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Types of Anorectal Abscess: Causes, Symptoms & When to See a Doctor

An anorectal abscess is a painful collection of pus near the anus or rectum. It happens when a small gland inside the anus gets blocked and infected. Anyone can get it — young or old — and it usually starts suddenly with severe pain.

Knowing the different types of anorectal abscesses helps patients understand why some abscesses seem simple while others require specialized surgical care.

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1. Perianal Abscess (Most Common)

This is the simplest and most frequent type.

Where it occurs: Just under the skin around the anus.

Symptoms:

  • Swelling near the anus
  • Redness and severe pain
  • Difficulty sitting
  • Sometimes fever

Treatment: A small cut to drain the pus (usually a quick procedure). Patients feel relief almost immediately.


2. Ischiorectal Abscess

This abscess lies deeper in the buttock, in a space called the ischiorectal fossa.

How it feels:

  • Pain that spreads to the buttock
  • Difficulty walking or sitting
  • Fever or chills

Why it’s important: These abscesses may grow large and may spread to both sides, forming a horseshoe abscess.


3. Intersphincteric Abscess

This abscess is deep inside, between the two anal muscles (sphincters).

Patients usually notice:

  • Deep, throbbing pain inside the anus
  • Pain worse at night or during bowel movements
  • No visible swelling

Because it is hidden, doctors often use MRI or endoscopic ultrasound for diagnosis.


4. Supralevator Abscess

This is the deepest type of abscess and forms above the pelvic floor muscles.

Symptoms may include:

  • Pain deep in the pelvis
  • Pressure sensation
  • Fever
  • Difficulty passing stool

These abscesses must be drained carefully, because a wrong drainage route may create a complex fistula.


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5. Horseshoe Abscess

A horseshoe abscess spreads around the back of the anus, involving both sides of the buttock.

Typical symptoms:

  • Severe pain around the whole anal region
  • Swelling on both sides
  • Difficulty sitting or walking

It requires expert drainage from the midline and both sides to prevent recurrence.


6. Submucosal Abscess

This abscess forms just under the lining of the anal canal.

Symptoms:

  • Sharp anal pain
  • Sometimes minor bleeding
  • No visible swelling outside

Treatment is simple: a small cut inside the anal canal.

Why Early Treatment Is Important

Anorectal abscesses do not go away on their own.

Delaying treatment can lead to:

  • More pain
  • Larger infection
  • Formation of a fistula (an abnormal tunnel)
  • Recurrence

At Karan Hospital in Jalandhar, we offer advanced treatment for all abscess types, including laser procedures and minimally invasive methods, ensuring quicker recovery with less discomfort.

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When to See a Doctor

Seek medical help immediately if you have:

  • Severe anal or buttock pain
  • Swelling or redness around the anus
  • Fever with rectal pain
  • Difficulty sitting
  • Pus discharge

Early drainage prevents complications and ensures a smoother recovery.

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