Anal Abscess

Overview of anal abscess

An anal abscess, also known as a rectal abscess is a condition characterized by the filling of the anal cavity with pus. It causes severe pain, rectal discharge, fever, and fatigue. In many cases, an anal abscess can result in anal fistulas which may be very painful. This happens when the abscess fails to heal and breaks open on the skin’s surface. In the event that anal abscess fails to heal, it can cause much pain and may require surgery.

Causes of anal abscess & risk factors

An anal abscess may be caused by a blocked anal gland, an infected anal fissure or a sexually transmitted infection. Other risk factors include:

  • Ulcerative colitis or Crohn’s disease. This is an inflammatory bowel disease that results in the body attacking healthy tissues.
  • Diabetes
  • A poorly functioning immune system. This may be caused by HIV or AIDS.
  • Engaging in anal sex. This increases the risks of abscess in both gender.
  • Use of medications such as steroids or prednisone.
  • Constipation
  • Diarrhea
  • Chemotherapy (whether current or recent).

Children or toddlers who have a history of anal fissures also have a high risk of developing anal abscess much later in life. Such fissures might occur in children who have suffered constipation in the past.

Anal abscess
Photo Credit: Wikipedia

Symptoms of an anal abscess

Constant pain or throbbing in the anal area is a common and immediately noticeable symptom of an anal abscess. The pain is usually accompanied by swelling in the anal region, and extreme pain during bowel movements.

Other signs of an anal abscess include:

  • Rectal bleeding or discharge
  • Constipation
  • Tenderness or swelling of the skin surrounding the anus
  • Fatigue

At times, a lump or nodule may be felt at the rim of the anus. This is usually swollen, red and tender. Some persons may also have urinary symptoms or rectal bleeding such as difficulty in urinating.

Anal abscesses may also occur in the deeper regions of the rectum, especially in persons with inflammatory bowel diseases. This may cause abdominal pain or discomfort. Toddlers do not exhibit many symptoms except pain or discomfort. This may result in irritability in the child. A nodule or lump may also be visible or felt in the region.

Diagnosis of anal abscess

The physician will carry out a physical examination prior to diagnosing an anal abscess. This involves examining the area for characteristic nodules. The physician will also check for redness, swelling and, pain in the anal area.

In some people, there may be no visible signs of the abscess on the surface of the skin around their anus. Instead, the physician will inspect the anal canal with an endoscope. At times, the abscess may be deeper than a physical examination can find. In such cases, the physician may order an ultrasound or MRI to have a better look. There may also be a need for further tests to ensure that Crohn’s disease is not a contributing factor. In such cases, imaging, blood test, and colonoscopy may be done. The physician will make use of a flexible and lighted scope to examine your colon.

How is an anal abscess treated?

Without treatment, an anal abscess will persist. The most common and simple form of treatment is for your physician to drain the pus from the infected region. This can be done in the physician’s office. A medication will be used to numb the area. This will relieve all uncomfortable pressures, allowing the tissues to heal properly.

If anal abscesses are not treated, they will result in very painful anal fistulas which can only be treated by surgery. A study by the American Society of Colon and Rectal Surgeons (ASCRS) has it that about 50 percent of people with an anal abscess will develop an anal fistula in the long run. A fistula is an abnormal opening in the skin near the anal region. A fistula is generally fixed by a surgery.

If the anal abscess is very large, then there may be need for a surgery. In some cases, a catheter may be used to completely drain the abscess. Abscesses that have been completely drained are left open. They do not require stitches. If you have a compromised immune system or diabetes, you may be asked by your physician to stay for a few days in the hospital. The aim is to watch for any infection.

After surgery, you will be asked to have warm baths. This will help to reduce the swelling and enhance drainage of the abscess. Antibiotics may also be prescribed for you if you have a compromised immune system or if the infection has spread.

How to prevent anal abscess

Not much is known about prevention of anal abscess. However, there are some steps you may take, including:

  • Use of condom during anal sex. The aim is to safeguard against sexually transmitted infections that may cause abscess.
  • Prompt treatment and protection against sexually transmitted infections
  • Regular cleaning of the anal region.

Anal abscess may result in complications. These complications are however treatable. It is best that you understand the risk factors and ensure you closely monitor and manage other health conditions that may increase your risk of having an abscess. If you develop any problems in the anal region, do not hesitate to contact your physician. Prompt treatment will prevent it from getting worse.