Ano-Rectal Abscess

Anal abscesses are most often diagnosed through a physical exam where a doctor checks the area for characteristic nodules. The doctor may also check for pain, redness, and swelling in the anal area and rule out other conditions.

In some people, there may not be any visible signs of the abscess on the surface of the skin around their anus. The doctor will instead use an instrument called an anoscope to look inside the anal canal and lower rectum.

Sometimes, the abscess may be deeper than a physical exam can find. The doctor may order imaging tests, such as a CT scan, MRI, or ultrasound, to get a better look.

Further tests may be necessary to make sure Crohn’s disease isn’t a contributing factor.

In these cases, blood and stool tests, imaging, and a colonoscopy may be needed. A colonoscopy is an outpatient procedure in which a doctor uses a flexible scope with a light to examine the colon and large intestine.

Anal abscesses rarely go away without treatment from a doctor. Treatment may include drainage or surgery.

The most common and simple treatment is for a doctor to drain the pus from the infected area.

This can usually be done in the doctor’s office. The doctor will use medication to numb the area. Any uncomfortable pressure should be relieved, allowing the tissue to begin healing properly.

If there’s an extremely large anal abscess, surgery with anesthesia may be required. In some cases, a catheter may be used to make sure the abscess drains completely. Abscesses that have been drained are typically left open and don’t require stitches.

If you have diabetes or a weakened immune system, your doctor may ask you to stay in the hospital for a few days to watch for any infection.

Treatment following drainage may include:

Medication. The doctor may prescribe antibiotics if you have a weakened immune system or if the infection has spread. Antibiotics are not considered sufficientTrusted Source to treat the infection on their own but may be prescribed after draining the abscess.

Laxatives or fiber supplements. As you heal after draining the abscess, your doctor may recommend laxatives or fiber supplements to avoid constipation.

Warm baths. After this procedure, the doctor may provide guidance on how to keep the area clean and may recommend a sitz bath. It’s recommended you take warm (not hot) baths. Sitting in warm water may help reduce swelling.

Follow-up appointments. Because there is a chance for anal abscesses to recur or fistulas to develop, it’s important to attend all follow-up appointments. A 2019 studyTrusted Source found that having a higher body mass index (BMI) may be correlated with abscesses recurring.

The recovery period for a drained rectal abscess is about 3 to 4 weeksTrusted Source.

If anal abscesses are left untreated, they can turn into painful anal fistulas that may require more surgical treatment.

According to the American Society of Colon and Rectal Surgeons, about 50 percent of people who have an anal abscess will eventually develop an anal fistula. A fistula generally requires surgery.