How Recurrent Anal Abscesses Increase Your Risk of Developing a Fistula

Glands inside the anus can sometimes become blocked with bacteria, fecal matter, or other foreign debris, causing an infection within the gland. This infection produces pus and creates a painful anal abscess that usually requires surgical drainage. 

Anal fistulas are abnormal channels under the skin that connect the anal canal with an opening on your buttocks. These, too, can cause pain and infection, along with pus-filled drainage at the anal opening. 

These two conditions are closely connected, since your risk of developing an anal fistula grows after you’ve had an anal abscess. Dr. Lisa Perryman at Colorado Colon & Rectal Specialists in Parker, Colorado, treat anal fistulas and abscesses, along with many other conditions of the colon and rectum. Understanding abscesses and fistulas helps you to recognize when treatment becomes necessary.  

Anal abscess

The formation of an anal abscess is similar to that of an acne pimple. But, instead of the  sebaceous oils and dead skin cells that clog a hair follicle to form a pimple, fecal matter tends to be the reason an anal abscess forms. 

There are other causes contributing to anal abscesses besides blocked glands, including infections of anal fissures and some sexually transmitted infections. Your risk of abscesses climbs with any of these factors: 

• Colitis
• Diabetes
• Diverticulitis
• Inflammatory bowel disease (including Crohn’s disease and ulcerative colitis)
• Pelvic inflammatory disease
• Certain medications, including prednisone
• Receiving anal intercourse

About 50% of people who develop anal abscesses will also develop anal fistulas, according to the American Society of Colon & Rectal Surgeons (ASCRS). Recurring anal abscesses increase your risk of developing anal fistulas.

Anal fistulas

Most anal fistulas occur during or after an anal abscess. A fistula forms as the infection burrows through the abscess and spreads toward the surface skin of the buttocks, creating a tunnel that’s lined with epithelial walls. Pus may leak from the fistula to this new opening, or the opening itself can become clogged, leading to recurring anal abscesses. 

Treatments for abscesses and fistulas

Dr. Perryman recommends a quick in-office drainage of an anal abscess that requires only local anesthetic. Abscesses that are large and deep may require surgery and, in some cases, a drain placed to help remove material from the body. 

Although fistulas usually appear after an abscess is drained, both may be present at the same time. Treating fistulas usually requires surgery. Dr. Perryman uses contemporary surgical techniques that minimize damage to surrounding, healthy tissue. 

Persistent anal pain, accompanied by bowel movement pain, skin irritation, or the discharge of pus may be a sign of an anal abscess. Contact Colorado Colon & Rectal Specialists by phone or online to schedule an examination at the first sign of trouble.