Rectum and Anal Canal
Anal Abscess Facts
perirectal abscess is a collection of pus in the deep tissues
surrounding the anus.
- By contrast, a perianal
abscess is a shallower collection of pus under the skin surrounding the
anus; however, both are sometimes described as an anal abscess.
- Both types of abscesses need
immediate medical attention; however, a perirectal abscess usually is the
more severe infection.
- A delay in treatment may
cause serious worsening of the condition and unnecessary complications.
Anal Abscess Causes
and perianal abscesses are thought to develop from the glands surrounding the
anus; on occasion, perianal abscesses may develop from infected skin adjacent
to the anus. Glands may plug up, usually leading to bacterial infection. When
the glands fill with pus, they may burst inward, releasing their infected
contents into the spaces around the rectum and anus. This pus causes an
abscess, or pus collection, in the spaces surrounding the rectum or
anus. The anal abscess may enlarge, causing pain, fever, and
difficulty with bowel movements.
people are more likely to develop perirectal and perianal abscesses, including
those with the following medical conditions:
- AIDS or HIV infection
with low white blood cell counts
- Crohn’s disease
- Persons on medications that
suppress the body’s immune system, such
as steroids (prednisone, methylprednisolone), or those
undergoing chemotherapy for cancer
- Placement of foreign bodies
into the anus
- Sexually transmitted diseases
- anal fissures
Anal Abscess Symptoms
symptoms of perirectal and perianal abscesses include the following:
- Pain in the anal area
- Pus drainage near the anus
- A lump in the anal area
- Painful bowel movements
- Lower abdominal pain
- Swelling in the anal area or
- Night sweats
When to Seek Medical Care for an Anal Abscess
person suspects they have a perirectal or perianal abscess they should see a
healthcare professional. The diagnosis is not always easy to make, and the
healthcare professional may need to do tests or consult with specialists.
Go to an
emergency department when you have any of the following symptoms:
- High fever or shaking chills
- Significant rectal/anal pain
- Inability to have a bowel
movement, or a painful bowel movement
- Persistent vomiting
- Any other unusual signs or
symptoms that may indicate an emergency condition
Anal Abscess Diagnosis
healthcare professional will ask questions about the patient's condition. Give
the healthcare professional all necessary information. Discussing the details
may be embarrassing, but healthcare professionals and other medical personnel
are required to maintain confidentiality. Honest responses to the
healthcare professional's questions will help provide the patient faster
- The healthcare professional
will then examine the patient and should explain the parts of the exam may
be uncomfortable and will be careful to protect the patient’s modesty.
- The healthcare professional
should provide clear answers to any questions the patient asks; they
should understand the treatment plan.
- Sometimes the diagnosis is
obvious, and no tests are needed. At other times, blood and urine tests
and special imaging tests such as X-ray, CT scan, MRI,
and ultrasound may be needed. The healthcare professional may
also consult other specialists to confirm the diagnosis or to come up with
the best treatment plan.
- acetaminophen (Tylenol and
others), may help control the pain and fever.
- If the abscess opens by
itself there will be a release of pus, and possibly some relief of pain
and fever. Regardless, the abscess are still should be examined by a
- Even if the symptoms improve
with home care, the affected individual should seek medical attention.
Abscesses need to be evaluated and treated by a healthcare professional.
They rarely resolve on their own. Many people need further special
treatment, especially with perirectal abscesses, to avoid complications or
a return of the abscess.
Anal Abscess Medical Treatment
upon the severity of the abscess and any other medical problems, treatment may
be accomplished on an outpatient or inpatient basis. The treatment plan should
be explained to the patient in detail.
- Minor surgery may be
performed in the healthcare professional’s office or in the emergency
department using local anesthesia (an injection in the infected area), and
possibly IV sedation. Most patients are referred to a surgeon for
treatment of perirectal abscesses because the abscess may involve
additional structures or require more debridement that may not be apparent
until it is surgically explored. Patients should be able to go home when
they awake and will be given prescription pain medication for the first
few days with some uncomplicated abscesses.
- Alternatively, the surgery
may be done in the operating room by a surgeon using spinal anesthesia
(the patient is awake and numb from the waist down) or general anesthesia
(patient is ‘asleep’ under sedation). The hospital stay may be overnight
or several days.
- Admission to the hospital
may be required with an IV line for fluids, antibiotics, and pain
- Patients may need an update
of their tetanus booster, if this has not been done in the past
- Blood and other tests may
need to be repeated to evaluate the patient’s progress after treatment.
Anal Abscess Follow-up
may have pain for several days following surgery, but should improve over time.
- Patients may not
have stitches. Infected wounds such as abscesses are left
open to drain. If they were stitched shut they would just fill with pus
again. There may be packing left in the wound, which usually will be
removed by the healthcare professional after a few days.
- Patients may need to take an
antibiotic and pain medication for several days, depending on their
- Using stool softeners and
adhering to good hygiene, such as sitz baths after every bowel movement,
decreases the patient’s discomfort and helps recovery.