Buttock abscess

Synonyms in a broader sense

  • Anal abscess
  • Swamp ass

More frequent than the abscess in the abdomen is the abscess at the buttock/anal abscess. Depending on its location in the area of the buttocks (anus), a distinction is made between: Furthermore, in the case of an abscess on the buttocks, a further distinction is made between ischiorectal abscesses located further back, which lie between the iliac crest and the rectum, and pelvirectal or iliorectal abscesses, which lie between the pelvis and the rectum or ileum and rectum. – subcutaneous abscesses (directly under the skin)

  • Perianal abscesses (next to the anus)
  • Periproctic abscesses
  • Submucous abscesses (below the skin layer mucosa)
  • Intermuscular abscesses (between the muscles of the anus).

Symptoms of a buttock abscess

In addition to the general symptoms of the disease, such as chills and fever, patients with anal abscesses usually also complain of pain (pain in the anus) when sitting or defecating (so-called defecation pain). . You can also read about all the symptoms that indicate an abscess in the following article: Symptoms of an abscess


In addition to questioning the patient in the case of an abscess on the buttocks (anamnesis by the doctor), a redness in the anus or around it is usually suspicious of an abscess. The physical examination, during which the doctor performs a palpation of the anus, can sometimes confirm the suspicion of an abscess. In addition to these examination options, endoscopy of the rectum or the entire colon is also available and can diagnose an abscess.

So-called endosonographies, an ultrasound scan performed from the inside after the sonography head has been inserted into the intestine, can be the most reliable diagnosis of an anal abscess in addition to the CT examination. In the case of an existing abscess, one can first go to a general practitioner. After an initial assessment of the severity, he can, depending on the equipment of the practice, split or treat the abscess himself.

Some family doctors or general practitioners have the space in their practices to perform such a minimal procedure. If a serious abscess is present or the doctor cannot create a sterile place for the procedure, he can refer the patient to a specialist. This could be a specialist in visceral surgery, for example.

Visceral surgery deals with the treatment of the internal organs and also performs minor procedures such as splitting an abscess. Therapy can be carried out either in hospital or by a specialist in private practice. A referral from a general practitioner is also required for admission to hospital or treatment in a surgical outpatient clinic.

Emergencies are an exception to this rule. An open abscess can have various causes. One possible reason is that the abscess was already so far advanced in its inflammation that it bursts due to the tension of the skin.

The abscess is surrounded by a thin capsule which can no longer withstand the pressure and eventually tears. An open and infectious wound then forms. The containing pus emerges and also contains the pathogenic bacteria.

If such a burst abscess is present, it is advisable to consult a doctor and receive professional treatment because of the danger of infection and the carry-over of the germs. Under correct hygienic conditions, the doctor can clean and rinse the open wound. The complete removal of the pus is particularly important to prevent recurrence.

The wound then remains open for healing. It is possible that a drainage is placed in the wound to drain off newly formed pus and wound fluid directly. The wound thus remains sterile and can heal.

The dressing should be changed regularly. Here, too, care must be taken to ensure thorough hygiene so that the bacteria are not carried over into other areas. For this reason a layman should not open an abscess on his own.

The use of pulling ointments (such as Ilon® Classic Ointment) can also cause the abscess to open spontaneously. The ointment promotes this process and thus contributes to a better discharge of the pus. Here, too, surgical repair (surgery) is the most important and safest method of treatment.

However, it must be noted that the sole incision (cutting) of the abscess membrane and draining the pus at the buttocks is usually not sufficient. There should be a T-shaped or oval opening of the abscess cavity, which should be as high as it is deep. This is followed by open wound treatment and the insertion of a tamponade strip.

In the case of an abscess on the buttocks, which is located directly next to the sphincter of the anus, it must be noted that the sphincter can be incised up to 4/5 without leaving any incontinence. The so-called puberectal loop must not be injured under any circumstances. In the case of an abscess on the buttocks, surgery is necessary in most cases.

The therapy consists of the surgical opening of the pus cavity so that a generous discharge of pus can take place. Often the skin incision is not even perceived as painful, since the opening of the abscess and the associated pressure relief is even felt as relief. The symptoms usually subside quickly after the operation.

The operation is usually performed under general or spinal anaesthesia. During the operation, the surgeon looks for a possible connection between the pus cavity and the anus. The problem with a buttock abscess is often that the pus cavity can form fine ducts (so-called fistulas) through the sphincter apparatus, which can be injured.

In the case of a buttock abscess, the surgical wound can be of considerable size, as all inflammatory structures must be completely removed. The wound is treated openly and not sutured, so that pus can be prevented from accumulating. In some cases, a drainage is inserted to assist the drainage of pus.

The creation of an artificial bowel outlet is usually not necessary; the toilet can usually be used as usual after the operation. Since the wound is treated openly, bleeding and especially secondary bleeding may occur. In addition, a new infection can develop.

In rare cases there is severe scarring of the wound, in extreme cases the anus can be affected and bowel movements can become difficult and painful. Due to the inflammatory reaction of the abscess and the operation, injuries to surrounding structures can occur. In cases where the sphincter muscle is involved, there may be a weak closure with poor control over bowel movement.

Before the surgical procedure, the bowel is cleaned (enema, enema) and, if necessary, anticoagulant drugs must be discontinued for a certain period of time (e.g. ASS, Marcumar®). After the surgical opening of an abscess on the buttocks, a lot of wound secretion often accumulates in the dressing, which must be changed frequently in the initial period. Sitting baths with sea salt can be used to support the healing process, especially after bowel movements.

In the long term, hygiene in the anal area should be given increased attention. The prognosis of an operation for an abscess on the buttocks is usually very good. The operation itself is usually a simple procedure and causes few problems.

The healing process is often quick and the symptoms are quickly alleviated. The open wound can take several weeks to heal. An abscess on the buttocks is often temporary and leads to increasing swelling, which must be treated quickly as it is usually very painful and in some cases accompanied by fever.

In addition, a protracted abscess on the buttocks can lead to a scattering of the pathogens via the bloodstream. In the worst case, this can lead to sepsis, a potentially life-threatening clinical picture. In most cases, an abscess on the buttocks does not heal on its own.

If the abscess is not treated quickly, it will increase in size and the discomfort and pain caused by the abscess will also increase. In addition, the risk of a fistula forming increases if the abscess is not opened quickly. A fistula is a fine, tubular duct that starts from the abscess and forms a connection between the rectum and the skin.

A fistula tract is not life-threatening, but they often remain even after the pus of the abscess has drained. This can lead to recurring inflammation. A permanent impairment of the surrounding organs can also lead to further complaints.

In the case of an abscess on the buttocks, the function of the sphincter muscle is particularly at risk. In the worst case, the infection can spread from the abscess into the blood (sepsis). It is important that you never try to express an abscess on your own, as this can cause the pus cavity to open inwards and into the neighbouring tissue and release the pathogens into the blood, which can lead to dangerous infections and thus the abscess can become chronic.

After each touch of the abscess, one should wash one’s hands thoroughly. In such cases, showering is better than bathing to avoid transmission to other skin areas. Underwear, bedding and towels should also be washed at 90 degrees to kill the bacteria.

The toilets and the bathroom should be thoroughly cleaned during the time you suffer from the abscess on your bottom. Various home remedies can be tried in the early stages of a minor abscess. The main thing to do is to warm the affected area of skin with warm compresses.

For an abscess on the buttocks, thick padding of the area can be helpful against the pain when sitting. A smaller abscess can sometimes be cured with a few measures, but a doctor should always be consulted beforehand. Infusion ointments from the pharmacy contain shale oil active ingredients such as ammonium bituminosulphate.

By applying pulling ointment, a small abscess is supported in “maturing” and in the best case empties itself. Also in this case one should not help oneself and should not push around it. When the pus has emptied, the small crater should be thoroughly cleaned with wound disinfectant and covered with a plaster.

The open abscess should be freshly bandaged twice a day and, if possible, thoroughly rinsed out. Disinfection spray or disinfecting ointments should be applied generously to the wound. However, if the wound area remains red, the pain does not subside or pus reappears, a doctor should be consulted.

Another problem in treating a buttock abscess is that the anal area is colonised by numerous bacteria that can worsen the inflammation. It is advisable to consult a doctor about the abscess on the bottom. Depending on the size and location, the doctor will recommend treatment with a pulling ointment or an antibiotic ointment.

Internal antibiotic treatment can also be attempted, but abscesses on the buttocks are often well encapsulated, making it difficult for the antibiotics distributed through the bloodstream to reach the inflammation. For these reasons, treatment with antibiotics alone often does not lead to long-term success, the healing process is rather delayed and serious complications can be the result. Surgery is necessary in most cases of abscesses on the bottom.

The pus is released from the infected cavity by using a scalpel to make an opening in the skin near the anus. This allows the pressure in the swelling to be relieved. Such an operation can often be carried out on an outpatient basis in a surgery and under local anaesthetic.

However, large or deep abscesses on the buttocks must be opened in hospital. Particularly in the case of inaccessible abscesses, special measures such as imaging procedures (e.g. ultrasound, computer tomography) must be used to split the abscess correctly. An abscess is a collection of pus in a cavity.

The abscess is therefore surrounded by a capsule of connective tissue and cannot spread, but it can become enlarged. When bacteria enter the body and settle in one place, they can cause an inflammatory reaction and multiply frequently. The anal abscess is an abscess lying in the skin and therefore noticeable for the affected person.

It causes the patient pain and can swell. Often patients tend to want to treat the abscess themselves. However, depending on the size of the abscess, doctors recommend that the treatment be left to a doctor, especially if the abscess is not opened by the patient himself.

There is a risk that the bacteria are carried away or the inflammation increases due to lack of hygiene. The treating physician, on the other hand, can create a clean and hygienic work surface and also has a better view of the abscess. With appropriate medication he can disinfect the abscess and thus prevent a further worsening of the inflammatory reaction.

The abscess can be observed by the patient himself or can be treated with ointments to relieve the pain and promote the reduction of the swelling and redness. An abscess on the buttocks can also be treated by natural means. The pulling ointment Ichtholan®, for example, is a herbal remedy which is rich in sulphated shale oil.

It has an antibacterial, anti-inflammatory and anti-itching effect. In the early stages of a developing abscess, the pulling ointment can be applied to the affected area. The ingredients prevent the progression of the inflammation and, if pus has already accumulated, allow it to be broken down and drained.

The ointment initially leads to a stronger inflammatory reaction and the abscess can also become larger and worse in the first few days. The vessels around the inflamed area of skin dilate and the blood supply to the area increases. With the blood, defence cells such as lymphocytes, mast cells and macrophages are washed up to fight the bacteria.

This enables the body’s own defences to displace the abscess towards the skin surface. There the pus can finally flow off better and healing begins. Care should be taken to ensure that the capsule is completely free of pus so that no new colonisation of bacteria occurs.

If a healing process does not take place despite regular treatment with the ointment, the patient should consult a doctor and discuss with him other possibilities of therapy. In general, patients with an abscess on the bottom should consult a doctor. This doctor can assess whether home remedies can be used or whether the abscess needs to be split.

Otherwise, some home remedies are known that can help to heal the abscess. One possible home remedy that can help to break the abscess is a hot porridge made from oats and linseed. The cooked and still hot porridge is filled into a small bag.

Before the bag of porridge is then placed on the abscess, it should be tested that it is not too hot (danger of burning). The porridge should open the abscess. When this has happened, the open abscess should be covered with moist cloths.

Another possibility is to heat onion slices with steam (also possible in the microwave). The warm onion slices are placed on the abscess. This procedure should be repeated several times a day.

The onion can also be made into a pulp raw with water and then applied to the abscess. Furthermore, heated savoy cabbage leaves, which have an anti-inflammatory effect, are a household remedy that can speed up the healing of the abscess. The savoy cabbage leaves are flattened with a kitchen towel, then heated and finally placed on the abscess.

As soon as the cabbage leaf has discoloured, a new warm cabbage leaf is placed on the abscess. A compress soaked with chamomile can also help to open the abscess and assist in healing. For this purpose, about 2 to 3 teaspoons of chamomile flowers are poured over 150 ml of boiling water.

The tea should be steeped covered for 5 minutes. Dip the compress into the tea and then place it on the abscess for two hours. The procedure should then be repeated.

Applying tea tree oil – which has disinfecting and germicidal properties – can also help the abscess heal. An indirect household remedy is drinking nettle tea. A teaspoon of nettle leaves is poured over boiling water. After the tea has been steeped for a few minutes, it can be drunk. One cup of nettle tea should be drunk three times a day.