Anal Abscess

An anal abscess  is a painful condition in which a collection of pus develops near the anus. Most anal abscesses are a result of infection from small anal glands. The most common type of abscess is a perianal abscess. This often appears as a painful boil-like swelling near the anus. It may be red in color and warm to the touch. Anal abscesses located in deeper tissue are less common and may be less visible. Surgical incision and drainage is the most common treatment for all types of anal abscesses and is usually successful. About 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 site of the abscess and the skin. In some cases, an anal fistula causes persistent drainage. In other cases, where the outside of the tunnel opening closes, the result may be recurrent anal abscesses. Surgery is needed to cure almost all anal fistulas.

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

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

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.

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.

After abscess or fistula surgery, discomfort is usually mild and can be controlled with pain medications. People can expect to lose only a minimal amount of time from work or school.

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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The information contained in this post is for general information purposes only. The information is provided by "Anal Abscess "and while we endeavour to keep the information up to date.

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