What are available treatments for anal abscesses?

It is a collection of pus form of an infection that develops near the anus. Often, the anal abscesses are a result of infection from small anal glands. The anal abscesses can be found in deeper tissue are uncommon.

The common causes of anal abscesses include:

1. A tear in the anal canal - thus causing it to be infected
2. Blocked anal glands
3. Sexually transmitted infections - HIV, AIDS, Gonorrhea, etc.

The immediate treatment of a painful abscess will be to have the abscess drained. Often this is all that is necessary. Only if the condition is recurrent or if there is a persistent discharge following the drainage procedure, an examination under anaesthesia and possibly a biopsy will then be required.

Anal abscesses may sometimes first be treated with oral antibiotics. However, if the condition and abscess worsen, then surgical drainage of the abscess is required. Even if the abscess discharges spontaneously, surgical incision and debridement may be required for resolution of the abscess cavity.

Many anal abscesses are associated with and are caused by anal fistulae, which are “tunnels” or tracts connecting the inside of the anus with the skin around the anus. These fistulae need to be surgically treated since they will not heal or go away by themselves. The presence of fistulae may also cause recurrent anal abscesses.

It is also important to exclude other diseases such as infections, inflammatory bowel disease, cancer etc. if you have recurrent anal abscesses.

An anal abscess can be treated with antibiotics first if it is small and not very painful. An anal abscess may heal spontaneously after antibiotics. The success rate of oral antibiotics is quoted between 30-70%, depending on the clinical study performed. The wide variation should not deter you from trying antibiotics because the alternative to antibiotics is surgery.

However, if the abscess is very painful or large, it should be drained surgically. This is because antibiotics work by reaching the abscess through your bloodstream. Your blood can only reach the outer margins of an abscess. If the cavity is large, the antibiotics cannot penetrate into the centre of the abscess cavity and it will not work.