Anal Abscess

(Anal Rectal Abscess; Anorectal Abscess)

Definition

An anal abscess is a pus-filled pocket located in the spaces around the anus and rectum. The abscess can be found near the surface of the anal opening or deeper in the rectum.

Causes    TOP

An anal abscess is caused by a bacterial infection. Infection may occur when there is a blockage in one or more of the anal glands that secrete mucous, or from an anal fistula.

The Anus

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Risk Factors    TOP

Anal absesses are more common in men. Other factors that may increase your chances of an anal abscess:

  • Certain conditions such as Crohn disease, ulcerative colitis, or sexually transmitted diseases
  • Medications that suppress the immune system
  • Pregnancy
  • Receptive anal intercourse
  • Diabetes

Symptoms    TOP

Symptoms depend on where the abscess is located. An anal abscess may cause:

  • Painful bowel movements
  • Pain and tenderness radiating from the location of the abscess if it is near the surface
  • Lower abdominal pain if it is located deeper in the rectum
  • Redness and swelling—visible with a surface abscess, also occurs in a deep abscess, but cannot be seen
  • Pus drainage
  • Fever

Complications of an anal abscess may include:

  • Anal fistula—abnormal channel between the rectum and the surface of the anal skin leading to the outside
  • Systemic sepsis—serious, life-threatening infection that spreads throughout the body
  • Stool incontinence

Diagnosis    TOP

Your doctor will ask about your symptoms and medical history. A physical exam will be done. An abscess near the surface of the skin may be visible. A deeper abcsess may require a digital rectal exam. The doctor will feel the inside of the anal canal for any abnormalities.

Imaging tests to look at anorectal structures are not usually needed, but may include:

Treatment    TOP

Surgical drainage is necessary to treat an anal abscess. The type of procedure depends on its location and depth. It is possible that you may have a drain in the wound for up to 3 weeks to help the healing process.

Medications

Antibiotics are generally not necessary, but your doctor may recommend them under certain circumstances, such as if a skin infection is also present. Other medications may include:

  • Over-the-counter or prescription pain medication
  • Stool softeners, fiber, or bulk laxatives

Prevention    TOP

To help reduce your chances of an anal abscess, properly manage any health conditions that increase your risk of infections.

RESOURCES:

American College of Gastroenterology
http://patients.gi.org
American Society of Colon and Rectal Surgeons
http://www.fascrs.org

CANADIAN RESOURCES:

Canadian Association of Gastroenterology
https://www.cag-acg.org
Canadian Society of Colon and Rectal Surgeons
http://cscrs.ca

References:

Anal rectal abscess and fistula. Hemorrhoid website. Available at:
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Accessed December 18, 2017.
Anal abscess and fistula expanded information. American Society of Colon and Rectal Surgeons website. Available at: https://www.fascrs.org/patients/disease-condition/abscess-and-fistula-expanded-information. Updated October 2012. Accessed December 18, 2017.
Anorectal abscess. Johns Hopkins Medicine website. Available at: https://www.hopkinsmedicine.org/healthlibrary/conditions/adult/digestive_disorders/anorectal_abscess_134,175. Accessed December 18, 2017.
Fistula in ano and anorectal abscess. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated October 11, 2017. Accessed December 18, 2017.
Last reviewed December 2017 by EBSCO Medical Review Board Michael Woods, MD, FAAP
Last Updated: 12/20/2014

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