Causes of Anal Abscesses
An anal abscess can have many different causes. These include:
- An anal fissure, a tear in the anal canal, that becomes infected
- Sexually transmitted infections
- Blocked anal glands
Risk factors for anal abscesses include:
- Colitis
- Inflammatory bowel disease such as Crohn’s disease or ulcerative colitis
- Diabetes
- Diverticulitis
- Pelvic inflammatory disease
- Being the receptive partner in anal sex
- Use of medications such as prednisone
Symptoms of Anal Abscesses
Superficial anal abscesses are often associated with:
- Pain, which is usually constant, throbbing, and worse when sitting down
- Skin irritation around the anus, including swelling, redness, and tenderness
- Discharge of pus
- Constipation or pain associated with bowel movements
Deeper anal abscesses may also be associated with:
- Fever
- Chills
- Malaise
Diagnosis of Anal Abscesses
Usually, a clinical evaluation — including a digital rectal exam — is sufficient to diagnose an anal abscess. But some patients may require additional tests to screen for:
- Sexually transmitted infections
- inflammatory bowel disease
- Diverticular disease
- Rectal cancer
In rare cases, an examination may be done under anesthesia. The doctor may also ask for an ultrasound, a CT scan, or an MRI.
Treatment of Anal Abscesses
Prompt surgical drainage is important, preferably before the abscess erupts. Superficial anal abscesses can be drained in a doctor’s office using a local anesthetic. Large or deeper anal abscesses may require hospitalization and the assistance of an anesthesiologist.
After the procedure, most people are prescribed medications for pain relief. For otherwise healthy people, antibiotics are usually not needed. Antibiotics may be required, though, for some people, including those with diabetes or decreased immunity.
Sometimes, fistula surgery can be performed at the same time as abscess surgery. However, fistulas often develop four to six weeks after an abscess is drained. Sometimes a fistula may not occur until months or even years later. So fistula surgery is usually a separate procedure that can be performed on an outpatient basis or with a short hospital stay.
Complications after surgery can include:
- Infection
- Anal fissure
- An abscess returning
- Scarring
After an anal abscess or fistula has properly healed, it’s unlikely that the problem will come back. To prevent one from doing so, however, it’s important to follow the advice of your doctor or colon and rectal surgeon.
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