The rectum is the last part of the large intestine, where stools (bowel movements) are stored before leaving the body through the anal canal and anus. When the rectal space (the perirectal space) and glands in the rectum that make mucus are infected by bacteria, small hollow cavities or holes that fill with pus form. These collections of pus-filled cavities in this area are called perirectal abscesses. Abscesses can also form around the anus and are called perianal abscesses.
Anyone can have a perirectal abscess, but men get them more often than women.
The most common cause is a bacterial infection from the anal canal into one of the perirectal spaces. All these bacteria are normally found in the bowel (large intestine) and on skin outside the anal canal.
Symptoms include rectal pain that is lasting, throbbing, and often made worse with movement or straining. Others are fever, constipation, and trouble urinating. Sometimes, a rectal mass can be felt that is red, hot, tender, and swollen.
The health care provider makes a diagnosis from symptoms and doing a physical examination. Blood tests and urine tests may also be done.
The main treatment is surgery. People with surface abscesses can be treated as an outpatient with local anesthesia. Deeper abscesses usually need hospitalization. A general surgeon or surgeon who specializes in diseases of the colon and rectum does the operation.
Antibiotics are often given but don’t substitute for prompt surgery and draining the abscess. Pain after surgery is usually treated by sitting in warm water (called sitz baths) three or four times daily. Medicines can also help relieve pain.
Stool softeners are used to prevent getting constipated and stop straining with bowel movements.
Complications that can occur after surgery include incomplete healing, having the abscess come back, and formation of a fistula. A fistula is a tunnel connecting the skin with the anal gland that the abscess started from. A fistula usually occurs 4 to 6 weeks after abscess drainage and needs surgery to fix it.
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Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.
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