Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentRecurrence

Table of ContentsView All

View All

Table of Contents

Symptoms

Causes

Diagnosis

Treatment

Recurrence

An anorectal boil or abscess is a pus-filled cavity that forms within the furrows of the anal canal (called the anal sinuses). Depending on its location, it may also be called an anal abscess, rectal abscess, perianal abscess, or perirectal abscess.

This article discusses anal and rectal abscesses, also called boils. It also goes over what causes them and how they are treated.

Verywell / Laura Porter

Anorectal Abscess Symptoms

Perianal abscesses (“peri-” meaning “around”) are the most common type and can usually be identified visually as they occur in the upper layers of tissue.When touched, the lump will usually be tender, red, and warm.

By contrast, perirectal abscesses tend to form in deeper tissues and are often more felt than seen. Of the two types, a perirectal infection tends to be more serious.

As the pus starts to consolidate and form a palpable mass, other symptoms of an anorectal abscess appear, including:

If you experience any of these symptoms, it is important to see a healthcare provider and have a thorough examination.

Complications

If left untreated, an abscess can lead to the development of ananal fistula, an abnormal tunneling connection between the skin around the anus and the rectal or anal canal through which stool and pus may drain.This may require intensive surgery and a prolonged period of recovery.

If you develop a high fever (over 100.4 degrees), shaking chills, persistent vomiting, the inability to have a bowel movement, or extreme anal or rectal pain (with or without a bowel movement), go to the emergency room without delay. These may indicate a systemic infection that has spread from the site of the abscess into the bloodstream.

Without proper treatment, systemic infection of this sort can lead tosepsis, toxic shock, and even death.

Anal Abscess vs. Hemorrhoid

An anorectal abscess can develop in isolation, often due to the overgrowth of bacteria common in the digestive tract, such asEscherichia coli(E. coli).

However, in recent years, there have been an increasing number of cases associated with drug-resistant bacteria such asmethicillin-resistantStaphylococcus aureus(MRSA).

While anyone, young or old, can get an anorectal abscess, there are some conditions that can increase your risk. They include:

Everything You Need to Know About Anorectal Manometry

Most anorectal abscesses are diagnosed based on your medical history and a physical exam. If an abscess is internalized within the anal canal, your healthcare provider may want to perform an anoscopy using a flexible anoscope to get a better look inside.

Less commonly, imaging tests such as a computed tomography (CT) scan or atransrectal ultrasound (TRUS)may be used if the abscess is especially deep.

Other tests may be ordered if IBD, HIV, or diabetes is suspected, including blood tests andcolonoscopy.

Anorectal abscesses rarely go away on their own or resolve solely withantibiotic therapy. In most cases, the healthcare provider would need todrain the abscess, a relatively simple in-office procedure that involves a local numbing agent, a scalpel, and a pair of forceps.

If the abscess is especially deep or situated high in the rectum, the procedure needs to be performed in a hospital under general anesthesia.The surgery generally takes around 30 minutes. Some of the extracted pus may be sent to the lab to identify the causal bacterium.

Once the procedure is done, antibiotics are prescribed for around a week to help treat the infection and prevent any further spread. At-home measures that can help while you recover include:

After a bowel movement, dab softly with toilet paper and rinse with a squirt bottle filled with warm water. Wash lightly with soap but avoid alcohol or hydrogen peroxide, which can slow healing. If needed, pad the wound with gauze or a maxi pad.

You can also ask your healthcare provider about the short-term use of over-the-counter topical creams and gels, which may help soothe anal tissues.

Can I drain a boil myself?Do not try to drain a boil yourself. What looks like a small boil, or abscess, could be a much deeper and extensive infection.Applying heat may help the boil open on its own, which will cause it to drain.However, it’s best to have a healthcare provider drain the abscess in an office procedure that can ensure the area is kept sterile. Your healthcare provider will also usually prescribe antibiotics and may test the pus to identify the type of infection.

Can I drain a boil myself?

Do not try to drain a boil yourself. What looks like a small boil, or abscess, could be a much deeper and extensive infection.Applying heat may help the boil open on its own, which will cause it to drain.However, it’s best to have a healthcare provider drain the abscess in an office procedure that can ensure the area is kept sterile. Your healthcare provider will also usually prescribe antibiotics and may test the pus to identify the type of infection.

Do not try to drain a boil yourself. What looks like a small boil, or abscess, could be a much deeper and extensive infection.

Applying heat may help the boil open on its own, which will cause it to drain.However, it’s best to have a healthcare provider drain the abscess in an office procedure that can ensure the area is kept sterile. Your healthcare provider will also usually prescribe antibiotics and may test the pus to identify the type of infection.

Can the Abscess Come Back?

Recurrent abscesses around the anus could be related to an anal fistula.Your healthcare provider will need to surgically drain and correct the fistula and will prescribe antibiotics to clean up the infection and prevent recurrence.

Summary

18 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Wright WF.Infectious diseases perspective of anorectal abscess and fistula-in-ano disease.Am J Med Sci. 2016;351(4):427-34. doi:10.1016/j.amjms.2015.11.012Sahnan K, Adegbola SO, Tozer PJ, Watfah J, Phillips RK.Perianal abscess.BMJ. 2017;356:j475. doi:10.1136/bmj.j475Chang J, Mclemore E, Tejirian T.Anal Health Care Basics.Perm J. 2016;20(4):15-222. doi:10.7812/TPP/15-222Meshram MS, Khandare K.The management of perianal abscess with an Udumber Ksheer Pichu–A case report.Int J Innovative Scid Res Technol. 2022;7(8):1692-1695.Lohsiriwat V.Anorectal emergencies.World J Gastroenterol. 2016;22(26):5867-5878. doi:10.3748/wjg.v22.i26.5867Owen HA, Buchanan GN, Schizas A, Cohen R, Williams AB.Quality of life with anal fistula.Ann R Coll Surg Engl. 2016;98(5):334-338. doi:10.1308/rcsann.2016.0136Mitra A, Yadav A, Mehta N, Varma V, Kumaran V, Nundy S.Complicated Perianal Sepsis.Indian J Surg. 2015;77(Suppl 3):769-773. doi:10.1007/s12262-013-0997-yHarvard Health Publishing.Anal disorders.Bender F, Eckerth L, Fritzenwanker M, et al.Drug resistant bacteria in perianal abscesses are frequent and relevant.Sci Rep. 2022;12(1):14866. doi:10.1038/s41598-022-19123-6Adamo K, Sandblom G, Brännström F, Strigård K.Prevalence and recurrence rate of perianal abscess–a population-based study, Sweden 1997-2009.Int J Colorectal Dis.2016;31(3):669-673. doi:10.1007/s00384-015-2500-7Thomas T, Chandan JS, Harvey PR, et al.The risk of inflammatory bowel disease in subjects presenting with perianal abscess: Findings from the THIN Database.J Crohns Colitis. 2019;13(5):600-606. doi:10.1093/ecco-jcc/jjy210Colon & Rectal Surgeons of Greater Hartford.The link between STDs and abscesses.Vinkel C, Thomsen SF.Hidradenitis suppurativa: Causes, features, and current treatments.J Clin Aesthet Dermatol.2018;11(10):17-23.Pinnell R, Crozier M, Giles SM.The occasional anorectal abscess.Can J Rural Med. 2021;26(1):31-34. doi:10.4103/CJRM.CJRM_16_20Kim MJ.Transrectal ultrasonography of anorectal diseases: advantages and disadvantages.Ultrasonography. 2015;34(1):19-31. doi:10.14366/usg.14051Adamina M, Pozza G.How to drain an abscess. In:Anal Fistula and Abscess. Cham: Springer International Publishing. 2022:235-249.University of Michigan Health.Boils.American Society of Colon & Rectal Surgeons.Abscess and fistula.Additional ReadingMappes HJ.Anal abscess and fistula. Surgical treatment: Evidence-based and problem-oriented.

18 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Wright WF.Infectious diseases perspective of anorectal abscess and fistula-in-ano disease.Am J Med Sci. 2016;351(4):427-34. doi:10.1016/j.amjms.2015.11.012Sahnan K, Adegbola SO, Tozer PJ, Watfah J, Phillips RK.Perianal abscess.BMJ. 2017;356:j475. doi:10.1136/bmj.j475Chang J, Mclemore E, Tejirian T.Anal Health Care Basics.Perm J. 2016;20(4):15-222. doi:10.7812/TPP/15-222Meshram MS, Khandare K.The management of perianal abscess with an Udumber Ksheer Pichu–A case report.Int J Innovative Scid Res Technol. 2022;7(8):1692-1695.Lohsiriwat V.Anorectal emergencies.World J Gastroenterol. 2016;22(26):5867-5878. doi:10.3748/wjg.v22.i26.5867Owen HA, Buchanan GN, Schizas A, Cohen R, Williams AB.Quality of life with anal fistula.Ann R Coll Surg Engl. 2016;98(5):334-338. doi:10.1308/rcsann.2016.0136Mitra A, Yadav A, Mehta N, Varma V, Kumaran V, Nundy S.Complicated Perianal Sepsis.Indian J Surg. 2015;77(Suppl 3):769-773. doi:10.1007/s12262-013-0997-yHarvard Health Publishing.Anal disorders.Bender F, Eckerth L, Fritzenwanker M, et al.Drug resistant bacteria in perianal abscesses are frequent and relevant.Sci Rep. 2022;12(1):14866. doi:10.1038/s41598-022-19123-6Adamo K, Sandblom G, Brännström F, Strigård K.Prevalence and recurrence rate of perianal abscess–a population-based study, Sweden 1997-2009.Int J Colorectal Dis.2016;31(3):669-673. doi:10.1007/s00384-015-2500-7Thomas T, Chandan JS, Harvey PR, et al.The risk of inflammatory bowel disease in subjects presenting with perianal abscess: Findings from the THIN Database.J Crohns Colitis. 2019;13(5):600-606. doi:10.1093/ecco-jcc/jjy210Colon & Rectal Surgeons of Greater Hartford.The link between STDs and abscesses.Vinkel C, Thomsen SF.Hidradenitis suppurativa: Causes, features, and current treatments.J Clin Aesthet Dermatol.2018;11(10):17-23.Pinnell R, Crozier M, Giles SM.The occasional anorectal abscess.Can J Rural Med. 2021;26(1):31-34. doi:10.4103/CJRM.CJRM_16_20Kim MJ.Transrectal ultrasonography of anorectal diseases: advantages and disadvantages.Ultrasonography. 2015;34(1):19-31. doi:10.14366/usg.14051Adamina M, Pozza G.How to drain an abscess. In:Anal Fistula and Abscess. Cham: Springer International Publishing. 2022:235-249.University of Michigan Health.Boils.American Society of Colon & Rectal Surgeons.Abscess and fistula.Additional ReadingMappes HJ.Anal abscess and fistula. Surgical treatment: Evidence-based and problem-oriented.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Wright WF.Infectious diseases perspective of anorectal abscess and fistula-in-ano disease.Am J Med Sci. 2016;351(4):427-34. doi:10.1016/j.amjms.2015.11.012Sahnan K, Adegbola SO, Tozer PJ, Watfah J, Phillips RK.Perianal abscess.BMJ. 2017;356:j475. doi:10.1136/bmj.j475Chang J, Mclemore E, Tejirian T.Anal Health Care Basics.Perm J. 2016;20(4):15-222. doi:10.7812/TPP/15-222Meshram MS, Khandare K.The management of perianal abscess with an Udumber Ksheer Pichu–A case report.Int J Innovative Scid Res Technol. 2022;7(8):1692-1695.Lohsiriwat V.Anorectal emergencies.World J Gastroenterol. 2016;22(26):5867-5878. doi:10.3748/wjg.v22.i26.5867Owen HA, Buchanan GN, Schizas A, Cohen R, Williams AB.Quality of life with anal fistula.Ann R Coll Surg Engl. 2016;98(5):334-338. doi:10.1308/rcsann.2016.0136Mitra A, Yadav A, Mehta N, Varma V, Kumaran V, Nundy S.Complicated Perianal Sepsis.Indian J Surg. 2015;77(Suppl 3):769-773. doi:10.1007/s12262-013-0997-yHarvard Health Publishing.Anal disorders.Bender F, Eckerth L, Fritzenwanker M, et al.Drug resistant bacteria in perianal abscesses are frequent and relevant.Sci Rep. 2022;12(1):14866. doi:10.1038/s41598-022-19123-6Adamo K, Sandblom G, Brännström F, Strigård K.Prevalence and recurrence rate of perianal abscess–a population-based study, Sweden 1997-2009.Int J Colorectal Dis.2016;31(3):669-673. doi:10.1007/s00384-015-2500-7Thomas T, Chandan JS, Harvey PR, et al.The risk of inflammatory bowel disease in subjects presenting with perianal abscess: Findings from the THIN Database.J Crohns Colitis. 2019;13(5):600-606. doi:10.1093/ecco-jcc/jjy210Colon & Rectal Surgeons of Greater Hartford.The link between STDs and abscesses.Vinkel C, Thomsen SF.Hidradenitis suppurativa: Causes, features, and current treatments.J Clin Aesthet Dermatol.2018;11(10):17-23.Pinnell R, Crozier M, Giles SM.The occasional anorectal abscess.Can J Rural Med. 2021;26(1):31-34. doi:10.4103/CJRM.CJRM_16_20Kim MJ.Transrectal ultrasonography of anorectal diseases: advantages and disadvantages.Ultrasonography. 2015;34(1):19-31. doi:10.14366/usg.14051Adamina M, Pozza G.How to drain an abscess. In:Anal Fistula and Abscess. Cham: Springer International Publishing. 2022:235-249.University of Michigan Health.Boils.American Society of Colon & Rectal Surgeons.Abscess and fistula.

Wright WF.Infectious diseases perspective of anorectal abscess and fistula-in-ano disease.Am J Med Sci. 2016;351(4):427-34. doi:10.1016/j.amjms.2015.11.012

Sahnan K, Adegbola SO, Tozer PJ, Watfah J, Phillips RK.Perianal abscess.BMJ. 2017;356:j475. doi:10.1136/bmj.j475

Chang J, Mclemore E, Tejirian T.Anal Health Care Basics.Perm J. 2016;20(4):15-222. doi:10.7812/TPP/15-222

Meshram MS, Khandare K.The management of perianal abscess with an Udumber Ksheer Pichu–A case report.Int J Innovative Scid Res Technol. 2022;7(8):1692-1695.

Lohsiriwat V.Anorectal emergencies.World J Gastroenterol. 2016;22(26):5867-5878. doi:10.3748/wjg.v22.i26.5867

Owen HA, Buchanan GN, Schizas A, Cohen R, Williams AB.Quality of life with anal fistula.Ann R Coll Surg Engl. 2016;98(5):334-338. doi:10.1308/rcsann.2016.0136

Mitra A, Yadav A, Mehta N, Varma V, Kumaran V, Nundy S.Complicated Perianal Sepsis.Indian J Surg. 2015;77(Suppl 3):769-773. doi:10.1007/s12262-013-0997-y

Harvard Health Publishing.Anal disorders.

Bender F, Eckerth L, Fritzenwanker M, et al.Drug resistant bacteria in perianal abscesses are frequent and relevant.Sci Rep. 2022;12(1):14866. doi:10.1038/s41598-022-19123-6

Adamo K, Sandblom G, Brännström F, Strigård K.Prevalence and recurrence rate of perianal abscess–a population-based study, Sweden 1997-2009.Int J Colorectal Dis.2016;31(3):669-673. doi:10.1007/s00384-015-2500-7

Thomas T, Chandan JS, Harvey PR, et al.The risk of inflammatory bowel disease in subjects presenting with perianal abscess: Findings from the THIN Database.J Crohns Colitis. 2019;13(5):600-606. doi:10.1093/ecco-jcc/jjy210

Colon & Rectal Surgeons of Greater Hartford.The link between STDs and abscesses.

Vinkel C, Thomsen SF.Hidradenitis suppurativa: Causes, features, and current treatments.J Clin Aesthet Dermatol.2018;11(10):17-23.

Pinnell R, Crozier M, Giles SM.The occasional anorectal abscess.Can J Rural Med. 2021;26(1):31-34. doi:10.4103/CJRM.CJRM_16_20

Kim MJ.Transrectal ultrasonography of anorectal diseases: advantages and disadvantages.Ultrasonography. 2015;34(1):19-31. doi:10.14366/usg.14051

Adamina M, Pozza G.How to drain an abscess. In:Anal Fistula and Abscess. Cham: Springer International Publishing. 2022:235-249.

University of Michigan Health.Boils.

American Society of Colon & Rectal Surgeons.Abscess and fistula.

Mappes HJ.Anal abscess and fistula. Surgical treatment: Evidence-based and problem-oriented.

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