Do you have a painful pimple or boil around your bum? This is a very common condition and comes on quickly. It can be frightening and embarrassing because although it is common, no one ever discusses it. It is called a peri-anal abscess and if small, can be effectively treated with antibiotics. It is worth giving it a squeeze in the bath to encourage the infected fluid to come out.

If simple measures don’t work and the pimple gets bigger the skin overlying can become red and the lump very painful. In this scenario surgery – called ‘incision and drainage’ – is the only way to clear the infection. After surgery an open cavity is left and requires packing regularly with special dressings. Usually this wound would take 3 weeks to heal.

The reason for the pimple forming in the first place is due to blockage of anal glands. They are situated all the way around the ‘clock face’ of the anal canal, however it is the ones at the back that are commonly infected. Occasionally infections in this delicate area can signify underlying bowel problems such as Crohns disease, however in over 90% of patients they are just bad luck. A bit like a spot on your face. It is worth knowing that up to 30% of surgically drained, packed anal abscess wounds will fail to heal. The reason for this is that the infected anal gland area has an opening within the low rectum/anal canal. The bowel contents escape into this tunnel and drive continuous infection which tends to cause a persistent faecal/mucus discharge from the abscess site. This is called an anal fistula and is a tricky condition to treat. It may require several operations so brace yourself!

All in all, it is fair to say that an anal abscess and an anal fistula is an embarrassing situation to find yourself in. You may be reluctant to seek medical help and at the moment, might find it difficult to get an appointment for an examination with your local GP.

At The McCarthy Clinic we have adapted our clinics to allow for an urgent assessment with immediate surgery if necessary. If you think you have an acute anal abscess ( very painful condition), we can accommodate you urgently at the end of our clinic. We will examine you and discuss treatment options. As this is an urgent condition, we can offer you a surgical incision and drainage procedure during the same appointment. All procedures are offered under local anaesthetic and in our experience are well tolerated by patients with few experiencing pain. The procedure takes less than 10 minutes however we do require you to wait for 30 minutes after the procedure to ensure you are safe to be discharged. The wound will be packed with a special dressing and we will discharge you with spares until your follow up appointment 2 weeks later. Occasionally we will prescribe antibiotics for 1 week.

If you have an anal fistula, we will discuss treatment options with you and you will have a chance to consider which option you would prefer before booking in for treatment.