Perianal abscess – Causes, Symptoms, Risk factors, and Treatments

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A perianal abscess is nothing but a pus-filled mass resembling a boil or cysts that can appear around the anus, rectum or perineal area (the area between your genitals and anus).

In other words, an abscess with a pus-filled bulge formed near the anus or rectum is known as a perineal abscess. This abscess occurs when an anus gland becomes diseased and obstructed.

This comprises two anal sphincters and pelvic floor muscles forming the 2-inch-long canal (internal and external).

The muscles in the sphincters open and close to let faeces pass through. Your anus contains several glands that secrete mucus. Any form of obstruction or block can result in infection and the development of an abscess.

In general, anal or anorectal abscesses are other names for perianal abscesses.

Causes of Perianal Abscess

The following are some of the causes of Perianal abscess.

An infected anal fissure

One of your anal glands becomes clogged and infected, which causes infection in the anal region. Your chance of developing a perianal abscess may rise due to certain medical disorders or other circumstances. A perineal abscess can be drained with the effective treatment of doctors.

Pain around the abscess

Pain around the anus typically occurs when germs or stool gets stuck. Sometimes, it may result in tears in the lining of the anus that may cause inexplicable pain to the affected person.

Problem in the bowels or intestines

Perianal abscess patients frequently experience persistent pain around the anus, which may or may not be related to bowel movements. If the abscess is spontaneously draining, a purulent discharge may be observed.

Infected epidermoid

Small and noncancerous pimples seen beneath the skin are called epidermoids. This typically occurs due to infection or the formation of germs around the area of the anus.

Epidermoid can appear anywhere, including inside and outside of the body. Infected epidermoids cause virulence to the body and rarely create issues or require treatment because of their gradual growth and frequent lack of pain.

Symptoms of Perianal Abscess

The following are some of the symptoms of Perianal abscess.

Pus-like discharge from the anus

Symptoms like pus discharge, bleeding or itching are some of the notable signs of perianal abscess. Anal cleanliness is crucial to safeguard oneself from the perianal abscess.

Pain in your anus or rectum

Perianal abscess patients frequently experience persistent pain around the anus, which may or may not be related to bowel movements.


A small to medium lump can occasionally be seen around the anus, indicating that the person might be diagnosed with a perianal abscess.


Constipation accompanied by chills, constipation or diarrhea are some of the prime symptoms of perianal abscess. Pain around the anus may or may not be related to bowel movements.

Pain in the lower part of your abdomen

Swelling in the abdomen and anal region are typically present along with the pain. Constant pain that may be agonising, throbbing, dull, acute or dull-sharp is one of the common symptoms of a perianal abscess.

Risk factors of perianal abscess

The following are the risk factors associated with perianal abscess.


The fact that third-trimester anal pain affects one-third of pregnant women. Many other conditions can cause anal pain, but if it starts off mildly and worsens over a short period of time. Sometimes, it may be due to an anorectal abscess.


Individuals with type 2 diabetes were more likely to develop perianal abscesses than patients with type 1 diabetes, indicating that metabolic abnormalities may be more significant than autoimmune causes. Perianal abscess risk is seen high in people with poor glycemic control.

Crohn’s disease

A chronic inflammatory disorder called Crohn’s disease can affect any area of the gastrointestinal system, including the anus and mouth cavity. Anal canal lesions, perianal abscesses and perianal fistula are examples of the perianal symptoms of Crohn’s disease.

Chemotherapy drugs for cancer treatment

Intaking chemotherapy drugs can cause harmful side effects if you are diagnosed with a perianal abscess.

Treatments of Perianal Abscess

The following are some of the treatments given to perianal abscess patients.


Patients with perianal abscesses can take metronidazole 500 mg every 8 hours and ciprofloxacin 500 mg every 12 hours orally.

Laxatives or fibre supplements

Laxatives or fibre supplements are a category of drug that aids bowel movement and other perianal abscess conditions. It is widely given to those who are affected by perianal abscesses.

Follow-ups Appointments

Once you are diagnosed with a perianal abscess, make sure to have a follow-up with your doctor. You can also contact your health care physician if any of the following take place:

  • Swelling, redness or pain
  • Flow of pus from the abscess
  • Fever of at least 102°F (39°C) that lasts for a day after taking antibiotics
  • Signs like prolonged diarrhea, stomach pain or rectal bleeding

Your doctor will assess whether the abscess might indicate other illnesses.

Diagnosis of Perianal Abscess

The following are some of the ways to diagnose perianal abscess.

CT Scan

Computed tomography (CT) is an efficient, widely accessible diagnostic imaging method that is used to diagnose perianal abscesses.

MRI Scan

MRI is widely recommended for detecting perianal abscesses because of its non-invasive, practical and highly accurate technology. It helps to show the anatomical connection between abscess and anal canal clearly.   

MRI is accurate at displaying fistulas and aid in the surgical planning to prevent a recurrence.

Ultrasound Test

Perianal abscess can be easily diagnosed using transrectal endoscopic ultrasonography and pelvic computed tomography. It has been demonstrated that endoscopic ultrasound may accurately and efficiently produce detailed pictures of the perianal abscess.

Prevention of Perianal abscess

The following are some of the ways to avoid perianal abscess.

  • Wearing condoms, especially during sex.
  • Addressing illnesses like Crohn’s disease may result in anal abscesses.
  • Treat them with high hygiene and sanitation in the anal area.

When to see a doctor?

Most tiny, simple perianal and submucosal abscesses are drainable in the emergency room. In general, a colorectal surgeon should drain all other anorectal abscesses. When an abscess develops on the buttock, caution is advised because it could be an ischio rectal abscess (abscess formed near the space surrounding the rectum).

Summing up

Perianal abscess is not a fatal disease, but it should be treated with utmost care. If a perianal abscess is not treated well, it may sometimes cause unnecessary complications in the body, which may be fatal.

Taking proper medication and treatment under doctors’ advice would always help perianal abscess patients get rid of the disease.

Complications from anal abscesses are possible, but they are also curable. It’s critical to comprehend the risk variables and carefully monitor and control any health issues that could raise danger.

Contact a doctor if you experience any anal issues to receive treatment and stop them from worsening.


How severe is a perianal abscess?

Patients may experience severe discomfort as a result of these abscesses. They can spread untreated into the ischioanal or intersphincteric space and the regions around the anal margin.

How long does a perianal abscess take to go away?

The abscess probably needs three to eight weeks to recover fully. However, a passageway might occasionally develop between the abscess and the skin.

Can I sit after perianal abscess surgery?

Complete rest is mandatory for at least 24 hours as you recover from a general anaesthetic. After that, you can rest after your doctor’s advice.


The Information including but not limited to text, graphics, images and other material contained on this blog are intended for education and awareness only. No material on this blog is intended to be a substitute for professional medical help including diagnosis or treatment. It is always advisable to consult medical professional before relying on the content. Neither the Author nor Star Health and Allied Insurance Co. Ltd accepts any responsibility for any potential risk to any visitor/reader.

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