How and how to treat paraproctitis - subcutaneous, chronic, purulent

In 20% of cases, the cause of contacting a proctologist is purulent paraproctitis. It is an inflammatory process in the rectum, accompanied by subcutaneous abscesses, purulent discharge, painful sensations. The disease poses a threat to the body, with it often fistulas appear. If paraproctitis appears: treatment should be timely. We will examine in more detail what tools and methods are used to eliminate such a pathology.

Paraproctitis - what is it?

Paraproctitis is a tumor - a purulent abscess, which, due to various factors, occurs on the area of ​​pararectal tissue or other tissues located around the rectum (see photo: a - subcutaneous, b - ischiorectal, c - pelviorectal, d - submucosal).

The disease can occur in acute and chronic form. Acute paraproctitis is a disease that is diagnosed by a doctor for the first time. Chronic paraproctitis is a relapse of acute paraproctitis.

In the acute form of the disease, the patient may feel relief at the time of the opening of the purulent abscess - in this case, unpleasant discharge (pus, throat) will be observed from the anus. However, this entails a complication - the appearance of an opening (fistula), which requires surgical intervention.

Knowing the causes and conditions for the appearance of paraproctitis will help to avoid treatment and get timely help. The main factor causing purulent paraproctitis is infection. The causative agents that contribute to the infection of the tissues of the anus are anaerobic flora, Escherichia coli, and others. In general, tissue infection occurs due to constipation and hemorrhoids, accompanied by the appearance of cracks on the walls of the rectum or wounds. Through them, the infection also enters the body.

The focus of an infectious infection can be the mucous membrane of the anal gland, which has crypts - depressions that become inflamed due to exposure to pathogens. Later, the infection passes to the gland itself and to the subcutaneous tissue. Paraproctitis can also be caused by postoperative or accidental injuries of the anus, proctitis, and diabetes.

For more information about paraproctitis, the causes of its occurrence and surgical measures for treating the disease, see the video:

Symptoms and signs

Purulent paraproctitis appears sharply and requires immediate treatment. If you find any pathological symptoms, contact a proctologist who will help cope with the disease. Signs of paraproctitis:

  • Intoxication - high fever, general weakness, headache, loss of appetite, muscle aches.
  • The stool becomes hard, causing constipation. The patient has numerous inconclusive urge to defecate and pain during it.
  • The urethra is accompanied by pain.
  • The patient experiences acute pain in the lower abdomen, near the anus, in the small pelvis.

The localization of inflammation affects the symptoms of paraproctitis. For example, subcutaneous paraproctitis is characterized by redness, sitting pain, swelling, and seals in the anus.

Other species are more difficult to diagnose, as the process goes deeper in the subcutaneous tissues. Due to the general signs of intoxication, the patient perceives his condition as influenza, begins to be treated on his own, which entails a deterioration in the condition and complications. If general symptoms appear, it is important to consult a doctor who will diagnose, prescribe treatment, and undergo the necessary surgical intervention.

Forms of Paraproctitis

Paraproctitis has different clinical forms. Depending on them, the course of the disease will differ in symptoms, treatment, severity. There are acute, chronic, purulent, subcutaneous and ischiorectal paraproctitis.


The acute form of paraproctitis begins unexpectedly, has pronounced manifestations, differs only in the location of the focus of infection and the type of pathogen. The severity of the disease depends on the patient’s immunity. All common symptoms are present, but treatment is selected individually.

Chronic paraproctitis (fistulous form)

The chronic form of the disease is accompanied by the formation of a pathological passage, which begins in the rectum, ends on the skin of the anus. A fistula is formed after the abscess ruptures in the subcutaneous pararectal tissue, but mainly the pus "breaks" its way outward, forming an external opening. If the canal is well drained, the fluid exits, patients do not experience severe pain, but periods of remission are necessarily replaced by exacerbations.

This type of paraproctitis requires surgical treatment - dissection or excision of the resulting fistula.


With paraproctitis, a cavity filled with pus is formed. The patient experiences discomfort in the anus, there are intoxication, swelling, redness of the anal areas. The condition requires immediate treatment in order to prevent the appearance of a fistula, however, improper surgical measures, on the contrary, will only contribute to its formation.


Subcutaneous purulent paraproctitis is characterized by the localization of the abscess near the anus, under the skin of the perineum. Diagnosis is simple, thanks to the manifestations on the skin - swelling, the bulge of the place where the abscess is localized, redness.


The ischiorectal form of paraproctitis is diagnosed more difficult due to the fact that the abscess is at the level of the deep layer of subcutaneous pararectal tissue. During the illness, people themselves resort to improper treatment, taking the symptoms of paraproctitis as a respiratory infection.

Paraproctitis in children and infants - causes

Children's paraproctitis is a rare phenomenon, but does not have any special differences with adult disease. Its appearance is promoted by the disturbed microflora of the intestines of the child, an infectious infection, which, as a rule, occurs under external circumstances - wounds or skin irritations. Basically, the pathogenic process is caused by pathogens of staphylococci.

Surgical Treatment

Surgery is an effective treatment that helps get rid of paraproctitis. In this case, the surgeon opens up purulent inflammation, conducts drainage of the site, eliminates the focus of infection. Such a procedure cannot be performed under local anesthesia, therefore, general anesthesia or epidural analgesia is mainly used (drugs are injected into the epidural spine). If after the operation there is no deformation of the walls, and the fistula does not appear, the patient fully recovers.

Fistula itself occurs during the chronic form of paraproctitis. Therefore, treatment is carried out when the patient begins a period of remission and pain does not bother him. However, a long remission period of a chronic form may interfere with the operation - the fistulous course may "drag on." After treatment, the patient must follow preventive measures.

How to treat the disease - suppositories and antibiotics

Antibiotics (metronidazole, amikacin, gentamicin, etc.) are not an obligatory part of treatment - antibacterial agents are more often prescribed. There are times when you need to use them:

  • The moment after surgery, when the final analysis of the patient’s condition was carried out.
  • After excision of the fistula in the chronic form of the disease.
  • When the patient remains elevated body temperature.

Supportive therapy with the help of suppositories (antibacterial, healing, with antibiotics) is used in treatment when:

  • The patient goes through the postoperative period for prophylaxis.
  • To relieve symptoms if surgery is not possible.
  • During the treatment of chronic purulent paraproctitis in children who are under the age of one.
  • The presence of hemorrhoids, cracks (candles will help heal micro-wounds).

Treatment of paraproctitis with folk remedies, without surgery

Folk remedies will help to cope with severe symptoms, contribute to healing, but we must remember that surgical treatment is always necessary in the treatment of purulent paraproctitis. Useful folk remedies used to relieve symptoms are easy to prepare at home:

  • Microclysters. Their application requires safety precautions - you need to use pears with a rubber tip lubricated with oil. The tip should be inserted carefully so as not to cause additional irritation. Before an microclyster, as a rule, they put a usual enema so that the substances act better. As a filler, calendula tincture, honey diluted in 100 ml of water (a course of two weeks) is suitable.
  • Mummy. Ten tablets of the product must be dissolved in a glass of water, filtered. Fill the basin with five liters of warm water, add the mixture, take a bath for 15 minutes.
  • Badger fat. Tampons with fat at night are inserted into the anus.
  • Rowan. Squeeze out half a glass of juice from berries for a day, take 3 times before meals. A compress of squeezed fresh berries is applied to the anus.
  • St. John's wort will help with purulent paraproctitis. It is necessary to boil water, fill up 3 tablespoons of St. John's wort, cook for 15 minutes. Then strain the infusion, and put the hot grass on a rag or cellophane and sit on top of it with the affected area. Sit until it cools. After such treatment, pus will begin to go out on its own.

Diet and disease prevention

Simple preventive measures will make it possible to avoid the appearance of paraproctitis, you must carefully consider the diseases that cause it - hemorrhoids, diabetes, colitis, constipation. Necessary:

  • take vitamins to strengthen immunity;
  • avoid local and general hypothermia;
  • follow a diet, eat foods that do not cause constipation, do not irritate the rectal mucosa;
  • Do not neglect intimate hygiene.

Video: Paraproctitis Removal Surgery

The video below shows how to treat chronic paraproctitis by the surgical method of excising the resulting fistula:

Paraproctitis is a disease that can cause serious complications. Be attentive to the emerging symptoms of the disease. If available, consult a doctor immediately.

If you have experience treating paraproctitis, leave a comment at the bottom of the page.

Attention! The information presented in the article is for guidance only. Materials of the article do not call for independent treatment. Only a qualified doctor can make a diagnosis and give recommendations for treatment based on the individual characteristics of a particular patient.

Watch the video: Anal Fistulas Lecture for USMLE Step 2 (February 2020).