Diagnosis of Perianal Abscess or Fistula

Your child’s pediatrician will start diagnosing this condition with a physical exam. They will also consider your child’s personal and family medical history. Often, a physical exam alone is enough to diagnose this condition. From there, they may refer your child to a specialist (surgeon, gastroenterologist or the emergency department) who may then order one or more of the following tests to confirm perianal abscess or perianal fistula:

• X-ray. This imaging test uses radiation to create detailed pictures of the inside of your child’s anorectal area.
• Ultrasound. This imaging test uses sound waves to create detailed images of your child’s anorectal area.
• Computerized tomography (CT) scan. This imaging test uses specialized X-ray technology to create detailed pictures of the inside of your child’s anorectal area.

Treatments for Perianal Abscess or Fistula

A child with a perianal abscess may respond to antibiotic treatment. If not, the pediatrician or a surgeon will need to drain the pus from it. This is usually an outpatient procedure. This type of procedure does not require an overnight hospital stay unless your child has certain symptoms or medical problems requiring inpatient hospitalization.

Your child may be awake for this procedure and receive sedative (relaxing) medicine to help them stay calm. Otherwise, they may be asleep (fully sedated) under a general anesthetic. If your child is awake before starting this procedure, your child’s surgeon will inject a local anesthetic medicine that numbs the area around the anus. Then, the surgeon makes an incision in the abscess to drain the pus. Once all the pus has drained out of the abscess, your child’s surgeon may place a dressing and cover the incision site with a bandage.

Your child will also likely need to take a complete course of antibiotic medication to clear the infection that caused the abscess. If your child’s abscess or fistula was caused by an underlying health condition such as Crohn’s disease, their doctor would also treat that condition.

Home remedies

Your child may need to use the following home-based strategies to help manage problems related to perianal abscess or fistula:

• Eat a high-fiber diet. Eating foods rich in fiber can help soften your child’s stool, making it easier to pass.
• Practice good hygiene. You should help your child establish and practice good hygiene habits, especially after having a bowel movement.
• Take stool softeners or use enemas, as needed. Taking over-the-counter stool softeners may make bowel movements easier to pass. An enema (injecting fluid through the rectum to clean out the colon) may also help. If needed, an enema will be directed by one of your child’s specialists, such as a gastroenterologist or pediatric surgeon.