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Anorectal abscess

Anal abscess; Rectal abscess; Perirectal abscess; Perianal abscess; Gland abscess; Abscess - anorectal

An anorectal abscess is a collection of pus in the area of the anus and rectum.

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Causes

Common causes of anorectal abscess include:

Deep rectal abscesses may be caused by intestinal disorders such as Crohn disease or diverticulitis.

The following factors increase the risk for an anorectal abscess:

The condition affects men more than women. The condition may occur in infants and toddlers who are still in diapers and who have a history of anal fissures.

Symptoms

Common symptoms are swelling around the anus and a constant, throbbing pain with swelling. Pain may be severe with bowel movements, coughing and sitting.

Other symptoms may include:

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 some cases, a CT scan, MRI, or ultrasound is needed to help locate the collection of pus.

Treatment

The problem rarely goes away on its own. Antibiotics alone usually cannot treat an abscess.

Treatment involves surgery to open and drain the abscess.

Drained abscesses are usually left open and no stitches are needed.

The surgeon may prescribe painkillers and antibiotics.

You may need stool softeners. Practice good hygiene. Eat soft or liquid foods until the abscess has healed.

Avoiding constipation will help decrease pain. You may need stool softeners. Drinking fluids and eating foods with lots of fiber can also help.

Outlook (Prognosis)

With prompt treatment, people with this condition usually do well. Infants and toddlers usually recover quickly.

Complications can occur when treatment is delayed.

Possible Complications

Complications of anorectal abscess may include:

When to Contact a Medical Professional

Call your health care provider if you:

Prevention

Prevention or prompt treatment of STDs 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.

Related Information

Anal fissure
Abscess
Crohn disease
Diverticulitis
Systemic

References

Coates WC. Anorectal procedures. In: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 45.

Merchea A, Larson DW. Anus. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 52.

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Review Date: 6/11/2018  

Reviewed By: Debra G. Wechter, MD, FACS, general surgery practice specializing in breast cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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