Anal abscess

What is it about ?

An anal abscess is an inflammation located in the area of ​​the anus. An abscess is a cavity filled with pus. In 30 to 40% of cases, a fistula is also formed. A fistula is a passage between the abscess and the intestine or the skin around the anus.

Abscesses are usually caused by a small sore in the rectum. Through this wound, stool and bacteria enter the intestinal wall and cause inflammation. People with chronic bowel disease like Crohn’s disease are more likely to have an anal abscess.

What is its frequency?

There are no precise figures for the number of cases of anal abscess. They mainly occur in people between the ages of 30 and 50, more in men than in women.

How to recognize it?

The main symptoms are pain and swelling in or around the anus. Deep abscesses also cause pain during bowel movements. It may happen that you notice a small opening from which a dirty liquid comes out. This indicates the presence of a fistula between the abscess and the skin. The person may also have a fever.

How is the diagnosis made?

Usually, the doctor will be able to feel the soft mass of the abscess in the area of ​​the anus. If he notices a fistula opening, he will use a small probe to feel how deep the fistula is. A PPA (palpatio per anum) examines the inside of the anus by inserting a finger. This examination is often impossible to perform in the presence of an abscess due to the pain caused. Sometimes an ultrasound or CT scan may be needed.

What can you do ?

If you experience painful swelling, increasing in size in the area of ​​the anus, you should consult the doctor without delay.

What can your doctor do?

Antibiotics alone are not helpful. It is necessary to open the abscess. Then the doctor will always refer you to a surgeon.

The wound is left open after the operation. In this way, the wound can gradually heal from its base. This healing easily takes 4 to 6 weeks. Home care is needed every day to heal the wound.

If you develop recurrent anal abscesses or if the doctor suspects you have chronic bowel disease, they will give you an colonoscopy once the abscess has healed.

Want to know more?

• Ultrasound here Where to find on this page of Cliniques St Luc UCL
• The scanner, here, Where to find on this page of Cliniques St Luc UCL

Source

Foreign clinical practice guide ‘Anal abscess’ (2000), updated on 03/28/2017 and adapted to the Belgian context on 07/02/2019 – ebpracticenet