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Definition  

An anal abscess is a pus-filled pocket located in the spaces around the anus and rectum. An abscess can be found near the surface of the anal opening or deeper in the rectum.

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The Anus  
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Causes  

An anal abscess is caused by a bacterial infection. Infection may occur when there is a blockage in one or more of the anal glands that secrete mucous, or from an anal fistula.

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Risk Factors  

Anal absesses are more common in men. Other factors that may increase your chance of an anal abscess include:

  • Certain conditions, such as Crohn's disease, ulcerative colitis, or sexually transmitted diseases
  • Medications that suppress the immune system
  • Pregnancy
  • Receptive anal intercourse
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Symptoms  

Symptoms depend on where the abscess is located. An anal abscess may cause:

  • Pain and tenderness radiating from the location of the abscess if it is near the surface
  • Lower abdominal pain if it is located deeper in the rectum
  • Redness and swelling—visible with a surface abscess, also occurs in a deep abscess, but cannot be seen
  • Pus drainage
  • Fever

Complications of an anal abscess may include:

  • Anal fistula—abnormal channel between the rectum and the surface of the anal skin leading to the outside
  • Systemic sepsis—serious, life-threatening infection that spreads throughout the body
  • Stool incontinence
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Diagnosis  

Your doctor will ask about your symptoms and medical history. A physical exam will be done. An abscess near the surface of the skin may be visible. A deeper abcsess may require a digital rectal exam. The doctor will feel the inside of your anal canal for any abnormalities.

Imaging tests to look at anorectal structures may include:

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Treatment  

Surgical drainage is necessary to treat an anal abscess. The type of procedure depends on its location and depth. It is possible that you may have a drain in the wound for up to 3 weeks to help the healing process.

Medications  

Antibiotics are generally not necessary, but your doctor may recommend them under certain circumstances. Other medications may include:

  • Over-the-counter or prescription pain medication
  • Stool softeners, fiber, or bulk laxatives
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Prevention  

To reduce your chance of an anal abscess, be sure to manage any health conditions that increase your risk of infections.