Anorectal Abscess / Fistula

What is an anal abscess?

An anal abscess is an infected pus filled cavity that’s near the anus or rectum. An abscess results from an acute infection of a small anal gland due to bacteria or foreign matter. Certain conditions, such as Crohn’s disease or other inflammation of the intestine, can sometimes make these infections more likely to occur.

How do you treat an abscess?

First, an abscess is treated by draining the pus from the infected cavity, making an opening the skin near the anus to relieve the pressure. This often can be performed in our office with a local anesthetic.

A large or deep abscess may require hospitalization. Hospitalization may also be necessary if you’re prone to more serious infections – such as patients with diabetes or a decreased immune system.

Antibiotics are not usually an acceptable alternative to draining the pus, because they fail to provide drainage of the pus and cannot penetrate the infected area.

After treating an abscess, it’s recommended that you soak the affected area in warm water (sitz bath) 3-4 times per day. We also might recommend stool softeners. Bowel movements will not affect the healing process.

What is an anal fistula?

An anal fistula is almost always the result of a previous abscess. It is a small tunnel connecting the anal gland where the abscess occurred to the skin of the buttocks, outside the anus.

After an abscess is drained, the tunnel may persist in connecting the anal gland to the skin. If this occurs, there’s usually persistent drainage to outside opening.

How do you treat a fistula?

There are many options available to treat an anal fistula.  Most of the options require a surgical procedure.  The choice of surgical procedure greatly depends on the size and relative location of the fistula, as well as the patient’s sphincter muscle function.  We regularly discuss all the options with our patients detailing the pros and cons of the different surgical approaches.