two is that they are closely related to bowel habits. Prevention requires fundamental improvement of bowel habits, such as drinking more water, eating more fiber-rich vegetables and fruits, and exercising moderately.

Although the pain of anal fissures can easily cause anxiety, perianal abscesses may pose a greater threat to health and should not be taken lightly. If severe symptoms or repeated infections have occurred, appropriate measures should be taken in accordance with the above suggestions and medical treatment should be sought if necessary. A healthy lifestyle and early prevention and control are always the key to maintaining good health.