What is a perianal abscess and how is it treated?

So, you think you have a perianal abscess? It’s a common condition that we see and I’ll tell you more about it.


An abscess is a localized collection of infection (pus). It can occur anywhere, but near the anus is a common location.


The most common presentation is anorectal (butt) pain. It may be associated with some swelling. The pain typically comes on gradually over several days (not to be confused with the pain from a thrombosed hemorrhoid that comes on more acutely and is associated with a lump). You may have a fever or chills, but most commonly, people say that they “didn’t feel right” or “I knew something was wrong.”


Unfortunately, many patients go to their primary care doctor and are prescribed antibiotics. Antibiotics don’t typically work for abscesses. They may make the symptoms somewhat better, but they don’t heal the problem.


So what needs to be done? The infection needs to be drained. This is often done in the office with local anesthesia (lidocaine, like your dentist uses). Occasionally, it will need to be done in the operating room under anesthesia.


The most common question that I get about anorectal abscesses is “What causes this?” About half of the time, an abscess is caused by an anal fistula, which is a connection from inside the anus to the outside. I’ll talk more about fistulae here as they require a different treatment.


What should you do? If you think you have an abscess, you should be examined by a physician. As board-certified colon and rectal surgeons, perianal abscesses are a common thing that we treat and we’d be happy to see you as a patient.


Call (615) 329-7933 for an appointment

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