Anal Abscess Fistula

Medically reviewed by: Gary H. Hoffman, MD

An anal abscess is an uncomfortable, pus-filled cavity that develops near the rectum. Caused by an infection of a small internal gland of the anus, a large anal abscess can often result in symptoms like chills, fever and feelings of general discomfort and illness. Inflammations of the intestine, like colitis, can make the development of an anal abscess more probable.


An anal abscess must be drained of pus in order to begin healing. Though an abscess will sometimes drain naturally, the intervention of a doctor or surgeon is usually a necessity. With small abscesses near the skin’s surface, a local anesthetic is applied and a small incision is made in the skin, relieving the pressure and giving the pus a drainage point. Some larger abscesses may require more extensive surgery, though this usually amounts to an outpatient operation.

Once drained, relief will begin immediately, though full healing of the cavity can take up to several weeks. The abscess may continue to drain throughout this period, and though this is a sign of healing, a gauze dressing or pad may be required to prevent the drainage from soiling clothing. Submerging the area in warm water for 20 minutes three to four times daily will help relieve the pain and speed along the healing process.


About half of those who develop an anal abscess will also develop what is known as an anal fistula. An anal fistula is a small, abnormal passageway from the interior of the anus to one or more areas outside of the anus, such as the skin of the buttocks. Anal fistulas can result in skin irritation and drainage of stool or mucus and their development will usually be evident within 4 to 6 weeks after an abscess is drained. In some cases, anal fistulas can develop months or even years after the drainage of an abscess.

A surgical procedure is required in the treatment of fistulas, which is usually handled in an outpatient operation. Discomfort caused is typically mild and can generally be controlled with pain medications.

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