An anorectal abscess is a collection of pus in the area of the anus and rectum.
Anal abscess; Rectal abscess; Perirectal abscess; Perianal abscess; anal gland abscess; Abscess - anorectal
Common causes of anorectal abscess include:
- Blocked glands in the anal area
- Infection of an anal fissure
- Sexually transmitted infection
Deep rectal abscesses may be caused by intestinal disorders such as Crohn's disease or diverticulitis.
The following factors increase your risk of an anorectal abscess:
- Anal sex
- Chemotherapy drugs used to treat cancer
- Inflammatory bowel disease (Crohn's disease and ulcerative colitis)
- Use of corticosteroid medicines
- Weakened immune system (such as from HIV/AIDS)
The condition may occur in infants and toddlers who are still in diapers and who have a history of anal fissures.
Common symptoms are swelling around the anus and a constant, throbbing pain. Pain with bowel movements may be severe.
Other symptoms may include:
- Discharge of pus from the rectum
- Fatigue, fever, night sweats, and chills
- Redness, painful and hardened tissue in the area of the anus
In infants, the abscess often appears as a swollen, red, tender lump at the edge of the anus. The infant may be fussy and irritable from discomfort. There are usually no other symptoms.
Exams and Tests
A rectal examination may confirm an anorectal abscess. A proctosigmoidoscopy may be done to rule out other diseases.
In rare cases, a CT scan, MRI, or ultrasound is needed to locate the collection of pus.
The problem rarely goes away on its own. Antibiotics alone usually cannot treat an abscess.
Treatment involves surgery to open and drain the abscess.
- Surgery is done using local numbing medicine, along with medicine to make you sleepy. Spinal anesthesia may be used.
- Surgery is most often an outpatient procedure, which means that you go home on the same day. The surgeon cuts open the abscess and drains the pus.
- If the pus collection is deep, you may need to stay in the hospital until the abscess has completely drained.
- After surgery, you need warm sitz baths (sitting in a tub of warm water). This helps relieve pain, reduce swelling, and make the abscess easier to drain.
Drained abscesses are usually left open and no stitches are needed.
Your doctor may prescribe pain medication and antibiotics.
You may need stool softeners. Practice good hygiene. Eat a soft or liquid diet until the abscess has healed.
With prompt treatment, people with this condition usually do well. Infants and toddlers usually recover quickly.
Complications can occur when treatment is delayed.
- Anal fistula (abnormal collection between the anus and another structure)
- Infection that spreads to the blood (sepsis)
- Continuing pain
- Problem keeps coming back (recurrence)
When to Contact a Medical Professional
Call your health care provider if:
- You notice rectal discharge, pain, or other symptoms of anorectal abscess
- You have fever, chills, or other new symptoms after being treated for this condition
Prevention or prompt treatment of sexually transmitted diseases may prevent an anorectal abscess from forming. Use condoms during intercourse, including anal sex, to prevent such infections.
In infants and toddlers, frequent diaper changes and proper cleaning during diaper changes can help prevent both anal fissures and abscesses.
Marcello PW. Diseases of the anorectum. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, PA: Elsevier Saunders; 2010:chap 125.
Nelson H. Anus. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 53.
John A. Daller, MD, PhD, Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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