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Anorectal Abscess

Alternate Names

  • perirectal abscess
  • perianal abscess
  • Rectum and Anus

Definition

An anorectal abscess is a pocket of pus that forms in the anus and/or the area just above it, called the rectum.

What is going on in the body?

Most anorectal abscesses begin as bacterial infections of the glands in the anus that produce mucus. Infection can cause inflammation, which in turn creates a wall around the bacteria and forms an abscess. This protective wall makes it hard for the immune system to fight the bacteria.

Risks

What are the causes and risks of the condition?

Most anorectal abscesses are caused by bacteria in the lining of the anus or rectum. Factors that increase a person's risk for an abscess include:
  • chronic constipation
  • diabetes
  • inflammatory bowel diseases, including Crohn's disease and ulcerative colitis
  • immunodeficiency disorders, such as HIV
  • pregnancy

Prevention

What can be done to prevent the condition?

Anorectal abscesses cannot always be prevented. Early treatment of erosions of the bowel lining can help prevent an anorectal abscess. Stool softeners can be used to improve chronic constipation. Effective treatment of underlying disorders, such as diabetes, can decrease the risk of abscess formation.

Diagnosed

How is the condition diagnosed?

The diagnosis of anorectal abscess begins with a medical history and physical exam. Diagnostic studies of the anus or rectum can determine the size of the abscess. These may include special X-ray tests, such as a CT Scan, MRI or ultrasound. An anoscopy may give the healthcare provider a direct look at the inside of the bowel. A special thin tube with a camera and light on the end of it is inserted into the anus and advanced into the bowel.

Long Term Effects

What are the long-term effects of the condition?

An anorectal abscess that is untreated or not fully healed can get worse. It can develop into a fistula or a life-threatening infection. A fistula is an abnormal opening or connection between two organs where none should exist.

Other Risks

What are the risks to others?

An anorectal abscess is not contagious and poses no risk to others.

Treatments

What are the treatments for the condition?

Treatment of an anorectal abscess usually involves surgery to drain the pus pocket. Antibiotics and pain medicines may be prescribed.

Side Effects

What are the side effects of the treatments?

Surgery can bwe complicated by bleeding or an allergic reaction to the anesthesia. Sometimes, surgery in the anorectal region can make an infection worse despite the best surgical technique. Antibiotics and pain medicines can cause allergic reactions and stomach upset.

After Treatment

What happens after treatment for the condition?

After successful treatment and recovery, a person can generally return to normal activities.

Monitor

How is the condition monitored?

Someone with inflammatory bowel disease often needs lifelong monitoring by a healthcare provider. Any new or worsening symptoms should be reported to the healthcare provider.

Sources

Principles of Surgery, 1998, Schwartz et al.

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