Anorectal abscess Whēwhē ki te tou

There are different types of anorectal abscesses depending on their location around your anus and anal muscles.

Anorectal abscesses are:

• more common in men than women
• most likely to happen between the ages of 20 and 50.

These infections can be serious – especially if you have diabetes or a weakened immune system.

Anorectal abscesses sometimes start in a gland located between the 2 rings of muscles in your anus called sphincters.

It happens when bacteria get into the gland, causing an infection that grows into an abscess.

It could also start with an anal fissure from a sexually transmitted infection (STI) or blocked glands in your anus.

It could also start with:

• an anal fissure (crack in the skin)
• a sexually transmitted infection (STI)
• blocked glands in your anus.

Symptoms differ, but you may:

• notice a painful lump in your anus or bum
• feel a severe throbbing pain that gets worse when you sit down, move, cough or do a poo
• see pus or blood-stained fluid come from the lump if it starts to leak
• have a fever, sweating or shaking episodes
• lose your appetite or feel tired and unwell.

You could develop a tunnel between your skin and anal canal (a fistula).

If this happens, you will be referred to hospital for follow up and further treatment as needed.

This happens in around 30% of people with an anorectal abscess. In some people, an abscess can recur, requiring further treatment.

Your healthcare provider will ask you about:

• your bowel habits
• any stomach pain you have been feeling.

They will examine the area around your anus to look for swelling or signs of infection. They may need to put a gloved finger into your bottom to feel the abscess.

If your healthcare provider finds an anorectal abscess, they will refer you to hospital for treatment.

If the abscess needs to be surgically drained, you will be given a general anaesthetic (you will be asleep). The abscess will be cut open and drained, and the wound packed and dressed.

You may also need to have antibiotics if:

• the infection has spread
• you have diabetes or Crohn's disease.

After surgery, you may need to have your wound repacked daily so it can heal. This is usually managed by a district nurse.

To make sure you are healing well, you should see your healthcare provider 2 weeks after surgery and again at 6 weeks.

After your surgery, you will feel some discomfort. It is important to have good pain relief that you can take regularly.

Pain relief medicines for adults

Other things to help you recover include:

• drinking plenty of fluids to reduce the chance of becoming constipated
• eating plenty of fibre-rich foods such as vegetables, fruit, wholegrains, nuts and seeds
• avoiding pushing too hard when doing a poo.