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Emergency abscess and fistula surgery

Published 12 March 2026 ·Last reviewed 12 March 2026 by the editorial team ·How we create our content

A composite account, drawn from many real anonymised experiences. It is not any one person's story.

What this experience covers

A composite picture of what people commonly experience when a perianal abscess and fistula are discovered and surgically treated in a single emergency event. This draws from many anonymized experiences and represents common patterns, not any single person’s story.

Common elements: sudden escalation of symptoms, emergency diagnosis of both abscess and fistula, surgery that same day or the next, waking up to a new reality, and navigating recovery for a condition they did not know existed hours earlier.

The pattern

Before the emergency

Most people describe a period of symptoms they did not fully understand:

  • Pain that came on over days, sometimes with swelling they assumed was a hemorrhoid
  • Discomfort while sitting or moving that steadily worsened
  • Some people noticed discharge or a lump and tried to manage it at home
  • A point where the pain became unbearable — this is typically what drove the emergency visit

The emergency room

The emergency room experience is described with a mix of fear, confusion, and relief at finally being seen:

  • An examination that identifies the abscess. For many, this is the first time they hear the word “abscess” applied to them.
  • Being told a fistula is also present — a tunnel connecting the abscess to the anal canal. Most people have never heard of a fistula before this moment.
  • The decision for surgery, often within hours. People describe the speed as both frightening and reassuring — frightening because it is happening so fast, reassuring because the medical team is taking it seriously.

The surgery

People describe the surgery itself as a blur:

  • General or regional anaesthesia. Going under with very little time to process what is happening.
  • Waking up with the abscess drained and the fistula addressed — sometimes with a seton placed, sometimes with a fistulotomy.
  • The immediate post-surgery period in recovery: confusion, grogginess, and a gradual awareness of what happened.

Coming to terms

The days after surgery are dominated by two parallel challenges: physical recovery and emotional processing.

  • The physical reality: An open wound, drainage, dressing changes, pain that is different from the abscess pain — more surgical, less urgent.
  • The emotional reality: Twenty-four hours ago, they had never heard of a fistula. Now they have one, have had surgery for it, and are being given instructions for wound care they did not expect.
  • Information overload: Medical terms, follow-up appointments, wound care instructions, the possibility of further surgery — all absorbed while groggy and in discomfort.

The first weeks

People describe the early recovery as a learning curve:

  • Wound care that feels overwhelming at first but becomes routine
  • Sitz baths multiple times daily
  • Managing drainage and dressing changes
  • Gradual return to daily activities, often slower than expected
  • Processing the diagnosis — reading about fistulas, understanding what happened, and coming to terms with the possibility of further treatment
  • A strong need to connect with others who have been through the same thing
When to seek care Heavy bleeding or feeling faint? Get emergency help now. Emergency: 911

Not sure how urgent it is? Get help today.

  1. Emergency

    Heavy bleeding, black tarry stools, feeling faint, severe pain or trouble breathing.

    Call 911 or go to the ER.

  2. Today

    Fever, pain getting worse, a hot swollen lump, or trouble passing urine.

    Call your doctor or go to urgent care.

  3. Soon

    Bleeding or bowel changes nobody has checked, or anything lasting 3 weeks.

    Book a doctor’s appointment.

Feeling overwhelmed? Call or text 988, any time.

See all the signs

For this topic, get medical advice if you notice:

  • Severe or worsening pain
  • Heavy bleeding
  • Fever
  • Black stools
  • Fainting or dizziness
  • Pus or unusual discharge
  • Inability to pass stool or gas
  • Unexplained weight loss

Recording how you feel is not the same as being checked. These are the signs that need a doctor’s attention.

Call 911 or go to the emergency room now if you have:

  • bleeding that will not stop, a lot of blood (the toilet water turns red, or you pass large clots), or any bleeding with feeling faint or dizzy
  • fainting, a racing heart or trouble breathing
  • confusion or slurred speech, extreme shivering, no urine in a day, or blotchy skin
  • sudden severe belly pain, or a swollen, hard belly with vomiting or not passing stool or gas
  • you cannot pass urine at all, or your bladder feels full and painful and you can’t empty it
  • redness, swelling or severe pain spreading quickly around your anus, genitals or groin, especially with a fever or feeling very ill
  • a fever with a painful swelling near your anus if you have diabetes or a weakened immune system (for example, from chemotherapy or transplant medicines)
  • black, tarry stools

Call your doctor or go to urgent care today (or the ER if you can’t be seen today) if you have:

  • a temperature of 100.4°F (38°C) or higher, chills, vomiting, or feeling generally unwell
  • pain that is getting worse over days, or severe pain that stops you sitting or sleeping
  • a hot, swollen or very tender lump near your anus or at the top of the crease between your buttocks, or foul-smelling discharge
  • trouble urinating
  • bleeding that is getting heavier or more frequent, or blood mixed into your stool
  • feeling much more tired than usual, looking pale, or getting out of breath more easily than you used to
  • not passing stool for several days, or new belly pain

Make an appointment with your doctor if:

  • you have never had these symptoms checked by a doctor or nurse — whatever your age
  • you have had rectal bleeding for more than 3 weeks
  • your bowel movements have been looser, thinner or more frequent than usual for 3 weeks or more, or you have lost weight without trying
  • symptoms have not settled after a week or so, or keep coming back
  • you notice a new lump near your anus, between your buttocks or in your belly, or an itch or discharge that does not clear
  • you have new leakage or trouble controlling your bowels
  • you are 45 or over, or have a family history of bowel cancer or inflammatory bowel disease, and any of these symptoms are new for you

If you are unsure, it is always reasonable to ask. If things feel overwhelming, call or text 988 (Suicide & Crisis Lifeline) or chat at 988lifeline.org, any time. If you don’t feel safe, call 911.

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Discreet symptom tracking

Symptoms that come and go? Keep track, day by day.

For hemorrhoids, fissures, fistulas and other anal and rectal problems. A short, discreet email asks how things have been, and saves each answer, so you can look back at every flare and every good week in your own words. If you haven’t had your symptoms checked, see your doctor first.

  • About ten seconds a check-in. No app, no password.
  • Nothing in the subject or preview says what it’s about.
  • Each Sunday, a link to your week, ready for your next appointment.

Your notes

Your check-in

Takes about ten seconds.

20:00
Example. Nothing on the lock screen hints at symptoms or conditions.

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