Perianal Abscess and Anal Fistula: Symptoms and Treatment
An anal abscess and an anal fistula are closely linked. An abscess is a painful collection of pus near the anus. A fistula is a small tunnel that can form afterwards, connecting the inside of the anal canal to the skin.
What are an anal abscess and a fistula?
Small glands inside the anal canal can become blocked and infected, forming an abscess. Signs include a painful, swollen area near the anus, redness and sometimes fever. In some people, a fistula develops after the abscess has drained or healed. A fistula may cause ongoing discharge, irritation or recurring abscesses.
Common symptoms include:
- Pain and swelling near the anus
- Discharge of pus or blood that stains underwear
- Skin irritation around the anus
- Fever or feeling unwell (with an abscess)
A painful, swollen lump near the anus should be assessed promptly, ideally within 24 to 48 hours. If you cannot get an appointment that quickly, go to an emergency department. If you have a fever, diabetes or a weakened immune system, go to the nearest emergency department without waiting.
Treatment Options
1. Drainage of an abscess
An abscess is treated by draining the pus, which relieves the pain quickly. This is often done under local anaesthetic.
2. Fistula surgery
A fistula rarely heals on its own. Your doctor will assess its path and recommend the most appropriate procedure, such as a fistulectomy, which removes the tunnel. Fistula surgery is performed in state-of-the-art operating rooms located near the Center.
Complex fistulas, including those related to Crohn's disease, are assessed here and may be referred to gastroenterology for combined care.
After Treatment
Healing usually takes a few weeks. You will receive written instructions on wound care, hygiene and pain relief, and a follow-up visit to check healing.
When to Seek Medical Care After Abscess Drainage or Fistula Surgery
Contact your doctor if you experience:
- Fever
- Increasing pain, redness or swelling
- Heavy bleeding
Abscesses and fistulas are uncomfortable, but treatment is effective. A consultation clarifies what is going on and what the next step should be.
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