What are possible causes of recurrent anal abscesses?

People who have a lot of perianal hair follicles are more prone to perianal abscesses. For patients who have recurrent anal abscesses, after excluding hygiene issues, we will need to exclude the underlying unresolved conditions. These can include an underlying sinus tract. It is a channel that connects the lumen of the anus or rectum to the abscess.

The other possibility is that there remains a deeper abscess collection which has not been treated. We must also exclude chronic infective or inflammatory conditions such as chronic tuberculosis or inflammatory bowel disease.

A history of repeated trauma may also increase the risk.

If an anal abscess recurs in the same location, it is almost always due to an undiagnosed anal fistula.

When a patient has an anal abscess, that causes a painful swelling around the anus. The pus may drain spontaneously if the skin over the abscess ruptures or if the abscess is drained surgically. Once the pus has been drained and antibiotics are taken, the skin over the abscess can heal. However, the abscess may still be communicating with the anal canal and that allows recurrent infection.

You should speak to a colorectal surgeon. During a clinical assessment, a fistula tract can often be felt under the skin, confirming the location of the fistula tract. If the surgeon is not convinced about the location of the fistula tract, he/she may perform an endoanal ultrasound or MRI to determine the fistula tract. You should undergo a surgery to cure you of the anal fistula.

I would say that the most common cause of recurrent anal abscesses is the presence of an anal fistula, which may remain undiagnosed.

An anal fistula is a “tunnel” or tract that connects the inside of the anal canal with the skin surrounding the anus. This allows bacteria to enter the tunnel and cause an infection in the tissue around the abscess. An anal fistula requires surgery to be treated well and will not resolve on its own.

Other causes of recurrent anal abscesses that are important to exclude, especially in the elder age group, are cancerous tumours. Inflammatory bowel disease and other types of infections such as TB may also be considered.

Your doctor may suggest colonoscopy (endoscopic examination of the colon) to exclude other diseases.