Patient education: Anal abscess and fistula (The Basics)

What is an anal abscess? — An anal abscess is a pus-filled lump around the anus (figure 1). It happens when a gland inside the anus gets infected.

What is an anal fistula? — An anal fistula is a tunnel that forms between the anus and the skin (figure 1).

What are the symptoms of an anal abscess? — The symptoms of an anal abscess include:

●Severe, constant pain in the anal area

●Fever

●Feeling sick and tired

What are the symptoms of an anal fistula? — The symptoms of an anal fistula can be the same as an anal abscess. But the pain is not as bad and might happen only occasionally. Other symptoms can include:

●Red, itchy skin near the anus

●Pus draining from the skin around the anus

Are there tests for anal abscesses or fistulas? — Yes. To check for an anal abscess or a fistula, your doctor or nurse will look at your anus and do a "digital rectal exam." During this exam, they will put a gloved finger into your anus and rectum to feel for lumps or anything abnormal.

They might also order an "imaging test," such as an MRI or a CT scan. Imaging tests create pictures of the inside of the body.

Should I see a doctor or nurse? — Yes. It's important to see your doctor so they can treat you as soon as possible. Waiting too long to get treatment can lead to problems.

How is an anal abscess treated? — The doctor will cut a small hole in your skin to drain out the pus. Often, this is done in an operating room.

How is an anal fistula treated? — There are many different treatments. If the fistula is shallow, the doctor will usually cut open your skin so the fistula can heal.

For a deep fistula, doctors might need to do more than 1 procedure:

●First, they will remove the pus and insert a special thread called a "seton." The thread usually stays in for 6 weeks or longer. It can help relieve symptoms and mark the fistula for doctors to fix later. While the thread is in place, it will not hurt or affect your bowel movements.

●For the second procedure, the doctor will fix the fistula. There are several different ways they can do this, depending on the type of fistula. It might involve tying off the fistula, sealing off the inside fistula opening, or using special glue or a plug to fill in the fistula.

More on this topic

Patient education: Anal pruritus (anal itching) (The Basics)