What is this Condition?

Anorectal abscess is a localized accumulation of pus that results from inflamed tissues near the rectum or anus. Inflammation may produce a fistula – an abnormal tubelike passage in the skin – that opens into the rectum. This condition is far more common in men than in women, possibly because men wear coarser clothing, which may irritate the skin and interfere with air circulation.

What Causes it?

Inflammation and the resulting abscess typically begin with a scrape or tear in the lining of the anal canal, rectum, or skin that later be­comes infected. It may be caused by an injection for treatment of internal hemorrhoids; an enema tip; internal puncture wound from undigested sharp objects such as eggshells or fishbones; or by insertion of a foreign object. Muscle strains or an illness may start the abscess, but many abscesses develop without an obvious cause.

As pus develops, a fistula may form in the soft tissue beneath the muscle fibers of the sphincters (especially the external sphincter).

What are its Symptoms?

The person with an abscess feels a throbbing pain and tenderness at the infection site. A hard, painful lump develops on one side that makes sitting uncomfortable.

How is it Diagnosed?

The doctor can find the abscess with his or her fingers and by a visual exam. Usually it appears as a red, tender, oval swelling close to the anus. Sitting or coughing increases pain, and pus may drain from the abscess. Less often, the abscess covers a large area and the doctor can see a hard mass that bulges into the anal canal. An abscess higher in the canal may produce a dull, aching pain in the rectum, tenderness and, occasionally, a swelling and hardness the doctor can find with his or her finger.

An abscess high in the pelvis is rare, but it may be heralded by a fever and a tender mass. Sometimes the doctor will insert a scope to examine the area or order barium enema X-rays to rule out other problems.

How the Abscess Drains

If the abscess drains by forming a fistula, the pain usually goes away. The doctor sees the drainage and irritated skin where the fistula opens. If the infection is severe, the person may have chills, fever, nausea, vomiting, and feel generally uncomfortable.

How is it Treated?

Anorectal abscesses require surgery, with a local anesthetic, to drain the pus. If the abscess has formed a fistula, that must also be removed and then a drain inserted for 48 hours.

What can a Person with an Anorectal Abscess do?

after surgery, the person receives medication for pain relief and begins a recovery that takes 4 to 5 weeks for a common abscess and 12 to 16 weeks it it’s more involved. Cleaning the area regularly and gently will avoid another infection. The person also may need a stool­softening laxative, such as Hydrocil Instant or Metamucil, to avoic constipation, which might stress the incision.