Anorectal Abscess: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Anorectal Abscess?
An anorectal abscess is usually treated by a colorectal surgeon, a doctor who operates on the colon, rectum, and anus. Emergency medicine doctors can drain small, superficial abscesses. A primary care doctor can spot the problem and refer you. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is an anorectal abscess?
An anorectal abscess is a collection of pus in the area of the anus and rectum. Pus is a thick fluid that forms where the body fights infection. The anus is the opening at the end of the bowel. The rectum is the last part of the large intestine, just above the anus.
The problem rarely goes away on its own. Treatment involves surgery to open and drain the abscess. With prompt treatment, people with this condition usually do well.
Symptoms
Common symptoms are swelling around the anus and a constant, throbbing pain. Pain may be severe with bowel movements, coughing, and sitting. Other symptoms may include:
- Discharge of pus from the rectum or near the anus.
- Red, painful, and hardened tissue near the anus, with tenderness.
- Fever, chills, night sweats, and fatigue.
- Constipation, which means stools that are hard to pass.
In infants and toddlers, the abscess often looks like a swollen, red, tender lump at the edge of the anus. The child may be fussy and irritable.
Causes and who gets it
The most common cause is blocked glands in the anal area. These small glands can get plugged, and bacteria then grow inside them. Other causes include infection of an anal fissure (a small tear in the anus lining), sexually transmitted infections, and trauma to the anal area. Deep abscesses can come from bowel problems such as Crohn disease or diverticulitis (infected pouches in the colon).
Risk factors include diabetes, a weak immune system, inflammatory bowel disease, corticosteroid medicines, chemotherapy medicines, and anal sex. Smoking and obesity also raise the risk. The condition affects men more than women. It can also happen in infants who still wear diapers and have had anal fissures.
How doctors diagnose it
Doctors start with a physical exam, often with a gentle digital rectal exam. That is when a doctor wears a glove and checks inside the anus with a finger. A proctosigmoidoscopy may be done to look for other diseases. This test uses a thin, lighted tube to look inside the lower bowel. Some cases need a CT scan, MRI, or ultrasound to locate the pus.
Treatment
The main treatment is surgery to open and drain the pus. Antibiotics alone usually cannot treat an abscess. Drainage is often an outpatient procedure. That means you go home the same day. The doctor uses numbing medicine and medicine to make you sleepy.
Antibiotics are saved for certain cases, such as skin infection around it, sepsis, or a weak immune system. Sepsis is a serious illness that happens when an infection spreads through the body. The surgeon may prescribe painkillers and antibiotics when they are needed.
After surgery, warm sitz baths help relieve pain and swelling. A sitz bath means sitting in a tub of warm water. Avoiding constipation helps too. Drinking fluids and eating foods with lots of fiber can help, and you may need stool softeners. The wound is usually left open to heal, and healing can take up to 8 weeks. Follow-up visits matter, because abscesses can come back.
When to see a doctor
See a doctor right away if you have rectal pain, swelling, or discharge of pus. An untreated abscess needs prompt surgery, so do not wait for it to burst. Call 911 if you have a fever, a fast heartbeat, or you feel very unwell. Also call 911 for confusion, trouble breathing, or fainting. These can be signs that the infection is spreading through the body (sepsis). Also call your doctor if you get chills or other new symptoms after treatment.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either can examine you, arrange imaging, and coordinate care with a surgeon. They can also follow your recovery after drainage and manage problems like diabetes that raise the risk.
Common questions
Can an anorectal abscess go away without surgery?
It rarely goes away on its own. Antibiotics alone usually cannot treat it. Treatment involves surgery to open and drain the abscess.
What is an anal fistula?
A fistula is a small tunnel that forms between the end of the bowel and the skin near the anus. Most anal fistulas develop after an abscess. They will not usually get better on their own, and surgery is recommended in most cases.
How long does recovery take?
The wound can take up to 8 weeks to heal completely. Sitz baths, wound care, and avoiding constipation help. With prompt treatment, people with this condition usually do well, and infants and toddlers usually recover quickly.
Can anorectal abscess be prevented?
Not every case can be prevented. Prompt treatment of sexually transmitted infections lowers the risk, and condoms help prevent those infections. A high-fiber diet helps prevent constipation and blocked anal glands. People with diabetes should keep tight control of their blood sugar.
Sources
- MedlinePlus - Anorectal abscess: MedlinePlus Medical Encyclopedia
- StatPearls, NCBI Bookshelf - Anorectal Abscess
- NHS - Anal fistula
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
