What You Must Know about Anal Abscess

Anal Abscess refers to the condition characterized by an accumulation of pus near the anal area. This condition is often a result of infection from the small anal glands.

Perianal Abscess
The most common form is the perianal abscess, which looks like boils near the anus. The boil-like swellings are red and tender.

Perirectal Abscess
Perirectal abscess, which is located in the deeper tissue, is rare and less visible.


• Common Treatment
The most common treatments for all types of this disease are surgical incision and drainage.

• Anal Fistula, The Complication
It’s important to remember however that a complication called anal fistula happens for about 50 percent of patients who undergo surgery and drainage. This complication refers to a small abnormal tunnel connection between the site of the abscess and the skin. Anal fistula may also be treated with surgery.

What Are The Causes?
Anal abscess may be caused by:
– blocked anal glands
– infection of the anal fissure
– sexually transmitted infections
– small superficial tear that can be found in the anal canal skin

Risk Factors
Factors that increase the risk of this condition include:
– colitis
– diabetes
– anal sex
– diverticulitis
– pelvic inflammatory disease
– use of medications like prednisone
– inflammatory bowel disease like ulcerative colitis or Crohn’s disease

What Are The Symptoms?
Anal abscesses located in the outer surface have symptoms like:
– constipation
– discharge of pus
– pain during bowel movements
– constant throbbing pain that worsens when the person is sitting down
– skin irritation in the anus such as redness, tenderness and swelling

Those located in the deeper tissues cause less pain but have other symptoms like:
– fever
– chills
– malaise

Sometimes, fever is the only symptom of deep anal abscess.

How Is This Condition Diagnosed?
• Clinical evaluation that includes a digital rectal exam is needed to diagnose anal abscess.

• In some cases, additional tests are necessary for the screening of other problems like:
– rectal cancer
– diverticular disease
– inflammatory bowel disease
– sexually transmitted disease

• Other tests, although rarely needed, are rarely needed are:
– CT scan
– ultrasound

How Is Anal Abscess Treated?

• Immediate Drainage
Immediate surgical drainage is necessary. It’s ideal to do that before the abscess erupts. Superficial types can be drained in the doctor’s clinic with local anesthesia.

• Anal Abscess Surgery
For those types that are larger and deeper, hospitalization and assistance of an anesthesiologist may be required. After the procedure, the doctor will prescribe medications for pain relief. Antibiotics may also be prescribed for those who have decreased immunity or diabetes.

• Anal Fistula Surgery
In some cases, the fistula surgery is performed at the same time the abscess surgery is done. But since some fistulas don’t develop after months or years, this may not always be an option for some patients. Fistula surgery may be performed as an outpatient basis. It may also be done with a short stay in the hospital.

Complications After Surgery
– scarring
– infection
– anal fissure
– recurrence of abscess

Can Anal Abscess Be Prevented?
• Use of condoms during sexual intercourse particularly during anal intercourse can help prevent this condition.

• Frequent diaper changes and proper cleaning of the anus is recommended for babies and toddlers to prevent anal fissures as well as perianal abscesses.

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