Rectal Abscess

A rectal abscess is a pus-filled pocket that forms in your rectum.

What increases my risk for a rectal abscess?

  • Blocked anal glands or an infected anal fissure (tear in the lining of your rectum)
  • Diseases such as diabetes or Crohn disease
  • A puncture from items such as fish bones that are swallowed
  • Internal hemorrhoids, acute appendicitis, or diverticulitis
  • Trauma to the rectum, such as from anal sex, an enema, or treatment for an internal hemorrhoid
  • Surgery on your anus or rectum, or your vaginal area (women)

What are the signs and symptoms of a rectal abscess?

  • Pain in your rectum, especially when you sit or have a bowel movement
  • Swelling that is painful, hard, tender, or red
  • Pus that drains from the swollen area
  • A foul-smelling discharge from your anus
  • Trouble urinating, or constipation
  • Fever or unusual tiredness

How is a rectal abscess diagnosed?

Your healthcare provider will ask about your symptoms and when they started. Tell him about any recent changes to your bowel movements, such as color or how often you have them. Tell him if you have constipation or diarrhea. Tell him if you have had any nausea or vomiting when you were not sick. Also tell him about any medical conditions you have, such as Crohn disease or diabetes. You may need any of the following:

  • Blood tests may show signs of a bacterial infection or other cause of the abscess.
  • A manual rectal exam is done so your healthcare provider can feel for lumps or other problems. He will insert a gloved finger into your rectum through your anus.
  • Anoscopy is a procedure used to examine your rectum. Your healthcare provider will insert an anoscope (speculum) into your rectum. He may also take a tissue sample to be tested.
  • CT, MRI, or ultrasound pictures may show the abscess. The pictures may also show damage to the rectum.

How is a rectal abscess treated?

Treatment will depend on the type of abscess and where it is located in your rectum. You may need any of the following:

  • Incision and drainage is a procedure used to drain the abscess.
  • Medicines may be given to fight the bacterial infection or to reduce pain. You may also need medicine to soften your bowel movements to prevent straining.
  • Surgery may be needed to fix damage to your rectum.

What can I do to manage or prevent a rectal abscess?

The abscess may take a few weeks to heal. The following can help manage symptoms and prevent another abscess:

  • Prevent constipation. Eat more fruits, vegetables, and whole-grain breads to increase the amount of fiber you have each day. Drink more liquids. Fiber and liquid help prevent constipation. It may also help to create a bowel movement routine. Do not strain to have a bowel movement. The strain may cause more damage. Your healthcare provider may give you or recommend medicine to soften your bowel movements if you are having problems.
  • Take sitz baths as directed. A sitz bath is a portable tub that fits into the toilet basin. You can also soak in a bathtub that has 4 to 6 inches of warm water. Stay in the sitz bath or tub for 15 to 20 minutes. Ask your healthcare provider how often to do this.
  • Apply warm compresses as directed. A warm compress may help relieve your symptoms. To make a warm compress, soak a small towel in warm water. Apply the compress to the area for 15 to 20 minutes. Ask your healthcare provider how often to do this.
  • Do not insert anything into your rectum unless directed. Items such as rectal thermometers and suppositories can cause damage while you are healing.

When should I seek immediate care?

  • You have severe pain during a bowel movement, or pain that lasts for hours afterward.
  • You see blood in your bowel movement.
  • You see a tear in the anus, or a skin tag near the tear.
  • You have itching, burning, or irritation near your anus.
  • You have new or worsening pain or other symptoms.

When should I contact my healthcare provider?

  • You have questions or concerns about your condition or care.