Anal Abscess or Fistula

What is an anal abscess?

An anal abscess is a painful infection that causes a pocket of pus to form near the anus or rectum. These infections can develop quickly and often require prompt medical attention to relieve discomfort and prevent complications.

What causes an abscess?

An abscess results from an acute infection of a small gland just inside the anus, when bacteria or foreign matter enters the tissue through the gland. Certain conditions – colitis or other inflammation of the intestine, for example – can sometimes make these infections more likely.

What is an anal fistula?

An anal fistula is often the result of a previous abscess. Just inside the anus are small glands. When these glands get clogged, they may become infected and an abscess can develop. A fistula is a small tunnel that forms under the skin and connects a previously infected anal gland to the skin on the buttocks outside the anus.

What causes a fistula?

After an abscess has been drained, a tunnel may persist connecting the anal gland from which the abscess arose to the skin. If this occurs, persistent drainage from the outside opening may indicate the persistence of this tunnel. If the outside opening of the tunnel heals, recurrent abscess may develop.

What are the symptoms of an abscess or fistula?

Symptoms can vary from person to person, but many you may experience pain, swelling, tenderness, or drainage near the anus. Some people may also develop fever, chills, fatigue, or feel generally unwell. If you notice these symptoms, it's important to seek medical evaluation so treatment can begin as soon as possible.

Does an abscess always become a fistula?

No. A fistula develops in about half of all abscess cases, although reported rates vary. There is really no way to predict when an abscess will become a fistula.

How is an anal abscess treated?

The most effective treatment for most anal abscesses is draining the infected area to relieve pressure and help the body heal. Depending on the size and location of the abscess, this may be performed in the office or in the hospital. Your care team will recommend the treatment option that is safest and most appropriate for your individual situation.

How is an anal fistula treated?

Most anal fistulas require surgery to help the tunnel heal properly. A colorectal surgeon will evaluate the location and complexity of the fistula and discuss treatment options designed to promote healing while preserving normal bowel function.

How long does it take to recover from surgery to close an anal fistula?

Discomfort after fistula surgery can be mild to moderate for the first week and can be managed with medication. You can usually return to work or school soon after surgery.

Treatment of an abscess or fistula is followed by a period of time at home, when soaking the affected area in warm water (sitz bath) is recommended three or four times a day. Stool softeners or a bulk fiber laxative may also be recommended. It may be necessary to wear a gauze pad or mini-pad to prevent the drainage from soiling clothes. Bowel movements will not affect healing.

What are the chances of a recurrence of an abscess or fistula?

Many people heal successfully and do not experience future problems. However, every situation is different, and follow-up care is important to ensure proper healing and address any concerns that arise during recovery. Be sure tofollow the directions of your surgeon to help prevent recurrence.

When should I see a colorectal specialist?

If you are experiencing pain, swelling, drainage, fever, or other symptoms near the anus or rectum, it is important to seek medical evaluation. Early diagnosis and treatment can help relieve discomfort and may reduce the risk of complications. Our colorectal specialists have experience diagnosing and treating anal abscesses and fistulas and will work with you to develop a personalized treatment plan.