What this experience covers
This experience looks at what people describe about having perianal abscesses that keep coming back, even when no fistula has been identified. It is a composite drawn from many anonymised accounts.
The pattern
The cycle
People describe a recognisable and frustrating cycle:
- An abscess develops — pain, swelling, sometimes fever
- It is drained — either surgically or it drains spontaneously
- Relief follows for days to weeks
- Another abscess forms, often in a similar location
- The cycle repeats
The diagnostic frustration
When an abscess recurs without an obvious fistula tract being found:
- People feel confused about why it keeps happening
- Investigations may not reveal a clear fistula tract
- Some fistulas are too small or too deep to identify easily
- MRI scanning may be used to look for subtle tracts
- The lack of a clear diagnosis makes treatment planning difficult
What the recurrence means
Recurrent abscesses in the same area may indicate:
- A fistula tract that is too small or complex to identify on examination
- An underlying condition that predisposes to abscess formation
- Incomplete drainage of the previous abscess
- A need for more detailed imaging or examination under anaesthesia
The emotional toll
The cycle of recurrence takes a significant emotional toll:
- Fear of the next abscess developing
- Frustration at the lack of a definitive answer
- The disruption to daily life with each episode
- Anxiety about whether a hidden fistula is present
- Fatigue from repeated medical encounters
What people wish they had known
- That recurrent abscesses without an obvious fistula are a recognised pattern
- That further investigation (MRI, examination under anaesthesia) may reveal a hidden tract
- That persistent recurrence is a reason to seek specialist assessment
- That the emotional burden of the cycle is valid and worth mentioning to clinicians
Everyone’s situation is different. If you want to talk through yours in a private, judgement-free space, our chat is here.
When to contact your doctor
Seek medical attention if you experience:
- A new painful, swollen lump in the perianal area
- Fever or chills
- Increasing pain, redness, or warmth
- Discharge from a previous drainage site
- Recurrence that has not been discussed with a specialist