What is an Anal Abscess?
An anal abscess is a collection of pus (infection) near the anus or buttock. It happens when bacteria infect small glands in the anal canal.
As the pus builds up under the skin, it causes: pain (often severe and throbbing), swelling and redness.
What is an Anal Fistula?
An anal fistula is a small tunnel that forms under the skin. It usually develops after an abscess has drained or been treated. The tunnel connects the inside of the anus → to → the skin outside. This can lead to ongoing or repeated infection.
What Causes Them?
Inside the anus are tiny glands that can become blocked and infected. Certain conditions such as colitis or inflammation of the bowel can sometimes make these infections more likely.
How it develops:
- Infection starts in an anal gland
- Pus collects → forms an abscess
- Abscess drains (naturally or surgically)
- A tunnel may remain → forming a fistula
Common Symptoms
Anal Abscess
- Severe pain near the anus
- Swelling or lump
- Fever and chills
- Feeling unwell
Anal Fistula
- Persistent or intermittent pus discharge
- Skin irritation or itching
- Pain that may improve after discharge
- Recurrent infections
Most commonly seen in adults aged 30–50 years.
How Are They Treated?
Anal Abscess
- Main treatment: Surgical drainage
- A small cut is made to release pus
- Done under anaesthesia
⚠️ Antibiotics alone are usually not effective
Anal Fistula
- Requires surgery to cure
- The fistula tract is opened to allow healing from inside out
- May involve cutting a small portion of the anal sphincter muscle
Most cases are straightforward and can be treated as day surgery. Complex cases may need imaging and scans (e.g. ultrasound scan or MRI), require specialised procedures.
Recovery After Surgery
Mild discomfort after surgery is manageable with painkillers. Quick return to normal activities. The wound needs to be cleaned regularly by using a warm water spray to the wound about 3 to 4 times a day. Expect mild blood-stained discharge. Use gauze or a pad to protect clothing. Stool softeners and mild laxative may be prescribed. Bowel movements will not affect the wound healing process.
Healing & Recurrence
The wound may take up to 4 weeks to heal completely, although it is usually not uncomfortable after 2 weeks. If properly healed, the problem will usually not return. But if the wound fails to heal, it indicates recurrence; the chance of this is very low. It is important to follow the directions of the surgeon to help prevent recurrence.
Healing & Recurrence
The wound may take up to 4 weeks to heal completely, although it is usually not uncomfortable after 2 weeks. If properly healed, the problem will usually not return. But if the wound fails to heal, it indicates recurrence; the chance of this is very low. It is important to follow the directions of the surgeon to help prevent recurrence.
When to Seek Medical Help
See a doctor if you have:
- Persistent anal pain or swelling
- Fever with anal discomfort
- Recurrent discharge or infection