HomeAnswersMedical Gastroenterologyperianal abscessI had constipation followed by a fissure in my perineal area. After a few weeks, it tunneled through my left buttock area, with pus discharge. What can this be?

How to manage pain caused by a perianal abscess?

Share

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At August 18, 2023
Reviewed AtAugust 18, 2023

Patient's Query

Hi doctor,

I had constipation for a few days, which led to a solid stool being passed, creating a small fissure inside. I did not think anything of it, but a few days later, the pain developed in my perineum area. I thought it was hemorrhoid, and I went to get a cream or medication for it. The medicine was not working. So I suspected it was not the right thing. I went to a specialist who did a physical assessment and told me it was an abscess, and the only solution was surgery. I did not want to pursue surgery, so they gave me antibiotics. I took them, but the abscess never went away completely. A few weeks later, it tunneled out, and a pimple-like area appeared about an inch to the left on my left buttock area. It has almost healed, followed by a week of swelling and slight pus discharge. Two months after it broke through my skin, I passed a black seed through the small hole opening. Two weeks ago, I saw another dark object surfacing toward the hole, and once it was close enough to grab with tweezers, I pulled it out. It was the shell of a seed. How can I heal this naturally? Since I have passed two seed-like objects through this hole, can I soon expect to have this healed? Please help.

Thank you.

Hi,

Welcome to icliniq.com.

I understand your concern.

Your history is suggestive of perianal abscess or fistula. According to me, it is more like a fistula-in-ano. It usually improves with antibiotics but if it is recurring, it may need surgery. A natural way of helping out is that your stools should be soft, so you must add more fiber to your food. I suggest you clean the wound with antiseptics daily.

I hope this information will help you If you have any further queries you can get back to me anytime.

Thank you.

Differential diagnosis

The differential diagnosis is Peri anal abscess.

Probable diagnosis

The probable diagnosis is fistula in ano.

Treatment plan

I suggest you take tablet Ciprofloxacin 500 mg twice daily for one week, tablet Metronidazole 400 mg thrice daily for one week, and Ispaghula husk (Arabinose) in one glass of water.

Patient's Query

Hi doctor,

Thank you for the reply.

Are these antibiotics specifically to treat this particular issue? And are they both needed or can I take one of the two?

Thank you.

Hi,

Welcome back to icliniq.com.

I understand your concern.

You need to take both antibiotics, as these are in combination, which will increase the chances of healing. Both of them are used specifically for this issue. Consult your doctor and take medicines accordingly.

I hope this information will help you.

Thank you.

Patient's Query

Hi doctor,

Thank you for the reply.

I am allergic to Penicillin. Is there anything else you can recommend?

Thank you.

Hi,

Welcome back to icliniq.com.

You can use it, as none of these is Penicillin, and neither has cross-reaction. It can be used safely..

Please revert in case of more queries.

Thank you.

Patient's Query

Hi doctor,

Thanks for your reply.

Can I take the medicines at the same time? Or should I space them out from each other?

Thank you.

Hi,

Welcome back to icliniq.com.

I understand your concern.

You can take these medicines at the same time. There is no problem with it.

Please revert in case of further queries.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Mian Shah Yousaf
Dr. Mian Shah Yousaf

Medical Gastroenterology

Community Banner Mobile
By subscribing, I agree to iCliniq's Terms & Privacy Policy.

Ask your health query to a doctor online

Medical Gastroenterology

*guaranteed answer within 4 hours

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.

This website uses cookies to ensure you get the best experience on our website. iCliniq privacy policy