Crohn’s Disease ‘Scope Series’: Perianal Abscess

Crohn’s Disease ‘Scope Series’: Perianal Abscess

It Could Be Worse

Editor’s note: This is the fourth in a series of columns by Mary Horsley about IBD-related procedures. Part onepart two and part three also are available.

Continuing my “Scope Series” theme, this column recalls my experience with emergency surgery for a perianal abscess.

A perianal abscess, as you can imagine, deals with the anal region of your body, an abscess near or on your rectum.

An abscess — an area filled with pus and infection — can appear, sometimes creating a visible lump due to the swelling. The abscess is usually tender to touch, red-hot and extremely sore.

In my case, my abscess was around 11 o’clock on my rectum, respectively, and the area grew overnight. I woke with pain in my bottom. And I mean, it was pain IN MY BOTTOM.

I could barely walk for fear of tightening muscles down there. When I looked in a mirror, I saw swelling and bruising of the skin. My perianal abscess had gotten so swollen that it was the size of a golf ball. Pressed between my butt cheeks, it was putting me in constant pain. I needed a doctor. If you have pains like this, I suggest an emergency visit.

Your doctor will examine the swelling to determine it’s an abscess, and whether it needs to be cut open and drained, or if medication can handle the situation.

Crohn's Disease 'Scope Series': Perianal Abscess - It Could Be Worse
Crohn’s Disease ‘Scope Series’: Perianal Abscess – It Could Be Worse

Mine was first diagnosed as hemorrhoids, even though I knew this was wrong. In order to be certain, my doctor went to the emergency department and got the surgeon in charge to “come have a look.” Sometimes, a second opinion is needed. With Crohn’s, you may get comfortable showing the usually hidden body parts.

In my case, the second doctor grabbed my butt cheeks and spread them apart, his goal to insert a finger for inspection.  Anyone down the hall could have heard me screaming. To this day, it was the worst pain I have ever experienced. I truly hope your doctor is gentler with you. I pushed the doctor away and smacked at his hands to remove his grip from me. I was uncontrollable.

The doctor knew immediately that my perianal abscess needed surgery, or else the swelling was going to cause the skin to rupture on its own.  His exact words “We have to give you anesthesia; to do this without would be considered cruel.” On to emergency surgery I went.

Once I received morphine, my mood changed significantly, as shown in the photo.

After the surgery, I was given pain medication and instructions to go home and take it easy for the six-week recovery. I was given a sitz bath — a small tub to sit in with warm water to help clean my wound — and told how to remove the gauze still tucked in my bottom. They gave me a plastic pillow to sit on, as hard surfaces would hurt, and tons of gauze for me to wear for drainage.

After a few weeks, I returned for a follow-up and was told to prepare for a second surgery, where a fissure was present. A fissure, a tunnel that starts inside the anus and works its way to the outside of the skin, can lead to infection and requires being cut out – a fistulotomy.

In the next “Scope Series” column, I’ll discuss a fistulotomy, another painful procedure brought on by Crohn’s.
If you suffer any of these symptoms or pain, I suggest seeing a doctor immediately. My experiences may be different than yours, but you never can be too prepared for what could happen with Crohn’s — because for me, It Could Be Worse.
Note: IBD News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of IBD News Today, or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to inflammatory bowel disease.


  1. Autumn Sewell says:

    I’ve just been diagnosed with Crohn’s after battling doctors for the last 4 years. I’ve had chronic diarrhea the whole time, been diagnosed as severely anemic, and lost close to 45 lbs since the first of this year. I just had my second colonoscopy and EGS in three years because I currently have a perianal abscess- for 6 weeks now actually. It took me having to go through this to finally get a diagnosis. I had a drainage procedure done roughly 5 weeks ago with ONLY local anesthetic, OUCH!!!!!! Worst pain of my LIFE. Now this abscess has been recurring ever since, causing me extreme pain, leading to a lot of depression. Apparently we were waiting to get a yes or no on the Crohn’s diagnosis before treating the abscess because having Crohn’s changes the surgical approach for treatment. This has been such hell and I’m trying to stay on the bright side of finally having a diagnosis and taking steps towards getting better.

    • Mary Horsley says:

      I am so sorry that you have been just diagnosed, 4 years is a long time to suffer without answers or putting a name to the problem. I, too, suffer constant diarrhea and I lost weight with my Crohn’s too. I am SOOOOO sorry about the drainage, I know mine was painful so I cannot imagine your pain. I truly hope you can find relief!

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