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Anal Abscess

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Diagnosis of Anal Abscesses

Usually, a clinical evaluation -- including a digital rectal exam -- is sufficient to diagnose an anal abscess. But some patients may require additional tests to screen for:

  • Sexually transmitted infections
  • inflammatory bowel disease
  • Diverticular disease
  • Rectal cancer

In rare cases, an examination may be done under anesthesia. The doctor may also ask for an ultrasound, a CT scan, or an MRI.

Treatment of Anal Abscesses

Prompt surgical drainage is important, preferably before the abscess erupts. Superficial anal abscesses can be drained in a doctor's office using a local anesthetic. Large or deeper anal abscesses may require hospitalization and the assistance of an anesthesiologist.

After the procedure, most people are prescribed medications for pain relief. For otherwise healthy people, antibiotics are usually not needed. Antibiotics may be required, though, for some people, including those with diabetes or decreased immunity.

Sometimes, fistula surgery can be performed at the same time as abscess surgery. However, fistulas often develop four to six weeks after an abscess is drained. Sometimes a fistula may not occur until months or even years later. So fistula surgery is usually a separate procedure that can be performed on an outpatient basis or with a short hospital stay.

After abscess or fistula surgery, discomfort is usually mild and can be controlled with pain medications. People can expect to lose only a minimal amount of time from work or school.

People are usually advised to soak the affected area in a warm water (sitz) bath three or four times per day. Stool softeners may be recommended to ease the discomfort of bowel movements. Some people may be advised to wear a gauze pad or mini-pad to prevent the drainage from soiling their clothes.

Complications after surgery can include:

  • Infection
  • Anal fissure
  • An abscess returning
  • Scarring

After an anal abscess or fistula has properly healed, it's unlikely that the problem will come back. To prevent one from doing so, however, it's important to follow the advice of your doctor or colon and rectal surgeon.

WebMD Medical Reference

Reviewed by Melinda Ratini, DO, MS on June 30, 2013
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