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When to go to A&E for an abscess

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

At a glance

A perianal abscess can develop from a mild discomfort to a surgical emergency within days. Knowing when to go to A&E rather than waiting for a GP appointment can prevent serious complications and get you treatment faster.

Go to A&E if

These signs indicate the abscess needs urgent assessment:

Fever

A temperature above 38 degrees C alongside perianal swelling is the clearest indicator that the infection needs urgent attention. Fever means the body is fighting a significant infection, and the abscess likely needs drainage.

Rapidly worsening symptoms

If the pain, swelling, and redness are getting noticeably worse over hours rather than days, the abscess is growing and the infection may be spreading. Do not wait.

Feeling generally unwell

If you feel systemically unwell — fatigue beyond what the pain explains, chills, confusion, racing heart — this suggests the infection may be affecting your whole body. This is the early stage of potential sepsis and requires emergency assessment.

Red streaks

Red streaks spreading from the swollen area indicate cellulitis — the infection is moving beyond the abscess into surrounding tissue.

Severe pain that is not manageable

If the pain is so severe that over-the-counter medication provides no relief and you cannot sit, lie, or function normally, that severity warrants emergency assessment even without other signs.

You are immunocompromised or have diabetes

People with weakened immune systems or diabetes are at higher risk of rapid progression and complications from perianal infections. A lower threshold for A&E attendance is appropriate.

See your GP urgently (same day or next day) if

  • You have a painful, tender lump near the anus that is growing
  • The area is red and warm but you have no fever
  • The pain is significant but manageable
  • You have no signs of spreading infection

In these cases, a same-day or next-day GP appointment is appropriate, but do not wait longer than that. If GP access is not available within a day or two, A&E is the fallback.

What happens at A&E

Assessment

A doctor (often a surgical registrar) will:

  • Ask about your symptoms and medical history
  • Examine the area
  • Check your temperature, heart rate, and blood pressure
  • Determine whether drainage is needed urgently

If drainage is needed

Many perianal abscesses are drained on the same day as presentation:

  • Under local or general anaesthesia
  • The procedure is relatively quick
  • You may go home the same day or stay overnight depending on the severity
  • Wound care instructions and follow-up will be arranged

If you are sent home

Occasionally, the presentation is early and the abscess is not yet ready for drainage. In this case:

  • You may be prescribed antibiotics
  • Given clear instructions about when to return
  • Told specific signs that would warrant coming back immediately
  • Followed up with an outpatient appointment

Do not feel bad about going to A&E

People describe feeling embarrassed about going to A&E for a perianal problem, or worrying that they are wasting the department’s time. Perianal abscesses are a recognised surgical emergency. A&E staff see them regularly. You are not wasting anyone’s time — you are seeking appropriate care for a condition that needs it.

Common questions

Can I wait and see if it resolves?

Perianal abscesses very rarely resolve without drainage. Waiting allows the infection to grow, the pain to increase, and the risk of complications (including sepsis) to rise. Prompt assessment is strongly recommended.

What if it is out of hours?

A&E departments are open 24 hours. Perianal abscesses are a recognised surgical emergency. If you develop symptoms outside of GP hours, going to A&E is the appropriate action.

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:

  • Fever with perianal swelling — seek same-day care
  • Rapidly worsening pain, redness, or swelling
  • Feeling generally unwell, confused, or very fatigued
  • Red streaks spreading from the affected area

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 movementsPain after bowel movementsSwelling or lumpDischargePain while sitting

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