Bulbs and Fistulas Around the Rectum


A boil is an accumulation of where in the tissue. The bulge can sometimes develop into a small duct between the rectum and the skin outside the rectum, a so-called fistula. To get rid of the buttock or fistula, surgery is usually needed.

Symptoms of bulge

The sign that you have a bulge is that you get a lot of pain in the rectum. The area around the rectum can become swollen and red if the buttocks are superficial in the skin. Sitting deeper in the skin hurts and you may also have a fever.

If you have a fistula, it is common to have permanent or brownish floats alongside the rectum opening. The skin around the fistula may also be sore.

A special type of fistula goes from the rectum to the vagina. There may then be gas and feces from the vagina.

pilonidal cyst

One form of a boil is the so-called pilonidal cyst. It does not occur at the anal opening, but at the center of the back, exactly where the buttocks divide. Most often, the pilonidal cyst depends on the hairs that are encapsulated under the skin.

When and where should I seek care?

Contact a health care provider if you have any of the following symptoms:

  • You have afloat next to the rectum opening.
  • You have a swelling or a lump at the rectum.

You can contact many receptions by logging in.

If it’s in a hurry

If you have floats or a lump at the rectum and have any of the following symptoms, contact a health center or on-call clinic at the same time:

  • You’re in a lot of pain.
  • You have a fever.

If closed, seek care at an emergency room.


When you come to the doctor you will be told about your complaints and how long you have had them. You can also answer questions, for example, if you have had similar problems in the past or if you have an inflammatory bowel disease.

Then the doctor will examine you. If the doctor suspects a fistula, you will be examined by a resectoscope. It is to see the mucosa of the rectum. Sometimes you get a referral to the resectoscope, but often the doctor can conduct the examination directly.

What are the causes of fists and fistulas?

The inside of the rectum is covered with a mucous membrane. There are also glands that secrete mucus.


A bulge is due to a bacterial infection in the tissues around the rectum or in a gland.

The bacteria are usually found in the intestine or on the skin. They can enter the mucosa if there is a wound or crack there.

A gland can become infected if the entrance to it becomes clogged. Then bacteria can grow inside the gland.


A fistula is usually caused by a boil. The product formed in the inflamed buttocks needs to come out, and therefore seek out against the mucous membrane or skin. Often fluid flows through the fistula, which then cannot heal by itself. The duct formed can then become an opening for new infections.

It is most common for fistulas to be formed by bulbs, but they can also occur without them.

The risk of having boils and fistulas increases if you have an inflammatory bowel disease such as ulcerative colitis or Crohn’s disease  But you can also get bumps and fistulas without having any bowel disease.

Treatment Abscesses and Fistulas

Both abscesses and fistulas are treated with surgery. You are usually anesthetized during the operation, whether you are operated on for a bulge or a fistula.

Operation of boils

When you are anesthetized, the doctor opens the buttocks. The item can then be emptied.

Usually, you can go home the same day as the surgery and you can go to the toilet as usual. Instead of drying yourself with toilet paper, you can rinse with lukewarm water and pat yourself dry.

Fistula operation

There are various methods of operating a fistula. They involve clogging the fistula or opening the fistula completely. You get information from the surgeon on how to operate and if you need to pay attention to something after the surgery.

Sometimes you may need multiple surgeries, for example, if the fistula is inflamed or if it has an infection. The first operation involves getting the fistula to heal from the inflammation or infection.

After two to three months you will be operated again. Then the fistula closes.

After the operations

The surgical wound needs to be replaced during the healing period. This applies regardless of whether you have been operated on for a bulge or fistula. Most often you can repair the wound yourself, but if needed you can get help from a district nurse.

Often a little fluid flows from the operating wound. Therefore, it may be good to use a diaper or panty protection for the first few days after surgery, or as long as the fluid is flowing.

The wound heals after one to two weeks.

You usually do not need to receive antibiotics, either before or after surgery. But if there are signs that the infection has spread or worsened, you may need to get antibiotics.


Sometimes an operated fistula does not heal properly. Then it may need to be operated several times. But if the fistula is still not healing, you may need to get a temporary pouch on the stomach where the intestinal contents are emptied, so-called an ostomy. Then the stool is led away from the fistula, which gives a greater chance of healing.

An operated fistula can sometimes become infected. Signs of infection include that you get a fever and that the operated area becomes red and hurts. You then need to be treated with antibiotics. If you think the wound or fistula has become infected, contact the reception where you have been operated on.

Influence and participate in your care

As a patient, you have under the Patient Act chance to affect your health.

You can seek care at any medical center or open specialist clinic you want throughout the country. Sometimes a referral to the open specialized care is required.

You should understand the information

In order for you to be involved in your care and treatment, it is important that you understand the information you receive from the healthcare personnel. Ask questions if you don’t understand.

You have the opportunity to get help from an interpreter. You also have the opportunity to get help from an interpreter if you have a hearing loss 

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