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.