Anorectal abscess surgery

Anorectal abscess surgery drains a pocket of pus that has built up in the anal or rectal area. The doctor will make a cut to open the abscess. The cut is called an incision. Then the doctor will clean out the abscess. The doctor may leave a piece of gauze packing in the incision to help it heal. Or the doctor may put a plastic tube in the abscess to help it drain.

Most people go home on the same day as the surgery. The pain that was caused by the abscess often gets better right after surgery. You may have some mild pain from the incision for several days. You will probably be able to go back to work and your normal activities within several days after your surgery. It may take about 3 to 8 weeks for the abscess to heal completely.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• You may need to empty your colon with an enema or laxative. Your doctor will tell you how to do this.
• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Activity

• Rest when you feel tired. Getting enough sleep will help you recover.
• Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
• Ask your doctor when you can drive again.
• Most people are able to return to work 1 or 2 days after surgery.
• You may shower. Let water run over the abscess area. This will help the abscess heal. Pat your anal area dry with a towel when you are done.

Diet

• You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
• Drink plenty of fluids (unless your doctor tells you not to).
• Eat a low-fiber diet for a couple days or as your doctor suggests. It is best to eat many small meals throughout the day. Add high-fiber foods a little at a time.
• You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

• Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Take pain medicines exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
• If you think your pain medicine is making you sick to your stomach:
  • Take your medicine after meals (unless your doctor has told you not to).
  • Ask your doctor for a different pain medicine.

Incision care

• Wash your anal area daily with warm, soapy water, and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.
• After a bowel movement, use a baby wipe or take a shower or sitz bath to gently clean the anal area.
• If your doctor put gauze in your abscess during surgery, follow his or her instructions about when to remove it.

Other instructions

• Place a maxi pad or gauze in your underwear to absorb drainage from your abscess while it heals.
• Sit in a few inches of warm water (sitz bath) for 15 to 20 minutes 3 times a day. Do this as long as you have pain in your anal area.
• Apply ice several times a day for 10 to 20 minutes at a time. Put a thin cloth between the ice and your skin.
• Support your feet with a small step stool when you sit on the toilet. This helps flex your hips and places your pelvis in a squatting position. This can make bowel movements easier after surgery.
• Try lying on your stomach with a pillow under your hips to decrease swelling.