Anal Abscess

Anal abscess

An anal abscess is a painful, inflamed mass which fills with pus. An anal abscess happens when one of your internal anal gland becomes clogged. The mass then becomes infected from bacteria in the anal canal stool. Anal abscesses most often form alongside the anus.

It is likely your doctor will refer to your abscess as a perianal abscesses if the infection is around the anus. A diagnosis of perirectal abscess means your infection is around the rectum.

Symptoms of anal abscess

The symptoms of an anal abscess include:

• Severe, constant pain or pressure in the anal area ,worsening with bowel movements or sitting
• Area of redness and warmth to the touch beside the anus, has a boil-like appearance
• Fever or chills
• Feeling ill

In some cases the abscess will open on its own and the pus will drain.

Causes of anal abscesses

An anal abscess can have many different causes including:

• Infection of an anal fissure (a small tear in the skin of the anus)
• Blocked anal glands
• Other risk factors for anal abscesses include:
• Inflammatory bowel disease such as Crohn's or Ulcerative colitis
• Other types of colitis or diverticulitis
• Diabetes
• Poor immune system or use of medications that suppress the immune system
• Pelvic Inflammatory Disease

Treatment for anal abscess

The abscess, if it has not opened on its own, needs to be opened, allowing the infection to drain. Your doctor will cut a small hole in the skin over the abscess to help the pus drain. You can have this done in a doctor’s office.

But if you have a large or deep abscess, treatment is more complex. Your doctor might recommend a surgical procedure in a hospital setting. You will likely be under anesthesia for the surgery.

After opening and draining the abscess, you may have an open wound. You will need the wound to heal naturally. Closing the skin over the infection will cause the infection to come back. Your doctor will give you specific instructions to take care of your open wound.

Post surgery care

Your doctor will have specific instructions for you, but often they include:

• Take “sitz” baths – This is a shallow, warm bath that helps clean and heal the anal area. Take them 3-4 a day (and after bowel movements) for 15-20 minutes each. You can buy a sitz bath tub over the counter at any pharmacy, or fill your bathtub with 2-3 inches of water.
• Use a hand-held shower to gently spray the anal area to cleanse it at least daily. It is important to keep the area clean and dry as it heals.
• Avoid creams or ointments on the anal area unless instructed otherwise.

It is important that you follow up with a surgeon about 6-8 weeks after you have an abscess drained. During this visit, your doctor will check to see if you have an anal fistula. If you have an anal fistula as well, this will need treatment. Treatment will prevent abscesses from occurring in the future.