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Ano-rectal Abscess/Anal Fistula


An anal abscess is a pus-filled pocket in the spaces around the anus and rectum. It may be near the surface of the anal opening or deeper in the rectum.


This problem is caused by a bacterial infection. It may happen when there is a blockage in one or more of the anal glands. Or it may be from an anal fistula.

The Anus
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Risk Factors

Anal abscesses are more common in men. Other things that may raise the risk are:

  • Certain health problems, such as Crohn disease , ulcerative colitis , or sexually transmitted infections
  • Medicines that suppress the immune system
  • Pregnancy
  • Anal intercourse
  • Diabetes


Symptoms depend on where the abscess is located. Problems may be:

  • Painful bowel movements
  • Pain and tenderness from an abscess that is near the surface
  • Lower belly pain from an abscess that is deeper in the rectum
  • Redness and swelling of an abscess that is near the surface
  • Drainage
  • Fever


The doctor will ask about your symptoms and health history. A physical exam will be done. An abscess near the surface of the skin may be seen during the exam. A digital exam of the rectum may need to be done.

Imaging tests are not usually needed, but may be:


An anal abscess needs to be drained right away. The type of procedure depends on its location and depth.

Medicines may also be needed to ease pain and swelling.


The risk of this problem can be lowered by managing health problems that raise the risk of infection.


  • Abscess and fistula expanded information. American Society of Colon and Rectal Surgeons website. Available at: https://www.fascrs.org/patients/disease-condition/abscess-and-fistula-expanded-information. Accessed January 8, 2021.
  • Anorectal abscess. Johns Hopkins Medicine website. Available at: https://www.hopkinsmedicine.org/health/conditions-and-diseases/anorectal-abscess. Accessed January 8, 2021.
  • Fistula in ano and anorectal abscess. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/fistula-in-ano-and-anorectal-abscess. Accessed January 8, 2021.
  • Vogel JD, Johnson EK, et al. Clinical Practice Guideline for the Management of Anorectal Abscess, Fistula-in-Ano, and Rectovaginal Fistula. Dis Colon Rectum. 2016 Dec;59(12):1117-1133.