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Throbbing pain, can’t sit - Bum abscess


This is the mother of all boils in the mother of worse places - ever. Throbbing pain and swelling near the anus day by day – getting worse, pressure and pain. More and more intense, can’t sit or sit on one cheek or a cushion.  And you have a fever and feel unwell.    Welcome to your bum abscess and unless it bursts very soon – you need the doctor’s help.









Me, My Bum and My Bum Abscess

A bum abscess is painful because the pus in the abscess is trying to burrow out through the skin, to escape into the outside world.     Experienced abscess sufferers – those that have had to deal with this before – will sit in hot baths to make the abscess come to head and burst.  But if this is your first time - you need to see a doctor – especially if you are unwell with a fever and the skin around your bottom is red and inflamed.  


The two common bum abscesses are:



Usually the diagnosis of an abscess is very straight forward – there is a hot painful swelling near the anus.  If the abscess is small then the doctor may try and settle the problem with an antibiotic – like Metronidazole (Flagyl); which is a very effective and very selective antibiotic for a bum abscess.  An antibiotic can be enough to suppress the pain and the discomfort, but often the abscess comes back after antibiotics have finished or the bum abscess is just too big and painful to settle with antibiotics alone.  However, inconvenient you need to go to the hospital and have the abscess knifed – I mean drained.


My Bum Abscess goes to Hospital

The abscess is your body’s way of localising infection and then moving it to the outside by discharging through the skin.   The surgical management of the abscess is simply speeding this process up.  You come in, the doctors confirm the big red swelling near your anus – and you get an anaesthetic and a cut is made into the abscess to let all the infection out.


The cut is painful, but so was the pressure of pus from the abscess – so once that pressure is taken off you feel better, over all.   Through the opening in the skin a dressing (a pack) is placed into the cavity of the abscess.  The idea is that replacing (or repacking) the dressing keeps the skin wound open while the deep space of the abscess cavity is gradually filled by the body’s own tissues.  As the space fills up less and less dressing will go into the cavity and the final bit to heal is the skin wound.  This redressing/ repacking is carried out over 4 to 6 weeks by the district nurse and at the end of this time about 50% of bottom abscesses are healed for good – the other 50% will not heal up completely and may continue to discharge through a small opening – a fistula.


Info Box – Bottom Abscess and Fistula

Drainage Ischiorectal Abscess    1,211 / year
Drainage Perianal Abscess   10,329 / year

Laying open of fistula     5,291 / year
Insertion of Seton     3,113 / year  

based on HOSPITAL EPISODE STATISTICS: Main procedures and interventions: 4 character, 2008-09 [England]
We have a problem - fistula-in-ano