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American Society of Colon & Rectal Surgeons

Anal Abscess/ Fistula

A patient who feels ill and complains of chills, fever and pain in the rectum or anus could be suffering from an anal abscess or fistula. These medical terms describe common ailments which many people know little about.

What is an Anal Abscess?

An anal abscess is an infected cavity filled with pus found near found near the anus or rectum.

What is an Anal Fistula?

An anal fistula, almost always the result of a previous abscess, is a small tunnel connecting the anal gland from which the abscess arose to the skin of the buttocks outside the anus.

What Causes Anal Abscess?

An abscess results from an acute infection of a small glands 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 Causes 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 of both ailments include constant pain, sometimes accompanied by swelling, that is not necessarily related to bowel movements. Other symptoms include irritation of skin around the anus, drainage of pus (which often relieves pain), fever, and feeling poorly in general.

Does an Abscess Always Become a Fistula?

No. A fistula develops in about 50 percent of all abscess cases, and there is really no way to predict if this will occur.

How is Abscess Treated?

An abscess is treated by draining the pus from the infected cavity, making an opening in the skin near the anus to relieve the pressure.  Often, this can be done in the doctor’s office using local anesthetic. A large or deep abscess may require hospitalization and use of different anesthetic method. Hospitalization may be necessary for patients prone to more serious infections, such as diabetics or people with decreased immunity. Antibiotics are not usually an alternative to draining the pus, because antibiotics are carried to the blood stream and do not penetrate the fluid within an abscess.
 
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