Home Hemorrhoids Hemorrhoid Abscess: 9 Symptoms, 7 Causes & 6 Risk Factors

Hemorrhoid Abscess: 9 Symptoms, 7 Causes & 6 Risk Factors

An abscess due to hemorrhoids
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Hemorrhoid abscess is the development of an abscess in the perianal area because of hemorrhoids. An abscess is more painful and significant than an abscess or hemorrhoid. Painful swelling and inflammation can make sitting or moving around uncomfortable.

A hemorrhoid abscess is an infection at the site of the hemorrhoid, leading to a painful, swollen area filled with pus near the anus or rectum. Treatment typically involves drainage and may include antibiotics or surgery if necessary.

To help manage pain during the treatment process, consider using a numbing cream like Dr. Numb®. Additionally, follow your doctor's aftercare instructions carefully to ensure proper healing and reduce discomfort.

In this post, we will explain well-versed about what a hemorrhoid abscess is, its tell-tale symptoms, potential causes, risk factors, and, importantly, how it's diagnosed and treated.

Key Takeaways

  • Hemorrhoid abscesses are a painful condition caused by infected hemorrhoids, manifesting symptoms like discharge, anal or rectal pain, constipation, rectal bleeding, and fever, among others.
  • The causes of this condition include trauma, infected anal fissures, STIs, blocked anal glands, certain medical conditions, infected epidermoid cysts, and Hidradenitis Suppurativa.
  • Individuals with colitis, IBD, diabetes, pelvic inflammatory disease, and those engaging in receptive anal sex are at a higher risk of developing hemorrhoid abscesses.
  • Diagnosis involves a thorough clinical evaluation, including rectal examination, screening for associated conditions, and advanced imaging procedures.
  • Treatment for hemorrhoid abscesses primarily involves surgical drainage, supplemented by pain management, use of antibiotics when required, and post-procedure care for recovery.
  • Preventive measures include managing existing medical conditions effectively, maintaining good hygiene, and practicing safe sex during anal intercourse.

Hemorrhoid Abscess: 9 Symptoms

Nine symptoms of hemorrhoid abscess

This abscess occurs when hemorrhoids become infected. Abscesses can also refer to abscesses around hemorrhoids or abscesses around infected hemorrhoids. These conditions, while related to the anal and rectal areas, have distinct characteristics but can share some overlapping symptoms. Here are some symptoms:

Pus-like Discharge from the Anus

A pus-like discharge emanating from the anus is a powerful indicator of infection. In hemorrhoids, this symptom is unusual and suggests an added complication, such as an infection of a thrombosed hemorrhoid or an anal abscess. The discharge signifies the body's response to bacterial infection, producing pus as a combination of white blood cells, dead tissue, and bacteria.

Pain in Your Anus or Rectum

Pain is a common denominator in many anorectal conditions, including hemorrhoids and abscesses. However, the nature of the pain can offer clues to its cause. Hemorrhoids typically cause discomfort and pain, especially during bowel movements or sitting. An abscess can cause severe, constant, throbbing pain because of pressure buildup in the infected area.

Lump or Nodule That’s Red, Swollen and Painful

Lumps or nodules are palpable signs that something is amiss. With hemorrhoids, these lumps could show swollen hemorrhoidal veins. If these veins become thrombosed, the lump can be painful and stiff. With an abscess, the lump represents a pus that has formed under the skin, causing swelling, redness, and significant pain upon touch.

Constipation or Painful Bowel Movements

Both hemorrhoids and abscesses can make the prospect of bowel movements daunting. Hemorrhoids can cause pain and bleeding, particularly with strained bowel movements, leading to constipation because of fear of pain. Similarly, an abscess, because of its location and the pain associated with it, can make the act of defecation extremely painful, further exacerbating constipation.

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Irritation of the Tissue Around Your Anus

Irritation in the anal region can be attributed to both hemorrhoids and abscesses. Hemorrhoids, with their swollen vascular structures, can lead to itching and irritation because of mucus secretion or minor bleeding. For abscesses, the irritation is often caused by inflammation and infection spreading to the surrounding tissue.

Rectal Bleeding

Rectal bleeding is more directly associated with hemorrhoids, especially internal ones, which can bleed when irritated by bowel movements. Though less common with abscesses, significant infection and inflammation might lead to minor bleeding if the abscess is near or on the surface of the anal canal.

Pain in the Lower Part of Your Abdomen

While not a typical symptom of uncomplicated hemorrhoids, lower abdominal pain can occur if infection from an abscess spreads or exerts significant pressure on adjacent areas of the body, showing a more severe illness that requires immediate medical attention.

A Swollen and Tender Boil

This symptom is characteristic of an abscess, describing the lump formed by the accumulation of pus. It's tender and painful to touch, often warm, and visually noticeable. This distinguishable feature sets abscesses apart from hemorrhoids, which don't form boils.

Fever, Chills

Fever and chills are systemic responses to infection, signifying that the body is fighting pathogens. These symptoms are rarely associated with uncomplicated hemorrhoids but show an abscess or other infectious processes occurring in the body, causing prompt medical evaluation and treatment.

Hemorrhoid Abscesses: 7 Causes

7 Causes Of Hemorrhoid Abscesses

An anal or perianal abscess may accompany complicated hemorrhoids. An abscess in hemorrhoidal tissue can be quite painful, so get medical help immediately. Below are some causes that could lead to the development of what might be termed hemorrhoid abscesses:

Infected Anal Fissure

An anal fissure is a small tear in the anus's lining, often caused by straining during bowel movements, chronic constipation, or passing hard stools. When an anal fissure becomes infected, it can lead to the formation of an abscess in the nearby tissue.

The infection occurs because the tear provides a pathway for bacteria from the bowel or skin to enter the underlying tissues, accumulating pus as the body attempts to fight off the infection.

Trauma to the Area

Physical trauma, such as that which might occur during anal intercourse, can introduce bacteria into internal tissues, creating an ideal environment for an abscess to form. The trauma can cause skin or mucosal lining breaks, providing an entry point for infection. This risk is heightened if pre-existing damage or sensitivity exists in the area, such as with hemorrhoids.

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Sexually Transmitted Infections (STIs)

Certain STIs, especially those causing ulcers or lesions (like herpes simplex virus or syphilis), increase your risk of an abscess. These infections compromise the integrity of the anal or perianal skin, making bacterial invasion and subsequent abscess formation more likely.

Blocked Anal Glands

Anal glands at the opening of the anus can become blocked and infected, leading to abscess formation. The glands produce a fluid that helps lubricate the anal canal, but when they're clogged, the fluid backs up, becomes infected, and can cause an abscess. This condition is particularly concerning as it can recur and lead to chronic problems.

Medical Conditions Affecting the Bowels or Intestines

Chronic inflammation of the bowels, such as Crohn's disease or ulcerative colitis, can increase the likelihood of developing abscesses around the anal area. These conditions cause inflammation and ulcers within the gastrointestinal tract, which can extend to the anal area, compromising its defenses against bacteria and leading to abscesses.

Infected Epidermoid (Sebaceous) Cyst

Infected Epidermoid (Sebaceous) Cyst

Epidermoid cysts are benign growths that can occur anywhere on the body, including the perianal area. If one of these cysts becomes infected, it can become an abscess. These cysts form when the sebaceous glands become clogged, and if bacteria infiltrate the cyst, an infection can ensue, causing medical intervention.

Hidradenitis Suppurativa

This chronic skin condition features lumps under the skin, which can break open and cause abscesses. When it affects the perianal area, it can be problematic. The exact cause of hidradenitis suppurativa is unknown, but it involves blockage and subsequent infection of hair follicles, leading to painful abscesses that can mimic or complicate hemorrhoidal issues.

6 Risk Factors For Hemorrhoid Abscesses

Perianal or anal abscess with hemorrhoidal complications. An abscess in this region is a localized infection that results in the collection of pus. Certain conditions and behaviors increase the risk of developing such diseases. Here's a closer look at the risk factors mentioned.


Colitis refers to inflammation of the colon's inner lining and can include ulcerative colitis, among other types. This condition causes chronic inflammation and ulcers in the digestive tract, which can compromise the body’s ability to fend off infections, making the surrounding tissue, including that around hemorrhoidal areas, more susceptible to abscess formation.

Inflammatory Bowel Disease (IBD)

Inflammatory bowel diseases, such as Crohn's disease and ulcerative colitis, lead to prolonged inflammation of the gastrointestinal tract. The chronic inflammation associated with IBD can weaken rectal tissues and cause fissures or ulcers that are potential entry points for bacteria, increasing the risk of abscess development near hemorrhoidal tissues.

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Diabetes compromises the immune system, impairing the body's ability to fight off infections, including those that can lead to abscess formation. High blood sugar levels can also slow down the healing process, making diabetic individuals more prone to infections in cuts or breaks in the skin around the anal area, which might complicate existing hemorrhoids.


Diverticulitis, inflammation or infection of small pouches that can form in your intestines (diverticula), doesn't directly cause hemorrhoid abscesses but shows a susceptibility to gastrointestinal infections and inflammation. If an individual with diverticulitis also has hemorrhoids, the inflammation and infection from diverticulitis might contribute to an increased risk of disease in the anal area.

Pelvic Inflammatory Disease (PID)

While PID mainly affects the female reproductive organs, its presence shows a broader susceptibility to infection, which can, in theory, extend to areas like the anus and rectum, especially if hemorrhoids are present. The bacteria from the PID could theoretically spread, increasing the risk of abscesses in adjacent areas.

Being the Receptive Partner in Anal Sex

Engaging in receptive anal sex can increase the risk of developing hemorrhoid abscesses because of potential physical trauma and the introduction of bacteria into the anal canal, which can infect existing hemorrhoids or fissures, leading to abscess formation.

Use of Medications Such as Prednisone

Corticosteroids, like prednisone, suppress the immune system, reducing the body’s inflammatory response. While this can be therapeutically beneficial, it also decreases the body's ability to fight infections, potentially increasing the risk of infection in areas of pre-existing vulnerability, such as hemorrhoidal tissues, leading to abscess development.

Diagnosis of Anal Abscesses

Diagnosis of Anal Abscesses

Diagnosing anal abscesses accurately is crucial for effective treatment and to prevent potential complications. Clinical evaluations typically involve a history, physical examination, and digital rectal exam (DRE). A comprehensive approach and additional diagnostic tests may be required because of the complexity of the anorectal region and the many conditions that mimic anal abscess symptoms. Let's inspect the diagnostic process.

Clinical Evaluation and Digital Rectal Exam

The first step in diagnosing an anal abscess is a clinical evaluation. The healthcare provider will ask about symptoms, medical history, and any risk factors that may contribute to the condition. A digital rectal exam is performed during the physical examination, where the doctor inserts a gloved, lubricated finger into the rectum to feel for abnormalities. This exam can provide immediate evidence of an abscess by detecting tenderness, swelling, or a palpable mass.

Screening for Associated Conditions

Because anal abscesses can be associated with or exacerbated by other medical conditions, additional tests might be necessary to screen for:

  • Sexually Transmitted Infections (STIs): Since STIs can cause lesions or infections that increase the risk of abscess formation, screening for STIs can help inform the treatment plan.
  • Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can lead to complications, including abscesses. Blood, stool, and endoscopic exams might assess for IBD.
  • Diverticular Disease: Although primarily affecting the colon, diverticular disease can influence the health of the entire digestive tract. A CT scan or colonoscopy might be performed to diagnose this condition.
  • Rectal Cancer: Given that cancerous growths can sometimes present similarly to abscesses, particularly if they're causing blockage or infection, screening for rectal cancer through imaging tests or a biopsy may be necessary.

Advanced Imaging

Where the diagnosis is uncertain or to better define the abscess's extent:

  • Ultrasound: Can visualize soft tissue structures and helps diagnose abscesses in superficial locations.
  • CT Scan: This procedure provides detailed images of the internal structures and is excellent for identifying abscesses, their sizes, and their exact locations, especially those deep within the pelvic cavity.
  • MRI: Offers superior soft tissue contrast, making it ideal for diagnosing complex or recurrent abscesses and differentiating them from other conditions, such as fistulas.


A proctosigmoidoscopy involves inspecting the rectum and the lower part of the colon using a flexible tube equipped with a light and camera. This procedure can help identify underlying causes of abscesses, such as tumors, IBD-related ulcers, or diverticulosis.

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Examination Under Anesthesia (EUA)

In rare cases, especially when the pain is too severe for a thorough examination or when the presence of complex fistulas is suspected, an examination under anesthesia may be required. This allows the healthcare provider to thoroughly inspect the area without causing discomfort to the patient.

Treatment of Hemorrhoid Abscess

Anal abscesses are uncomfortable and potentially serious conditions that require timely medical attention. Understanding the treatment options can help you know what to expect and how to prepare for recovery.

Immediate Treatment Steps

The primary step in treating anal abscesses is prompt surgical drainage, ideally before the abscess breaks open on its own:

  • Superficial Abscesses: These can often be drained in your doctor's office with a local anesthetic to numb the area.
  • Larger or Deeper Abscesses: These cases might cause a hospital visit and involve general anesthesia for a pain-free procedure.

Post-Procedure Care

After draining the abscess, managing discomfort and preventing infection are key:

  • Pain Management: Most patients receive medication to alleviate pain after the procedure. For many, over-the-counter options are adequate.
  • Antibiotics: While not everyone will need antibiotics, they are crucial for patients with conditions like diabetes or those with weakened immune systems.

Handling Fistulas

A fistula, which is a tunnel connecting the abscess to the skin, might form after the abscess is drained:

  • Immediate Surgery: Sometimes, surgery to address a fistula can happen during the abscess drainage, though this is not always the case.
  • Separate Procedure: Often, fistula surgery is performed later, usually as an outpatient procedure, to ensure thorough healing.

Recovery Tips

Recovery from abscess or fistula surgery is generally straightforward:

  • Minimal Downtime: Most people can return to work or school quickly, with little disruption to their routine.
  • Pain Relief: Discomfort post-surgery is typically mild and manageable with prescribed medications.

Aftercare Recommendations

Following surgery, your doctor might suggest a few steps to aid in your recovery:

  • Warm Sitz Baths: Sitting in warm water several times daily can help reduce pain and swelling.
  • Medication: Depending on your situation, antibiotics, laxatives, stool softeners, and pain relievers could be recommended to ease discomfort and support healing.

Prevention Tips For Hemorrhoid Abscess

Prevention Tips For Hemorrhoid Abscess

Preventing a recurrence of a hemorrhoid perianal abscess involves proactive measures aimed at reducing risk factors and maintaining good health in the anal and genital areas. Here are effective strategies to help keep such abscesses at bay:

Manage Existing Medical Conditions

  • Control Diabetes: Proper diabetes management helps maintain normal blood sugar levels, which is crucial for preventing infections, including those that could lead to abscesses.
  • Treat and Monitor IBD: Regularly follow up with your healthcare provider to effectively manage inflammatory bowel diseases like Crohn's disease or ulcerative colitis. Adequate control of these conditions can reduce the risk of complications, such as abscesses.

Practice Good Hygiene

  • Clean Regularly: Wash the anal and genital areas at least once a day with gentle soap and water. Avoid harsh soaps that could irritate the skin.
  • Dry Thoroughly: After washing, dry the area carefully to prevent moisture build-up, which can create a breeding ground for bacteria.
  • Change Undergarments Daily: Wear clean, cotton underwear that allows your skin to breathe and keeps the area dry.
Don't Let Hemorrhoids Hold You Back
Say goodbye to discomfort, find quick relief with our 5% lidocaine hemorrhoid cream.

Safe Sexual Practices

  • Use Condoms: During anal sex, using condoms can significantly reduce the transfer of STIs and bacteria, ‌lowering abscess risk.
  • Lubrication: Use sufficient lubricant during anal sex to minimize friction and prevent tearing or injury to the anal lining, which can be an entry point for infection.


I'll wrap things up by saying hemorrhoid abscesses must be discussed. Knowing your body, understanding the signs, and getting medical attention promptly can make all the difference in managing this pesky problem effectively. Keep this knowledge about symptoms, causes, and risk factors in your health arsenal to stay proactive and prevent a recurrence.

After all, your well-being is not just a priority, and it's a necessity. So, never brush off any concerning symptoms; seeking medical help is the right move.

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Matt Callard
I am a passionate traveler, as if traveling were my full-time job. I like to change my surroundings and environment, like changing desktop wallpaper. Nature increases the concentration in my writing, which helps brainstorming flow in my blood. I have a cat named Kitana. She is the most desperate about traveling, more than any other cat. How do I know? If I miss any tour in any week, she literally destroys my clothing with her wolverine nails.

I and my cat also participate in extreme activities like surfing, biking, hill tracking, paragliding, boating, etc. She was always there in my accidents, injuries, and stitches. She always sits on my lap when it hurts me most. The funniest part is that she has experienced all my tattoos. She sleeps on my blanket when I go through any painful experience.

My hobbies and lifestyle added many pain and injuries to my life. That is why I have a lot of experience in dealing with different levels of pain and burn. It influenced me to become a pain expert and share primary suggestions to handle any unwanted situations that hurt.


  • How Is A Perianal Abscess Different From A Hemorrhoid?

    Itchy, bleeding or painful hemorrhoids are swollen veins in the rectum or anus that can cause perianal abscesses or hemorrhoids. Perianal abscesses result from an infection of the anal gland, while hemorrhoids are common during pregnancy or prolonged sitting.

  • Can A Perianal Abscess Heal On Its Own Without Treatment?

    It is doubtful that a perianal abscess will heal independently as they require prompt medical attention and intervention. Infections can spread or worsen without proper treatment, leading to more severe complications such as fistulas and abscesses.

  • How Long Does It Take For a Perianal Abscess To Heal?

    The healing time of a perianal abscess may vary depending on the severity and location of the infection. Most perianal blemishes heal within two to four weeks with proper medical intervention.

  • What Are The Potential Complications Of A Perianal Abscess?

    Complications of perianal abscesses may include the formation of anal fistulas and abnormal connections between the anus and the skin. The spread of infection can lead to recurrent abscesses and sepsis, potentially life-threatening.

  • Is It Safe To Pop A Perianal Abscess?

    No, Popping a perianal abscess can worsen the infection by spreading bacteria and making it more challenging to treat.

  • What Should I Do If My Perianal Abscess Bursts?

    If a perianal abscess bursts, it is essential to clean the area thoroughly with warm water and mild soap. Then, cover the area with a sterile dressing to prevent further contamination and seek medical attention immediately.

  • How Can I Prevent Perianal Abscesses From Occurring?

    A few preventative measures include maintaining good hygiene practices, avoiding constipation, and seeking prompt medical attention for rectal or anal symptoms.

  • When Should I See A Healthcare Provider For A Perianal Abscess?

    A healthcare provider should be consulted if you experience pain, swelling, redness, fever, chills, or a general feeling of illness. Prompt medical intervention can prevent the infection from worsening and reduce the risk of complications.

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