Anal Abscesses: Symptoms, Causes, and When to Seek Help

Anal abscess

Over the past few years, I have occasionally noticed a lump on my buttocks in different locations, more than five centimeters away from the anus.
Initially, I thought it was a sebaceous cyst and that it would resolve on its own since I couldn't feel it.
Later, after researching, I suspected it might be an anal abscess.
I haven't seen a doctor, but two years ago, I had a large lump more than five centimeters from the anus.
After healing, I couldn't feel the lump anymore, and there was no pus or opening on the surface, but there was a small circular area of pigmentation that looked like a scar.
When I pressed it with my finger, it felt indented.
There has been no recurrence since then.
Last year, another lump appeared a bit farther from the anus.
The healing of this wound was similar to the previous one.
A few months ago, I had another abscess in a different location, and I noticed that each time the abscess occurred, it was on the left side of my buttocks.

I would like to ask the doctor:
1.
Since each abscess is in a different location on the left side, is this indicative of an anal abscess, or could it possibly be a sebaceous cyst? (There is a subcutaneous lump that sometimes becomes very large and painful, but eventually resolves, leaving only the two scarred pigmented wounds mentioned above.)
2.
Why do these lumps keep appearing in different locations? How can I prevent this?
3.
The indentation I feel when pressing the wound, could it be an anal fistula? (It has healed on its own over the years, with no opening on the surface and no pus drainage, and there has been no recurrence of abscesses at the same location.) Under what circumstances should I see a doctor?
4.
If my buttocks swell again, should I see a doctor immediately, or can I wait to see if it heals on its own? Will the outpatient doctor drain it directly? If the drainage wound does not heal, does that mean it has turned into an anal fistula?

Miss Chen, 20~29 year old female. Ask Date: 2023/08/25

Dr. Ke Fangxu reply Surgery

It is necessary to conduct a physical examination to differentiate between an anal abscess and a sebaceous cyst.
Please consult a physician for an accurate diagnosis, as different conditions will require different recommendations and management strategies.
Without a confirmed diagnosis, it is not possible to provide advice.
Online consultations cannot replace in-person medical evaluations.
Please seek medical attention promptly to avoid delaying treatment.

Reply Date: 2023/08/25

More Info

Understanding anal abscesses is crucial for maintaining good health and addressing any potential complications. An anal abscess is a painful condition that occurs when a collection of pus forms near the anus, often due to an infection. This condition can be quite uncomfortable and may lead to further complications if not treated properly.

Symptoms of Anal Abscesses
The symptoms of an anal abscess can vary, but common signs include:
- Pain and Swelling: You may experience localized pain and swelling around the anus. This pain can be sharp and may worsen when sitting or during bowel movements.

- Fever: In some cases, a fever may accompany the abscess, indicating a more systemic infection.

- Redness and Warmth: The area around the abscess may appear red and feel warm to the touch.

- Discharge: If the abscess ruptures, you may notice pus or blood draining from the area.

Causes of Anal Abscesses
Anal abscesses can be caused by several factors, including:
- Infection: Bacteria can enter the anal glands and cause an infection, leading to the formation of an abscess.

- Blocked Glands: Blockage of the anal glands can trap bacteria and lead to pus accumulation.

- Inflammatory Bowel Disease: Conditions like Crohn's disease can increase the risk of developing abscesses.

When to Seek Help
It is essential to seek medical attention if you experience any of the following:
- Severe Pain: If the pain becomes unbearable or significantly affects your daily activities.

- Fever: A fever may indicate that the infection is spreading.

- Persistent Symptoms: If the abscess does not improve or continues to recur, it is crucial to consult a healthcare professional.

- Changes in Bowel Habits: If you notice changes in your bowel habits, such as increased frequency or difficulty passing stool.

Addressing Your Concerns
1. Location and Nature of the Abscess: Given that you have experienced multiple swellings in different locations, it is possible that these could be anal abscesses rather than sebaceous cysts (粉瘤). The fact that they are recurring and located on the left side suggests a potential underlying issue that should be evaluated by a healthcare professional.

2. Why Different Locations?: The recurrence of abscesses in different locations may indicate that there are multiple anal glands that are becoming blocked or infected. It is essential to understand the underlying cause to prevent future occurrences.

3. Dimpling or Indentation: The indentation you feel when pressing on the scar may indicate that there is a fistula or a connection between the anal canal and the skin surface. This can occur if an abscess has drained and left a tract behind.

4. When to See a Doctor: If you notice swelling, pain, or any signs of infection, it is advisable to see a doctor promptly. While some abscesses may resolve on their own, others may require drainage or further treatment to prevent complications.

Conclusion
In summary, if you are experiencing recurrent anal abscesses, it is crucial to seek medical evaluation. A healthcare provider can perform a thorough examination, possibly including imaging studies, to determine the nature of the abscesses and recommend appropriate treatment. Early intervention can prevent complications such as the development of fistulas or chronic infections. If you notice any concerning symptoms, do not hesitate to reach out to a healthcare professional for guidance.

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