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Perianal/Perirectal or Pilonidal Abscess

Updated on March 21, 2016

What is a Perianal, Perirectal or Pilondial Abscess?

A perianal/perirectal or pilonidal abscess is a very painful infection that in many cases needs to be attended to by a surgeon immediately. Many times a person will think that they have hemorrhoids and treat themselves with over the counter medication. It is not until they find that this medication is not helping the pain or shrinking the hemorrhoids that they consult a doctor.

Pilonidal cyst, pilonidal abscess, pilonidal sinus or sacrococcygeal fistula

Two pilonidal cysts that have formed in the gluteal cleft of an adult male.
Two pilonidal cysts that have formed in the gluteal cleft of an adult male. | Source

How The Pilonidal Abscess Starts

Abscesses can start with a simple ingrown hair follicle that becomes infected. Apparently these are more common in young men than in women but anyone at any age can get these.

Symptoms of Pilonidal Abscess

  • Very painful to have a bowl movement
  • Painful to sit
  • Constant throbbing
  • May be accompanied by fever
  • Feels as if you have a pimple or a bump within the mid-line of the buttock cleft

Diagnosis for a Pilonidal Abscess

A doctor or surgeon upon examination will be able to tell if there is a perirectal, perianal or pilonidal abscess present.

Treatment for a Perianal, Perirectal or Pilonidal Abscess

If this is caught right away it can be treated with antibiotics, but in most cases people do not realize what it is.

If not caught right away and the abscess gets large, a local anesthetic will be administered before the abscess is surgically opened and drained. It will then be packed with gauze and an antibiotic solution. No stitches can be used, as this type of a wound has to heal from the inside out. More than likely bleeding will continue while the wound is healing. Bleeding in this case is a good thing as if there is any infection left from the abscess it will come out with the blood. Sitz baths are required before the packing is changed daily. In some cases the patient will need to be on an antibiotic and most definitely a pain medication.

Healing Time

Depending on how deep the abscess is and how deep the surgeon has to cut to drain the abscess will depend on the recovery time of the patient. It can be anywhere from two to four weeks or in some cases up to eight weeks.

Long Term

This type of an abscess can return. Surgeons cannot always get to the root of the hair follicle and sometimes this abscess will return. After having one though the patient will be aware of what it feels like and hopefully catch it early enough so that a second surgery is not required.

© 2011 Susan Zutautas


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    • Just Ask Susan profile imageAUTHOR

      Susan Zutautas 

      8 years ago from Ontario, Canada

      John, My son said the same thing, he'd never gone through anything as painful as this. Thanks for the link and take care.

    • profile image

      John Garrod 

      8 years ago

      The doctor told me had a pilonidal cyst about 2 months ago. All I can say is, JEEZ! I have never experienced such pain and discomfort in my life! And I've broken my arm!

      So, consigned to sitting on my chair all day, I was glad when I found

      Saved me hours of research.

      I just pray that it never comes back!

    • Just Ask Susan profile imageAUTHOR

      Susan Zutautas 

      9 years ago from Ontario, Canada

      Sharyn, I am so sorry to hear this. My son finally returned back to work, but has not recovered 100% yet, but is getting there.

      I hope that you don't ever get it again and yes I agree Damn those Ingrown Hairs.

      Take care!

    • Sharyn's Slant profile image

      Sharon Smith 

      9 years ago from Northeast Ohio USA

      Oh Susan,

      I have such horrible first-hand memories. I have had a pilonidal cyst that started about 20 years ago at the base of my spine (without getting too descriptive). I had surgery on it once and couldn't work for a whole month. Every once in a while, it recurs. I don't think its the same cyst but another that recurs. All I have to say is DAMN INGROWN HAIRS!


    • WillStarr profile image


      9 years ago from Phoenix, Arizona

      Hi, Susan,

      My son never had a reoccurrence, thank the Lord!

    • Just Ask Susan profile imageAUTHOR

      Susan Zutautas 

      9 years ago from Ontario, Canada

      felicitylovespari, Thanks for stopping by to read this and for your comments. Very important for anyone who thinks that they may have this to get to a doctor ASAP.

    • Just Ask Susan profile imageAUTHOR

      Susan Zutautas 

      9 years ago from Ontario, Canada

      Bill, We have a nurse that comes in once a day to change the dressing and told us that this can reoccur more than once. I just hope that your son and mine do not have to experience this again.

    • felicitylovespari profile image


      9 years ago

      Gosh. Perianal, perirectal and pilonidal abscesses sure don't sound like a fun time at all. But people should be grateful you are helping make know how to treat them with the various treatments! Useful and up. Keep it up.

    • WillStarr profile image


      9 years ago from Phoenix, Arizona

      My oldest son also had this. The poor guy was in misery.

      Before that, I'd never heard of it.

      Excellent and informative Hub!

    • Just Ask Susan profile imageAUTHOR

      Susan Zutautas 

      9 years ago from Ontario, Canada

      mythicalstorm, Unfortunately there is nothing you can do to prevent this from happening. He thought it was hemorrhoids and treated it as such. Thanks I hope he feels better soon too :)

    • mythicalstorm273 profile image


      9 years ago

      Wow... I have never heard of something like this. It is crazy to think about all of the things that can happen to our bodies, especially if we do not treat them correctly. I just keep thinking... owe owe owe owe... I could not imagine going through something like this!! I hope your son feels better soon :-)

    • Just Ask Susan profile imageAUTHOR

      Susan Zutautas 

      9 years ago from Ontario, Canada

      I suppose it is similar to a boil. He is 23 and he said that this is the most painful thing he has ever had to go through. Thank you Sunshine, I hope he is up and back to himself soon.

    • Sunshine625 profile image

      Linda Bilyeu 

      9 years ago from Orlando, FL

      Hi Susan! Ouch!!! This sounds like a it similar? Oh the pain, how old is your son? I hope he heals quickly!

    • Just Ask Susan profile imageAUTHOR

      Susan Zutautas 

      9 years ago from Ontario, Canada

      RH, My son has not left the couch much since he had this done on the 21st of September. I had to research it since it was happening to him and because I had never heard of this before thought it would be a good topic to write about. Thanks so much for commenting.

    • RealHousewife profile image

      Kelly Umphenour 

      9 years ago from St. Louis, MO

      Susan - I have heard of this before! It can be extremely painful and debilitating. I know someone who had one and the poor guy couldn't hardly move! This is an excellent informational hub!


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