An anorectal abscess is a swollen, infected gland in the rectum that can cause discomfort and lead to complications. It is often caused by bacteria found in stool and can be associated with inflammatory bowel disease, weakened immune systems, and sexually transmitted diseases. Symptoms vary but may include pain, swelling, and blood or pus in the stool. Treatment usually involves surgical procedures to drain pus and remove blockages.
An anorectal abscess is an infected gland in the rectum that swells, fills with pus, and causes chronic discomfort. There are several mucus-filled glands along the lining of the rectum that provide lubrication during bowel movements. An anorectal abscess occurs when a cavity becomes irritated and infected with bacteria found in stool. Without treatment, an abscess can damage anal tissue and create a large cavity, known as a fistula, which can lead to further complications. Most abscesses can be treated with relatively simple surgical procedures to drain pus and remove blockages.
Many conditions and risk factors have been associated with the development of anorectal abscesses. People who have inflammatory bowel disease, including ulcerative colitis and Crohn’s disease, are particularly at risk due to persistent irritation and the possibility of ruptures within their rectums. Individuals with weakened immune systems due to HIV infection or another autoimmune disease are also at risk. Less commonly, a person can develop an abscess from a sexually transmitted disease acquired through anal sex.
Anorectal abscess symptoms can vary depending on the size and location of the problem. An abscess that forms near the opening of the rectum can produce a palpable, red, swollen lump that is tender to the touch. A person may have pain during bowel movements and blood and pus may be present in the stool. Some people become constipated and develop fever, chills and aches. A deep anorectal abscess is less likely to cause physical symptoms, although an individual may experience mild abdominal pain and bloody stools.
A person who believes they have an anorectal abscess should visit a doctor as soon as possible to receive a proper diagnosis and learn about options for treatment. A primary care physician can usually diagnose an abscess when a lump is clearly visible, but usually decides to refer a patient to a proctologist to confirm the problem. The specialist can inspect the abscess by feeling the anal cavity with a finger or by inserting a small lighted camera into the rectum. Imaging tests may be needed to detect deep anorectal abscesses.
Oral antibiotics may be able to temporarily relieve the symptoms of an anorectal abscess, but most problems ultimately require surgical procedures. A surgeon can drain pus from an abscess by making a small incision or puncture in the affected area and pulling the pus out with a tube. The pus is collected and sent to a clinical laboratory to confirm the presence of specific bacteria, allowing doctors to prescribe the appropriate follow-up antibiotics. If an anorectal abscess creates a fistula, the surgeon may have to cut out the cavity and suture the surrounding tissue. With prompt treatment and regular checkups, most patients recover within a few weeks.
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