What is an Anal Abscess, an Anal Fistula?  What are Causes, Symptoms and Treatment for Anal Abscess and Anal Fistula?

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

An anal  fistula is a small tunnel that forms under the skin that connects a previously infected anal gland to the skin in the buttocks outside the anus.

What Causes an Abscess?

An anal abscess is almost always the result of an acute infection of a small gland just inside the anus. Bacteria or other foreign matter enters the tissue through the gland. Certain conditions such as colitis, or inflammation of the intestine can be a cause of an abscess.

What Causes a Fistula?

A fistula occurs when an abscess has been drained, but the tunnel persists. In this case there may be continued drainage from the outside opening. If the outside opening heals, a recurrent abscess may develop.

What are the Symptoms of an Abscess or Fistula?

Pain and swelling around the anus are symptoms of an abscess, but some may experience fatigue, fever or chills. Symptoms of a fistula include irritation of the skin around the anus, drainage of pus and fever.

Does an Abscess Always Become a Fistula?

Whereas they are related, a fistula only develops in about half of the cases.

How is an Abscess Treated?

First the pus is drained through a small incision in the skin near the anus to relieve the pressure. This can often be done in the doctor’s office with a local anesthetic. Large or deep abscesses may require hospitalization. Those who are diabetic or have impaired immune systems also may require treatment in the hospital. Antibiotics are not effective.

How is a Fistula Treated?

Fistulas are treated with surgery and may be performed along with the abscess surgery. However, fistulas often develop several weeks or longer after an abscess is drained. Surgery usually involves opening the fistula tunnel and possible cutting a small part of the anal sphincter muscle that helps control bowel movements. It heals from the inside out. This is typically done on an outpatient basis, although some cases may require a short stay in the hospital.

Recovery

Discomfort usually occurs for a week and pain pills are given to relieve pain. A few days at home taking sitz baths (sitting in a few inches of warm water) three or four times a day are recommended. Stool softeners may also be recommended. Bowel movements do not affect healing.

Do Abscesses or Fistulas Recur?

With proper healing they generally do not. Follow your doctor’s instructions following treatment to insure the best results.

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