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Q. Lump on my right side of anus healed on medication and now it has recurred on the left. What to do?

Answered by
Dr. Ajeet Kumar Lohana
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on May 27, 2020 and last reviewed on: Jun 06, 2020

Hello doctor,

Eight months before, I felt a small lump around the right side of my anus area, (before I had itching around the anus for several months). Later that lump became larger and painful in a week. I consulted a homeopathic doctor and he gave me medicines (Paeonia off Q, Acid muraticum, Acidum nitricum), I took that medicines, and the lump wound burst in three days. But that wound skin has not dried yet, and it still watery, it also feels itchy sometimes. Besides this issue, for a week I am feeling another small lump on the left side of my anus area, and I feel like sure it would become big and painful like the previous one. So I need your consultation to cure it forever. And these wounds appear externally around my anus.

#

Hello,

Welcome to icliniq.com.

It seems you have a perianal abscess. Perianal means around anus and abscess means collection of pus. It can be secondary to chronic itching and excoriation of the skin resulting in abscess formation. It can occur secondary to poor hygiene in and around the anal area. Since the one abscess is already burst, this will allow pus to drain and would heal itself. But the other evolving abscess would burst and lead to pain as you may be experiencing.

There was the simple explanation of your problem, sometimes there is a problem with the small or large bowel, a condition is called Crohn's disease, which causes inflammation of the small, large bowel as well as perianal area resulting in an abscess, anal fissure, and fistula. I can recommend you some antibiotics but urge you to see a gastroenterologist in nearby and let be examined by him thoroughly. Or you can send me pictures of the area which is painful and discharging pus, as I can guide you further on this.

For now take the following regimen for seven days, and come back to me to inform about improvement in your symptoms. We can then adjust medicine or add others if this does not work.


The Probable causes:

Perianal abscess. Crohn's disease

Investigations to be done:

Stool for fecal calprotectin. Complete blood count.

Differential diagnosis:

Crohn's disease.

Probable diagnosis:

Perianal abscess.

Treatment plan:

Tablet Metronidazole 400 mg thrice daily for seven days, capsule Cefixime 400 once daily for seven days. Half tub of warm water, add 5 ml of Dettol antiseptic, sit in the tub for 5 minutes three times daily for seven days. Maintain hygiene innthat area, regular removal of area, avoid long sitting on hard surfaces like table, chair or floor.

Regarding follow up:

Follow up in one week with tests and inform me about the improvement of symptoms.


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