Manual on meat inspection for developing countries
Anal Abscess
An anal abscess is a painful, pus-filled lesion that forms in or near your anus, rectum, or the area between your genitals and anus. Depending upon its cause, location, and your doctor's choice of terminology, your condition may also be referred to as an:
Almost 90% of all anal abscesses are caused by blocked glands that become infected. The most common type of anal abscess is a perianal abscess, which typically appears as a painful swelling near the opening of your anus (the section at the end of your digestive tract where poop leaves your body). A perianal abscess may be red and feel warm when touched.
Perirectal abscesses are located inside the rectum (the section where poop is held in your digestive tract before it passes through the anus). This type of abscess is less common and often associated with inflammatory bowel diseases (IBDs), such as Crohn's disease.
Surgical incision and drainage is the most common treatment for all types of anal abscesses and is usually successful.
Perianal abscess vs. Anal fistula
As much as 50% of patients with an anal abscess will develop a complication called a fistula. A fistula is a small tunnel that makes an abnormal connection between the inside of your anus and your skin.
Fistulas usually develop when anal glands become infected. Your body creates the fistula as a way to drain pus from the infection. Pus-filled anal abscesses that result from infected anal glands cause 75% of anal fistulas.
Symptoms of anal fistulas include pain, swelling, itching, and redness around the anus. In some cases, fluids — including pus, poop, and blood — may drain from the fistula opening in your skin. In other cases, the opening of the fistula to the skin can become blocked. This may lead to recurrent anal abscesses.
Most fistulas need to be treated surgically. Fistulas can develop before or after an abscess is treated.
Anal abscesses have many different causes. These include:
Risk factors for anal abscess
Risk factors for anal abscesses include:
Symptoms of superficial perianal abscesses can include:
Deeper anorectal abscesses may not be as painful as superficial abscesses and are not externally visible. But they can cause:
Hemorrhoids and abscesses can develop in the same general area of your body. They can both be painful, itchy, and sensitive to the touch. But they are very different conditions.
Unlike abscesses, hemorrhoids aren't infections. They're veins, similar to varicose veins, that have become swollen and twisted.
There are two types of hemorrhoids:
How can you tell if you have an abscess or hemorrhoid? While an anal abscess will feel raised, fluid-filled, and warm to the touch, hemorrhoids appear as purplish, solid bumps. Since hemorrhoids aren't infections, they don't cause fever and chills like an abscess might.
Treatment options for hemorrhoids and abscesses are also very different. In most cases, hemorrhoids go away on their own, often with the help of simple treatments, such as warm compresses and over-the-counter ointments. Abscesses, on the other hand, usually need to be surgically drained by a doctor.
Usually, a primary care doctor or specialist can diagnose an anal abscess by doing a clinical evaluation.
During your visit, your practitioner will ask about your symptoms, take a health history, and visually examine your external anal area. They will also probably do a digital rectal exam, which involves inserting a lubricated, gloved finger into your anus and rectum to check for abnormalities.
In some cases, a doctor may want to do a more comprehensive rectal exam in an operating room with anesthesia. They may also perform or order additional testing to better understand your condition or to screen for other health issues such as sexually transmitted diseases, rectal cancer, IBD, and diverticular disease.
These procedures may include:
Anoscopy. A lighted device called an anoscope is gently inserted and then expanded inside the rectum, allowing for a clear and broad view of the area. You might feel some pressure during the procedure, and if your doctor chooses to take a small piece of tissue for examination (a biopsy), you may feel a brief, sharp pinch.
Ultrasound, CT scan, or MRI. These imaging studies are sometimes used by doctors to diagnose deeper abscesses and to visualize fistula tunnels.
Proctosigmoidoscopy. This test involves inserting a flexible tube with a light and camera into the rectum and anus. Your doctor may do it to find the source of bleeding and to rule out other health issues, such as cancer.
Colonoscopy. Using a flexible tube with a camera and light on one end, a physician can examine your large intestine. This procedure would likely be done to assess or screen for other conditions, such as IBD.
It's important to see a doctor if you think you might have an anal abscess. In most cases, they will want to drain the abscess surgically.
If your doctor, however, recommends that you first try treating the abscess at home, the following measures might help. They can also ease some of your discomfort as you await an appointment to have your abscess drained. (Under any circumstances, don't try to drain the abscess yourself, as this could risk infection and serious injury.)
Warm compresses. Soak a small, clean towel with warm water. Apply the compress to the abscess for 15-20 minutes, two or three times a day or as needed.
Sitz baths. A sitz bath is a warm, shallow soak for your buttocks and genitals. It can be very soothing and help heal anal abscesses and other conditions in this area of your body, such as fistulas and hemorrhoids. You can buy a sitz bath kit that can be fitted to your toilet. You can also take a shallow soak in a very clean bathtub. Some doctors recommend taking a sitz bath after each bowel movement or at least two to three times a day when you have an anal abscess.
Careful post-rupture wound care. If your abscess ruptures, you can develop a worse or new infection. To minimize this risk, gently clean the area with soap and water, cover the wound with a bandage, and change your bandages regularly. Watch your wound carefully, and if you see any signs of infection, call your doctor.
Surgical drainage
In most cases, prompt surgical drainage, ideally before your abscess erupts, is the go-to treatment for an anal abscess. Doctors can usually drain superficial anal abscesses in their office using a local anesthetic. Large or deeper anal abscesses may require hospitalization and the help of an anesthesiologist.
In all likelihood, your drainage incision won't need stitches. Bandaging may not even be necessary or advantageous. In certain cases, such as when abscesses are very large, doctors may place a catheter at the wound site so it can drain continuously.
After abscess or fistula surgery, your discomfort should be mild and you can expect to lose only a minimal amount of time at work or school.
The following can help ease any discomfort you might have and encourage healing during your recovery:
Pain medication. Depending upon the type of procedure you've had, your doctor might want you to have prescription pain medication or simply recommend over-the-counter analgesics such as acetaminophen. If you have very little discomfort, you might not need to take anything.
Antibiotics. If an abscess is particularly large or if you have a preexisting health issue such as diabetes or decreased immunity, your doctor might prescribe antibiotics to guard against an infection. Be sure to take the entire course of these drugs, even if you feel fine and are pain-free.
Laxatives. Bowel movements may be uncomfortable during the healing process. Your doctor might recommend that you take a laxative, which will soften your stool and make it easier to go to the bathroom.
Sitz baths. Sitting in a shallow tub of clean warm water several times a day can be very soothing, help keep the surgical site clean, and can encourage healing. Commercially sold sitz bath kits can be fitted to your toilet. You can also take a shallow soak in a clean bathtub.
Will perianal abscess go away on its own?
In the vast majority of cases, anal abscesses need to be surgically drained to heal properly and safely. However, in rare circumstances, an abscess may heal without surgical drainage.
Whatever the case may be, the decision isn't one to make on your own. It's important to see a doctor as soon as you have symptoms since improperly managed abscesses can lead to dangerous and even life-threatening infections.
Once they do an examination, your doctor can determine what the safest and most effective course of treatment will be for you.
Without prompt treatment, an anal abscess can lead to complications, which can be severe. These include:
Surgical incision and drainage of anal abscesses is often successful. Like most procedures, however, complications are possible. These include:
Infection/sepsis. This is a particular risk for patients with compromised immune systems
Anal fistula. About 40% of patients develop an anal fistula after their abscess is drained, especially within the first year of the procedure. The fistula can then cause recurrent abscesses, so surgery to remove the fistula is necessary. If a fistula is detected at the outset, the fistula will be removed at the same time the abscess is drained. Fistula surgery is typically done in a hospital setting.
Abscess recurrence. It's not uncommon for an abscess to return after it has been drained. This is often due to the formation of an anal fistula. For this and other reasons, it's important to schedule and keep follow-up doctor appointments.
Anal fissures. These are small, painful tears or cuts in the skin around the anus.
Damage or trauma to anal nerves. This is rare but can result in fecal incontinence.
Scarring. The incision may lead to scarring in the area around the anus.
An anal abscess, sometimes called an anorectal abscess, is a painful pus-filled pocket that forms under the skin in or near your anus or rectum. About half of people with an anal abscess also develop an anal fistula, which is an abnormal tunnel that drains pus from the inside of your anus to the skin. It's important to see a doctor if you have pain or leakage in your anal area because abscesses rarely go away on their own and can lead to serious infections and other complications. Surgical incision and drainage is the best way to treat anal abscesses in most cases and is usually successful.
How does a perianal abscess go away?
In most cases, perianal abscesses don't go away on their own. They usually must be surgically drained by a doctor.
Is it a fistula or an abscess?
An anal abscess is a tender lump in or near the anus or rectum that you can often see or feel with your fingers. A fistula is an abnormal tunnel that forms between an abscess inside your anus or rectum and the skin near your anus. If you are feeling or looking for something, you will probably not easily feel or see a fistula "hole." You may, however, be in pain and notice that you seem to be "leaking" pus, blood, or poop. In many cases, you could be dealing with both an abscess and a fistula, as they often occur together.
What is the difference between a pilonidal sinus and a perianal abscess?
An anal abscess is a painful pus-filled lump that forms under the skin near your anus or rectum. A pilonidal sinus is a small, abnormal opening inside your butt cheeks. When the sinus becomes infected, it will form a painful cyst that is typically filled with pus, hair, and dead skin.
FAST FACTS ABOUT STD'S
FAST FACTS ABOUT STD'SFAST FACTS ABOUT STD'S
(You may also want to check out Unspeakable.Com's STD Clinic Locator)
Human Immunodeficiency Virus (HIV)What It Is: The virus that causes Acquired Immunodeficiency Syndrome (AIDS). HIV works by attacking the body's immune system, leaving it susceptible to fatal infections and cancers.How You Can Get It: Through vaginal, oral, or anal sex. You can't get contract HIV from kissing, hugging, shaking hands, or even donating blood. You can, however, get it through using infected needles.Symptoms: You can be infected with HIV and have no symptoms; AIDS takes an average of 7-9 years to develop once HIV enters the body. Symptoms of AIDS, which are caused not by HIV but by the infections that take advantage of the body's weakened immune system, include rapid weight loss, chronic fever, diarrhea, fatigue, shortness of breath, difficulty swallowing, and nightsweats. These symptoms can last for weeks or months at a time, and will not go away without treatment. With that said, these are symptoms that are seen in many other diseases that are not AIDS-related, so don't panic and assume that one or more of these mean you have HIV or AIDS.Detect It: A blood test will determine whether or not you have HIV. The test can be done at an AIDS testing center, clinic, doctor's office, or even with a home test kit. You can request that testing be confidential.Is It Curable?: No. Contrary to popular belief, there is no cure yet for HIV/AIDS.Is It Treatable?: Yes, but not universally. Although there have been new developments in treatment over the last few years, and many patients' lives have been prolonged, different people respond to these medications in different ways. Treatment to slow HIV's attack on the immune system, which involves combining two classes of drugs, is complicated. The other major focus of HIV treatment is preventing and alleviating AIDS-related infections.Prevent It: Practicing safe sex. Until you trust your partner and know that she or he has been tested for HIV, use a latex condom.Where To Get Help: The CDC National AIDS Hotline, 1-800-342-AIDS; Planned Parenthood's clinic locator, 1-800-230-PLAN.
"HIV - Get Tested!" Week will take place from December 1-9, 2000 in Baltimore, Los Angeles, Miami, New York, and Washington, D.C. Visit www.HIVGetTested.Com for details on where to go for free, confidential testing and counseling.
HEPATITIS BWhat It Is: An infection of the liver causes by a virus which is 100 times more infectious than HIV. About 300,000 American contract hepatitis B every year. Although most people recover, some become chronic carriers of the disease. This means more problems down the road, such as liver cancer.How You Can Get It: Hepatitis B is spread like HIV: through contact with infected blood or bodily fluids. You can contract the virus through vaginal, oral, or anal sex.Symptoms: Poor appetite, vomiting, nausea, headaches, yellowing of the eyes and skin, dark urine, general fatigue. These usually show up within 2 to 6 weeks after infection. If you're a chronic carrier who has no symptoms, you can still pass it (unknowingly) to others.Detect It: If you are experiencing symptoms, or have had sexual contact with someone who has hepatitis B, you can get diagnosed through a blood test.Is It Curable?: Yes.Is It Treatable?: Treatment includes rest, diet, and medication. If your partner or anyone else you come in close contact with is diagnosed with the disease, you can get immunized.Prevent It: Practice safe sex by using a latex condom. To minimize your risk of getting hepatitis B, never share needles, syringes, or any instruments used for ear-piercing, tattooing, and hair removal. Don't share toothbrushes or razors either. If you find that you've contracted hepatitis B, avoid sex and other close contact (even kissing), until cleared by a doctor.Where To Get Help: The National STD hotline at 1-800-227-8922; Planned Parenthood's clinic locator, 1-800-230-PLAN.
GENITAL HERPESWhat It Is: A viral infection that often causes sores in the genital area. If these sores are open and exposed to body fluids that carry HIV (through sex with someone who has HIV), genital herpes increases the risk of contracting HIV. Once you contract herpes, you have it for life, along with the estimated 40 million people who also have it. Each year, about 500,000 new people get herpes, and even more who have it but experience no symptoms.How You Can Get It: By touching sores and blisters through vaginal, oral, or anal sex; you can also be exposed to the virus by kissing or caressing the infected areas. Areas where sores form are contagious for days before any visible symptoms break out.Symptoms: Small red bumps that turn into blisterlike sores on the genitals, rear end, thighs, fingers, mouths, etc. Women often experience vaginal discharge and/or burning. Other symptoms include fever, muscle aches, and headaches. All these pop up from between 2 to 20 days after sex with an infected partner. But here's the kicker: some people experience no symptoms.Detect It: A physical examination and/or a clinical test will determine whether you have herpes. The test involves collecting a small amount of fluid from a sore and sending it to a lab to see if the herpes virus is present.Is It Curable?: No.Is It Treatable?: Yes. Prescription antiviral drugs can reduce pain, length, and frequency of herpes outbreaks. The earlier you get treatment, the more effective it will be.Prevent It: Practicing safe sex. Limit the number of sex partners, use a condom all the time, and if you think you might be infected, don't hesitate to get tested.Where To Get Help: The National Herpes Hotline, 1-919-361-8486; The National STD hotline at 1-800-227-8922; Planned Parenthood's clinic locator, 1-800-230-PLAN.
CHLAMYDIAWhat It Is: A bacterial infection that can cause pelvic inflammatory disease (PID) and/or sterility if not treated in time. Chlamydia has the dubious honor of being the number one bacterial STD in the U.S. Today, with 4 million new cases every year. It's also known as a "silent epidemic" because 75% of the women and 50% of the men with the disease have no symptoms.How You Can Get It: Vaginal or anal sex.Symptoms: Others experience abnormal vaginal bleeding, whitish vaginal or penile discharge, painful or burning urination. Women may also experience lower abdominal pain, painful intercourse, and bleeding between periods. Men may have burning and itching around the opening of the penis and/or pain and swelling in the testicles.Detect It: With a test from a urine sample or a sample of fluid taken from the infected area.Is It Curable?: Yes.Is It Treatable?: Yes. Prescription antibiotics will do the trick. Douches, however, will not—and may cause someone to get treatment too late to keep the disease from spreading.Prevent It: Once again, safe sex is the solution. Approach sexual relationships responsibly, always use a condom, and avoid sexual contact until you can be tested and treated for chlamydia. If you find that you are infected, make sure your partner gets treated so that you won't get re-infected yourself.Where To Get Help: The National STD hotline at 1-800-227-8922; Planned Parenthood's clinic locator, 1-800-230-PLAN.
GONORRHEAWhat It Is: A bacterial infection in the vagina or cervix. If left untreated, it can spread to other parts of the body, such as the rectum, urethra, and uterus, potentially causing sterility. Occasionally, gonorrhea that goes without treatment can be fatal. About 1 million people in the U.S. Contract gonorrhea every year.How You Can Get It: Vaginal, oral, or anal sex.Symptoms: Some people have no symptoms; others experience a burning feeling during urination, frequent urination, vaginal or penile discharge, fever, stomach pain, nausea, backache, and painful intercourse. Women can also have bleeding in between periods; about half of the women with gonorrhea have no symptoms.Detect It: Gonorrhea is determined with a medical test in which a sample of fluid is taken from the penis or vagina, then sent to a lab for results.Is It Curable?: Yes.Is It Treatable?: Yes. Prescription antibiotics will kill the infecting bacteria. Treatment that's not completed can spell serious problems down the road, such as abdominal pain, sterility, tubal pregnancy, and painful joints. If you are being treated for gonorrhea, you must stop having sex until you're cured; the same goes for your partner. This will help you avoid getting reinfected or transmitting the disease to someone else.Prevent It: Approach your sexual relationships safely and responsibly: limit the number, always use a condom, and, if you think you may be infected, avoid sexual contact until you can get tested.Where To Get Help: The National STD hotline at 1-800-227-8922; Planned Parenthood's clinic locator, 1-800-230-PLAN.
SYPHILISWhat It Is: Syphilis can be very serious and actually result in death if left untreated. Like many other STD's, you can have syphilis without knowing it. About 120,000 new cases of syphilis get diagnosed in the U.S. Every year.How You Can Get It: Through oral, anal, or vaginal sex.Symptoms: The preliminary symptoms are often a painless sore around the vagina or penis, or inside the mouth or anus. Even if this sore disappeared on its own, the bacterial infection is still in the body. Later, you might develop flu-like symptoms, as well as potential hair loss and skin rashes. It's rare, but a third stage might develop years later as skin lesions, mental deterioration, loss of balance and vision, numbness, leg pain, and heart disease.Detect It: By getting a blood test; however, it takes 2 to 3 weeks after infection for the blood test to be accurate.Is It Curable?: Yes.Is It Treatable?: Yes, with antibiotic medication.Prevent It: Approach your sexual relationships safely and responsibly: limit the number, always use a condom, and, if you think you may be infected, avoid sexual contact until you can get tested.Where To Get Help: The National STD hotline at 1-800-227-8922; Planned Parenthood's clinic locator, 1-800-230-PLAN.
TRICHOMONIASISWhat It Is: "Trich" is an infection causes by the parasite Trichomonas vaginalis. It hits about 2 to 3 million Americans every year, and weakens the immune system, making an infected person more susceptible to HIV.How You Can Get It: Vaginal sex.Symptoms: Heavy greenish discharge with a foul odor, vaginal itching and/or burning, abdominal pain, frequent urination, painful intercourse. A woman's symptoms can get worse after her period. Most men with trich have no symptoms, but might have symptoms like unusual penile discharge, painful urination, and tingling inside the penis.Detect It: By getting a medical test in which a sample of fluid is taken from the penis or vagina, then sent to a lab for results.Is It Curable?: Yes.Is It Treatable?: Prescription antibiotics.Prevent It By: Practicing safe sex and knowing your partner's sexual history. Because Trichomonia can survive on objects such as sheets, towels, and clothing, it can potentially be transmitted by sharing these. Even though men with the disease are almost always without symptoms, it's extra-important that they be treated so they don't infect others.Where To Get Help: The National STD hotline at 1-800-227-8922; Planned Parenthood's clinic locator, 1-800-230-PLAN.
GENITAL HUMAN PAPILLOMAVIRUS (HPV)What It Is: A viral infection that causes genital warts; there are actually over 60 different types of this virus. About 40 million Americans are diagnosed with HPV, with 1 million new cases every year. If HPV goes too long without treatment, the risk of cervical cancer increases.How You Can Get It: Vaginal or anal intercourse; however, you can also contract HPV simply by touching the infected area.Symptoms: Warts on the genitals and anal area. A person may be infected and contagious with no visible warts. Either way, HPV can cause abnormal cell growth on the female cervix. Visible signs of HPV show up within 3 weeks to 6 months after having sex with someone who's infected.Detect It: A doctor can examine the potentially infected area for warts and other unusual tissue. Women can also have a Pap smear, which will detect changes to the cervix that may be caused by HPV.Is It Curable?: No.Is It Treatable?: The warts can be removed, but often return because the virus stays in the body. Your doctor can remove smaller warts, and severe cases can be treated with laser surgery.Prevent It: Condoms provide limited protection. The best way to reduce your risk of getting HPV is to limit your sexual partners. Women should have Pap smears every 6 months to screen for HPV.Where To Get Help: HPV Hotline at 1-877-HPV-5868; the National STD hotline at 1-800-227-8922; Planned Parenthood's clinic locator, 1-800-230-PLAN.
PUBIC LICE and SCABIES
What It Is: Pubic lice, also known as Crabs, are tiny insects that live on the skin. They infect the hairy parts of the body, and lay eggs on body hair. Scabies is the result of a tiny female insect, a mite, burrowing into a person's skin to lay eggs.How You Can Get It: Although these are often spread through sexual contact, you can also get them by using the same sheets, clothes, or towels as an infected person.Symptoms: Extreme itching in the genital areas. With pubic lice, you might see pinhead-sized insects or eggs on the skin or body hair. With scabies, a skin rash may develop.Detect It: A doctor's examination will determine whether you have pubic lice or scabies.Is It Curable?: Yes.Is It Treatable?: Yes, with shampoos, creams, and lotions that are often available without a prescription. Wash all infected clothing, sheets, etc. With very hot water.Prevent It: Know your partner's sexual history.Where To Get Help: The National STD hotline at 1-800-227-8922; Planned Parenthood's clinic locator, 1-800-230-PLAN.
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