What is perianal abscess?

An anal abscess is a painful condition where there is a collection of pus which develops near the anus. It may be red in colour and feels warm when you touch it. Perianal abscess is usually caused by infections of the small anal glands. In certain cases, the abscess is unable to heal and tears open on the surface of the skin, and this results in a painful anal fistula. The most common and effective way to remove perianal abscess is via surgical incision and drainage.

What causes perianal abscess?

Some causes of perianal abscess include infection of an anal fistula, blocked anal glands and sexually transmitted infections, which compromises your immune system and makes you more prone to having perianal abscess. You may have a higher risk of perianal abscess if you have Inflammatory Bowel Disease (IBD) such as Crohn’s disease or ulcerative colitis, constipation and/or diarrhoea, have anal sex, use of steroids such as prednisone or have diabetes.

How do I know if I have perianal abscess?

Common symptoms of perianal abscess include:

  • Constant and throbbing pain which worsens when sitting down and during bowel movements
  • Swelling, tenderness and redness around the anal area
  • Anal discharge or bleeding
  • Fever and chills

How is perianal abscess diagnosed?

Perianal abscess is most often diagnosed by a physical examination of the affected area. In certain cases of deeper perianal abscesses, where the signs are not immediately visible, the doctor will arrange for an imaging test such as a CT scan, ultrasound or MRI. This is such that a more accurate diagnosis can be made.

Why surgery to treat perianal abscess?

Perianal abscesses do not often go away without treatment. If left untreated, perianal abscess may develop into more serious conditions such as anal fistulas which are painful and require more extensive surgical treatment. It is estimated that 50 per cent of perianal abscesses develop into anal fistulas. Surgery is the most common and effective method to drain abscesses completely to prevent discomfort for the patient. This is why it is important to undergo prompt surgical drainage before the abscess erupts.