Anal/Rectal Abscess

Written by Carmella Wint and Matthew Solan | Published on July 18, 2012
Medically Reviewed by George Krucik, MD

Overview

An anal, or rectal, abscess occurs when a cavity in the anus becomes filled with pus. In addition to extreme pain, the abscess can cause fatigue, rectal discharge, and fever. In some cases, anal abscesses can result in painful anal fistulas. This occurs when the abscess fails to heal and breaks open on the surface of the skin. If an anal abscess does not heal properly, it can cause great pain and require surgery.

What Causes Anal Abscesses? Who Is At Risk?

Anal abscesses can be caused by a blocked anal gland, a sexually transmitted infection, or an infected anal fissure. Some other conditions or sexual activity that can put you at risk for anal abscesses are:

  • Crohn’s disease or ulcerative colitis—inflammatory bowel diseases that causes the body to attack healthy tissue
  • anal sex, which can increase the risk in both men and women
  • use of the medication prednisone
  • diabetes
  • a compromised immune system due to illnesses like HIV or AIDS
  • chemotherapy drugs

Toddlers or children that have had a history of anal fissures are also at a higher risk for developing anal abscesses later on.

What are the Symptoms?

A throbbing and constant pain in the anal area is probably one of the most common and immediately noticeable symptoms of a rectal or anal abscess. The pain is usually accompanied by swelling in the anal area and greater pain during bowel movements. Other common signs of an anal abscess are constipation, rectal discharge, and fatigue. Some sufferers may be able to feel a nodule or lump that is red, swollen, and tender at the rim of the anus. Fever and chills can result from the infection.

Anal abscesses may also occur deeper in the rectum, most often in those that also suffer from inflammatory bowel diseases. This can result in some pain or discomfort in the abdominal area.

In toddlers, however, there typically aren’t many symptoms other than signs of discomfort or pain, which may cause a child to become irritable. A lump or nodule may also be visible or felt around the anal area.

How are Anal Abscesses Diagnosed?

Anal abscesses are most often diagnosed through a physical exam where your doctor checks the rectum for characteristic nodules. In the case that abscesses are deeper than a physical exam can find, your doctor may order an MRI or ultrasound in order to get a better look.

Treatment Options for Anal Abscesses

Anal abscesses rarely go away on their own. Left untreated they turn into painful anal fistulas that may require surgical treatment. The most common and simple method of treatment is for your physician to drain the pus from the infected area. This can usually be done in the doctor’s office and typically requires only local anesthesia.

If there is an extremely large rectal abscess, surgery may be required. In some occurrences, a catheter may be used to make sure the abscess drains completely and properly. Abscesses that have been drained are typically left open and do not require any stitches. If you are a diabetic, your doctor may require you stay in the hospital for a few days to watch for any infection.

After surgery is performed, warm (not hot) baths are recommended. Sitting in warm water will help reduce swelling and aid in any additional drainage the abscess may need. Your doctor may also prescribe antibiotics. A liquid or soft food-only diet is also suggested.

Is There Any Way to Prevent Rectal Abscesses?

There is not much known about how to prevent a rectal abscess, but there are some steps you can take. Protection from sexually transmitted infections is important as is prompt treatment for any infections present. Condom use, especially during anal sex, is key in preventing STIs (sexually transmitted infections). Good hygiene and cleanliness in the anal area is an important safeguard for both children and adults.

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Article Sources:

  • Anal Abscess and Fistula - New York Presbyterian Hospital. (n.d.). New York Presbyterian Hospital - Top NYC Doctors, Comprehensive Medical Care. Retrieved March 23, 2012, from http://nyp.org/health/anal-abscess-fistula.html
  • Anal Abscess (and Anal Fistula). (n.d.). NYU Langone Medical Center. Retrieved March 23, 2012, from http://obgyn.med.nyu.edu/conditions-we-treat/conditions/anal-abscess-and-anal-fistula
  • Anorectal abscess - PubMed Health. (n.d.). National Center for Biotechnology Information. Retrieved March 23, 2012, from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002487/

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