A perianal abscess, anal abscess or anorectal abscess, is a pus-filled boil that develops around the anus, rectum, or perineal region – the area between the genitalia and the anus. It occurs when a blockage or infection occurs in one of the glands in the anus. Abscess surrounds the anus when pus and fluid gather in the anal gland.
Symptoms of this condition typically include discomfort, swelling, and redness in the area of the anus or rectum. Perianal abscesses affect men and women and may develop at any age.

Symptoms of perianal abscess

A perianal abscess typically emerges as a sensitive, swelling boil (resembling a huge pimple) on the skin just outside the anus. It could be bright red, excruciatingly painful, or throbbing nonstop.

An anal abscess may also cause the following symptoms:

Constant or increased pain around the anus, especially when seated or during bowel movements.
Pus-like discharge from the anus.
Redness and swelling around the anus.
A painful, red, swollen lump or nodule.
Bowel disorders, such as constipation or cramping.
Rectal bleeding.
Flu-like symptoms, including fever and chills.
Tissue irritation near the anus.
Pain in the lower part of the abdomen.
A feeling of general unease or exhaustion.

Causes of perianal abscesses

Perianal abscesses are frequently caused by a small organ located inside the anus that releases a fluid that aids in bowel movements. If the organ becomes obstructed, an infection may result in the formation of an abscess. Other contributors to the formation of a perianal abscess include:

Crohn’s disease.
Diabetes.
Compromised immune system.
An inflamed anal fissure or an injury in the anal lining.
Trauma to the area (such as during sexual activity).
STIs.
Diseases and disorders affecting the digestive tract.

Diagnosis of perianal abscess

Physical examination is the primary means of diagnosis when dealing with a perianal abscess. The doctor may examine the region visually and palpate (feel) for any lumps or thickening that may indicate an abscess. A rectal exam could be required in certain situations. Additional imaging tests like an ultrasound, MRI, or CT scan may be ordered if the doctor detects a deeper or more complicated abscess.

Treatment of perianal abscess

A perianal abscess typically requires surgical draining as the primary method of treatment. The physician will make a small incision in the abscess and drain the pus under local or total anaesthesia. Inserting a small rubber drain (seton) may be required to ensure continuous drainage.

It’s vital that you maintain the treated area dry and clean after the operation. Warm baths (sitz baths) can help to calm and cure the affected area. It’s also possible that you’ll be prescribed pain medication. Antibiotics may be recommended if the infection is severe or the patient has a compromised immune system.