Anorectal abscess

Definition

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

Alternative Names

Anal abscess; Rectal abscess; Abscess - anorectal

Causes, incidence, and risk factors

Common causes include:

Blocked gland in the area
Infection of an anal fissure
Sexually transmitted infection

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

The following factors increase your risk for an anorectal abscess:

Anal sex
Diabetes
Inflammatory bowel disease (Crohn's disease and ulcerative colitis)
Weakened immune system

The condition may occur in infants and toddlers who are still in diapers and who have a history of anal fissures.

Symptoms

Constipation (may occur)
Discharge of pus from the rectum
Fever
Lump or nodule, swollen, red, tender at edge of anus
Pain associated with bowel movements
Painful, hardened tissue

In infants, the abscess often appears as a swollen, red, tender lump at the edge of the anus. The infant may be fussy from discomfort, but there are generally no other symptoms.

Signs and tests

A rectal examination may confirm that you have an anorectal abscess. A proctosigmoidoscopy may be done to rule out other diseases.

Treatment

Treatment involves surgery to drain the abscess.

Warm sitz baths (sitting in a tub of warm water) may help relieve pain and swelling, and may help make the abscess easier to drain.

Your doctor may prescribe pain medication and antibiotics.

Expectations (prognosis)

With prompt treatment, a patient usually does well. Infants and toddlers usually recover very quickly.

Complications

Anal fistula
Body-wide infection
Problem keeps coming back (recurrence)
Scars

Calling your health care provider

Call your health care provider if you notice a rectal discharge, or if symptoms of an anorectal abscess develop. You should also call if you have fever, chills, or other new symptoms after being treated for this condition.

Prevention

Prevention or prompt treatment of sexually transmitted diseases may prevent this cause of anorectal abscesses. Use condoms during intercourse, including anal sex, to prevent such infections.

Frequent diaper changes and proper cleaning during diaper changes will help prevent both anal fissures and perianal abscesses in infants and toddlers.

Review date: 7/22/2008

Reviewed by: Shimul A. Shah, MD, Assistant Professor of Surgery, University of Massachusetts Medical School, Worcester, MA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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