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Perianal abscess signs and symptoms

Published 13 March 2026 ·Last reviewed 13 March 2026 by the editorial team ·How we create our content

At a glance

A perianal abscess is a collection of pus that forms near the anus, usually as a result of infection in one of the small glands inside the anal canal. It is painful, tends to get worse without treatment, and usually requires medical drainage. Recognising the signs early leads to faster treatment and a smoother recovery.

Common signs and symptoms

Pain

Pain is the dominant symptom. People describe:

Constant, throbbing pain near the anus — not the intermittent pain of a fissure or hemorrhoid
Pain that worsens progressively over hours to days
Severe pain with sitting — people describe being unable to sit normally
Pain that disturbs sleep
Pain that is not relieved by standard over-the-counter painkillers

Swelling and lump

A firm, tender lump near the anus — sometimes visible, sometimes felt more than seen
The lump is warm to touch
Redness of the overlying skin
The swelling may increase rapidly over 24 to 48 hours

Fever and feeling unwell

Low-grade fever is common
Some people describe feeling generally unwell — fatigue, chills, loss of appetite
Higher fever or feeling very unwell may indicate the infection is spreading and requires urgent attention

Other symptoms

Discharge — if the abscess is close to the surface, it may begin to leak pus
Difficulty with bowel movements — not because of constipation but because of pain
Sitting difficulty — finding any comfortable position becomes increasingly challenging

How it develops

The typical progression people describe:

Day one: mild discomfort near the anus — often attributed to a hemorrhoid or minor irritation
Day two to three: the discomfort intensifies into pain, a lump becomes noticeable, sitting becomes uncomfortable
Day three to five: the pain is significant, the area is visibly swollen and red, fever may develop, normal activities are difficult

Not everyone follows this timeline. Some abscesses develop very rapidly (within 24 hours), while others build more slowly over a week.

How it differs from other conditions

Feature	Perianal abscess	Hemorrhoid	Fissure
Pain pattern	Constant, worsening	Intermittent, related to BM	Sharp during and after BM
Lump	Firm, tender, warm	Soft, may protrude	Usually none
Fever	Common	Rare	Rare
Progression	Gets worse over days	Fluctuates	Stable or gradual
Discharge	Pus possible	Mucus possible	Blood, minimal
Treatment	Drainage needed	Self-care first	Self-care/topical

When to seek care

Perianal abscesses generally need prompt medical attention. Do not wait to see if it resolves on its own.

Seek same-day or emergency care if:

You have a fever alongside the swelling
The redness is spreading
You feel generally unwell, confused, or very fatigued
The pain is severe and worsening rapidly
You are immunocompromised or have diabetes (infection risk is higher)

See your GP urgently if:

You have a painful, growing lump near the anus
The area is red, warm, and tender
Symptoms have been getting worse over two to three days

Early drainage is a straightforward procedure that provides rapid relief. Delaying treatment allows the abscess to grow and increases the risk of complications.

Common questions

What does a perianal abscess feel like?

People commonly describe a painful, throbbing lump near the anus that gets worse over hours to days. The pain is often constant, worsens with sitting, and can be severe. The area feels warm, swollen, and tender to touch. Some people describe it as the worst pain they have experienced.

How is a perianal abscess different from a hemorrhoid?

Hemorrhoids tend to cause intermittent symptoms — bleeding, itching, mild swelling — that come and go. A perianal abscess causes progressive, worsening pain with a firm, tender lump. The pain escalates rather than fluctuating. Fever and feeling unwell are common with abscesses but rare with hemorrhoids.

Can a perianal abscess develop quickly?

Yes. While some develop over several days, others can form within 24 to 48 hours. People describe going from mild discomfort to severe pain in a very short time. The rapid onset is one of the distinguishing features.

Do all perianal abscesses need medical treatment?

The vast majority do. Perianal abscesses rarely resolve without drainage. Delaying treatment risks the infection spreading and the abscess growing larger. If you suspect an abscess, seeking medical attention promptly is strongly recommended.

When to seek care Heavy bleeding or feeling faint? Get emergency help now. Emergency: 911

Not sure how urgent it is? Get help today.

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

Call 911 or go to the ER.
Today
Fever, pain getting worse, a hot swollen lump, or trouble passing urine.

Call your doctor or go to urgent care.
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:

Worsening pain, fever, or swelling — seek same-day care
Abscess that has not been drained by a clinician
Signs of spreading infection such as red streaks or high temperature

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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Related symptoms

Pain during bowel movements Pain after bowel movements Swelling or lump Discharge Pain while sitting

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.

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