Symptoms and Signs of Anal Abscess

Medical Author:
Medically Reviewed on 9/24/2021

Doctor's Notes on Anal Abscess

The term anal abscess is frequently used describe any abscesses in the deep tissue surrounding the abscess (also termed a perirectal abscess) and in skin surrounding the anus (termed perianal abscess). However, both have essentially the same signs and symptoms although the perirectal abscess has more severe symptoms. The signs and symptoms of an anal abscess may include

  • pain in the anal area,
  • buttock pain,
  • a lump in the anal area,
  • pus drainage near the anal area,
  • swelling near the anus and/or buttocks,
  • painful bowel movements,
  • lower abdominal pain,
  • fatigue,
  • fever, and
  • night sweats.

If you develop high fevers, chills, severe rectal pain, nausea, vomiting, and/or the inability to move the bowels, you need to go to the emergency department.

Anal abscesses are mainly due to bacterial infections of the glands surrounding the anus. If the glands burst after being filled with pus, infection can extend to spaces around the rectum and anus. The bacteria can be introduced through small breaks skin or during placement of foreign objects into the anal/rectal lumen. People with anal fissures, diabetes, Crohn's disease, immune suppression, STDs, HIV/AIDS, or are pregnant are at higher risk to develop an anal abscess.

What Are Treatments for Anal Abscesses?

Surgical treatment is the treatment of choice. Surgical drainage of the abscess before it burst open is recommended. There are two procedures based on the location of the abscess and size:

  • Superficial small: It can be drained in a doctor's clinic with a local anesthetic.
  • Deep and large: It may require hospital surgery with aesthesia.

Antibiotics may be needed, for example, in patients with diabetes or in those who are immunosuppressed. Three warm water sitz baths per day and stool softeners are suggested to ease bowel movements.

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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.