You have either a perianal abscess, an infection that began in a mucous-secreting gland in the anal canal around your anus, or a pilonidal abscess, an infection in a hair follicle trapped under the skin overlying the tailbone. In either case, you did nothing to cause the infection, and you could have done nothing to prevent its development.

Drainage is the recommended treatment. First, the doctor injects a local anesthetic around the abscess to allow the drainage to be as painless as possible. An incision is made into the abscess to drain the pus. A portion of skin and fat is removed to allow drainage while your body heals the abscess. A gauze dressing is then applied. In addition to drainage, antibiotics are sometimes given to diabetics, patients with artificial heart valves or joints, or those who have decreased immunities.

Symptoms and Care:
You will have some pain after the local anesthetic wears off. It may be moderately strong. Your doctor may prescribe something for you. Do not take aspirin or products containing aspirin for at least seven days as they promote bleeding. You may take acetaminophen (Tylenol®) or ibuprofen. It takes a minimum of two to four weeks for the wound to heal. Don't worry if some bleeding, discharge, pus, or itching occurs during this time; it is part of the normal healing process. You may apply gauze, cotton dressings, or minipads to the wound as needed. Anal hygiene is important. Take a bath or shower at least twice a day. (A hand-held sprayer is helpful if you are taking a shower.) You have been asked to return to the office in 7 to 14 days for a check-up. Most patients with perianal abscesses will not need further drainage, but some will develop a fistula, a drainage tract from the anal canal to the skin, and surgery may be necessary. Pilonidal abscesses may recur, possibly requiring further surgery.

Diet:
It is important to keep your bowel movements soft and regular. Eat foods high in fiber and drink plenty of water (6-8 glasses a day). If you are constipated, take a fiber supplement such as Metamucil®, Konsyl-D®, Citrucel®, Effersyllium®, or Hydrocil®. Prune juice or small doses of milk of magnesia may also be used.

Activity:
Avoid strenuous activity for the rest of the day. Tomorrow you may go back to your normal activities.

If you need a refill for a pain medication, you must call your doctor during normal business hours. Our policy is that we do not refill pain medication prescriptions after hours or on weekends because your chart is not available. The doctor on call is not allowed to refill your prescription.

If any of the following problems occur, please call our office and speak with a nurse who will help you with your problem, or have the doctor call you.

• Excessive pain unrelieved by your pain medication
• Increasing pain several days after treatment
• Fever or chills
• Difficulty urinating
• Severe bleeding that won't stop with direct pressure using Kleenex or gauze
• Constipation (no bowel movement for three days)
• Diarrhea (more than three watery bowel movements within 24 hours)
• Nausea or vomiting

If your own doctor is unavailable, the doctor on call is available 24 hours a day, every day of the year. After hours, call any of our offices and the answering service will locate one of our doctors on call. In an emergency try to contact us for advice before you go to the hospital. A telephone call may save you a lot of time, discomfort, and expense.