How long does it take to know if it is an anal fistula after the perianal abscess is drained?

After the perianal abscess is drained, it usually takes about 4 to 6 weeks to confirm whether it has developed into an anal fistula, but the specific time will vary depending on the individual's recovery. If the wound fails to heal for a long time or there is continuous pus discharge, you should seek medical attention in time for a clear diagnosis and treatment. The basis for judging an anal fistula mainly includes the wound healing status, symptoms and further medical examinations.

1. Reasons why perianal abscess may turn into anal fistula

1. The infection is not completely controlled

The formation of perianal abscess is mainly due to local purulent inflammation caused by anal gland infection. If the infected lesion is not completely cleared after pus drainage, the continued reproduction of bacteria may further form fistulas, leading to the occurrence of anal fistulas.

Recommendation: After surgery, you must follow the doctor's instructions for strict anti-infection treatment, including the use of effective antibiotics (such as cephalosporins, quinolones or penicillins) and keeping the wound clean to avoid secondary infection and worsening of the condition.

2. Limited anatomy and healing ability

The special anatomical structure of the anal glands (similar to the blind end of the gland duct) may cause fistulas to form between the abscess cavity and the rectum or external skin. If the patient's own immunity is low or the wound recovery is slow and fails to heal successfully, anal fistulas are more likely to form.

Recommendation: Improving immunity is very important for recovery. You may want to supplement more protein-rich foods, such as fish, eggs, beans, and anti-inflammatory vitamin C sources, such as citrus and kiwifruit. You can use immune enhancers such as whey protein or Chinese herbal decoctions in moderation under the guidance of a doctor.

3. Misdiagnosis or incomplete drainage of abscess

In some patients, the root of the abscess is not fully cleaned during the initial examination and treatment, and the residual lesions may become the basis for the growth of fistulas. This situation is more common in patients with deep infection of the abscess cavity or incomplete treatment.

Recommendation: If incomplete pus drainage is suspected, the scope of the abscess cavity can be further clarified through anoscopy or B-ultrasound, and a secondary surgical cleanup can be performed if necessary.

2. How to determine whether anal fistula has formed

1. Wound healing observation

After the perianal abscess is drained, the wound will generally heal gradually within 1-2 weeks. If the wound continues to discharge pus, is repeatedly swollen and painful, or has a lumpy lump after 4 weeks, an anal fistula is likely to have formed and a follow-up visit is required.

2. Symptoms

Symptoms such as persistent increased secretions, recurrent perianal pain, and discomfort when having bowel movements or sitting for long periods of time may be typical manifestations of anal fistula.

3. Medical examination methods

Perianal MRI, angiography and anoscopy are important means to diagnose anal fistula. These examinations can determine the depth and course of the fistula and provide a basis for further surgery.

3. Treatment of anal fistula

If an anal fistula is diagnosed, the appropriate treatment plan should be selected based on the complexity of the fistula:

1. Simple fistulas can be treated with fistulotomy, which removes the entire fistula and opens it to the skin layer to promote inward healing of the wound.

2. Complex fistulas may require hanging thread therapy, where a rubber thread is inserted into the fistula to gradually tear the fistula until it closes, but the thread needs to be adjusted multiple times.

3. Minimally invasive surgery such as the LIFT method can reduce anal sphincter damage and is particularly effective for complex fistulas.

After the operation, continue to keep the anal area dry and clean, and carry out gentle pelvic floor exercises such as anal levator contractions to help blood circulation and wound healing.

4. Subsequent precautions

1. Adjust your diet, avoid spicy foods, and eat more fruits and vegetables rich in dietary fiber, such as celery and apples, to prevent constipation.

2. Clean after defecation and use warm salt water or commercially available mild disinfectant to clean the anus to prevent secondary infection.

3. Avoid sitting for long periods of time. Moderate activity can help improve local blood circulation.

Whether an anal fistula will form after the pus is drained from an anal abscess depends on multiple factors. Early detection and standardized treatment are the key to preventing the condition from worsening. If you are experiencing a wound that has not healed for a long time or symptoms recurring, be sure to consult a specialist as soon as possible without delay. While focusing on health, maintaining good living habits is the cornerstone of preventing anal diseases and keeping the body away from unnecessary trauma and pain.