“By my symptoms is it possible that I have an anal fissure, hemorrhoid, or both?”
I'm a 23 year old male. About 2 months ago, I had gone to the bathroom to have a bowel movement that was very painful with blood (I was straining a bit at the time it happened). The only way I could describe it was like me letting out a very sharp razor blade. The sharp pain and bleeding lasted a few days. (The weird part is I have strained a lot in the past and had constipation but never experienced anything ever like this)
The first day it happened after I left the restroom I let my mother know, as I currently live with her and I went online and searched my symptoms and related causes, I found anal fissures to be the closest thing to it, and what I read and videos I watched had exactly the same things I experienced and felt.
The pain eased down a bit within the first week and got a little better by the second week that it first happened. During the time I was eating plain Chobani yogurt with a little bit of honey to aid with probiotics and to ease my bowel movements (as recommended by the pharmacist), and ate oatmeal and vegetables, fruits for the fiber, and plenty of water. I didn't have many hard bowel movements then.
I also used some wipes and took sitz baths with some Epsom salt for a few days. When I showered I would use the showerhead and direct it towards my rectum but not directly at it just far enough for the water to reach while it was warm. I used Aloe Vera gel with Lidocaine and the A+D diaper rash ointment + skin protectant cream on my rectum but not internally.
The pain was very sometimes mild when walking (still feel around the same area inside my rectum when walking there is a weird uncomfortable sensation, not really a sharp sensation but kind of poking type sensation).
After that I started back to how I ate, I had Chinese food once and that didn't cause any issues during bowel movements. I also started drinking sweet water with lemon and some tea, I didn't have any issues with that either.
About two weeks ago I ate some pretzels and some off-brand cheez-it and I had slightly hard bowel movements but not much pain. In the same week, I made a loaf pan of sweet bread and I ate that up in a night while watching a movie. The next day after I ate a thick loaf of bread I had a big hard bowel movement I had to strain and push to get it out of me and I started to bleed again and the pain happened again, not as severe or razor-like as it felt the first time but it enough to make me very uncomfortable, felt like it re-tore in the same area. I know this part was all my fault as I shouldn't have eaten anything like that, especially in one night.
So for the first few days, I was extremely constipated and it was irritating what I believe to be a fissure. I couldn't take it any longer so I went to the ER.
When I was at the ER they gave me IV fluids and did an x-ray of my abdomen from front and back and saw that I was constipated. My urine and blood samples came back well. I also told them about my rectal issues and everything I did from the diet and diet change, what I ate, etc.
I also told them I did some research and the closest thing I saw was an anal fissure. As with most of it, I feel a bit internally but not deep inside my intestines.
They asked me did I have a history of any anal fissures or hemorrhoids and I told them no except what I have been feeling. So the doctor prescribes me some stool softeners to take for 10 days, proscribed me Hydrocortisone USP rectal cream to use externally, and told me that if the symptoms don't get better in 10 days to come and see a doctor, the doctor also suggested for me to take Magnesium Citrate to clear constipation. I was also told to eat a lot of fiber. Today would mark the 10th day.
The magnesium citrate worked well and in a few days I wasn't constipated anymore, I only took one bottle of it and had a lot of water and a fiber diet. Most of my stools are soft or not as hard but sometimes bulky and don't hurt much. But recently since last week, I've been feeling a bump or lump on my rectal area, with my hand. I did some research and saw that it could be a hemorrhoid or a lump from an anal fissure, or other issues which I hope I don't have.
Sometimes when I sit down I feel the bump there sometimes I do not without touching, and a bit uncomfortable too. A few times when I wiped just a small dot of blood was on the toilet paper but not pain or bad bleeding like before. The weird part is it sometimes feels like the bump or lump is never in the same spot as it was before, sometimes I don't feel it even with my hand.
So since as I mention going to the ER my diet for almost 2 weeks has been:
- Vegetables/Salads
- A lot of water, 3 to 4 bottle amounts daily.
- Fruit
- Yogurt
- Instant oatmeal/baby food oatmeal with probiotics, lentils, and vegetables in the mix
- Fiber and raisin bran cereal
So I'm not sure what is wrong with me as the doctors did not diagnose me with anything and they didn't even think to do a rectal exam to be certain. I don't have money or health insurance and was billed over $2k for the small amount of things they did at the ER that day. I don't have enough and nto covered for surgery.
So right now I'm taking home remedies and the cream the doctor proscribed me and at the last pill for stool softener.
I do not want this to be a chronic issue so is there any suggestions for what I should do?
The first day it happened after I left the restroom I let my mother know, as I currently live with her and I went online and searched my symptoms and related causes, I found anal fissures to be the closest thing to it, and what I read and videos I watched had exactly the same things I experienced and felt.
The pain eased down a bit within the first week and got a little better by the second week that it first happened. During the time I was eating plain Chobani yogurt with a little bit of honey to aid with probiotics and to ease my bowel movements (as recommended by the pharmacist), and ate oatmeal and vegetables, fruits for the fiber, and plenty of water. I didn't have many hard bowel movements then.
I also used some wipes and took sitz baths with some Epsom salt for a few days. When I showered I would use the showerhead and direct it towards my rectum but not directly at it just far enough for the water to reach while it was warm. I used Aloe Vera gel with Lidocaine and the A+D diaper rash ointment + skin protectant cream on my rectum but not internally.
The pain was very sometimes mild when walking (still feel around the same area inside my rectum when walking there is a weird uncomfortable sensation, not really a sharp sensation but kind of poking type sensation).
After that I started back to how I ate, I had Chinese food once and that didn't cause any issues during bowel movements. I also started drinking sweet water with lemon and some tea, I didn't have any issues with that either.
About two weeks ago I ate some pretzels and some off-brand cheez-it and I had slightly hard bowel movements but not much pain. In the same week, I made a loaf pan of sweet bread and I ate that up in a night while watching a movie. The next day after I ate a thick loaf of bread I had a big hard bowel movement I had to strain and push to get it out of me and I started to bleed again and the pain happened again, not as severe or razor-like as it felt the first time but it enough to make me very uncomfortable, felt like it re-tore in the same area. I know this part was all my fault as I shouldn't have eaten anything like that, especially in one night.
So for the first few days, I was extremely constipated and it was irritating what I believe to be a fissure. I couldn't take it any longer so I went to the ER.
When I was at the ER they gave me IV fluids and did an x-ray of my abdomen from front and back and saw that I was constipated. My urine and blood samples came back well. I also told them about my rectal issues and everything I did from the diet and diet change, what I ate, etc.
I also told them I did some research and the closest thing I saw was an anal fissure. As with most of it, I feel a bit internally but not deep inside my intestines.
They asked me did I have a history of any anal fissures or hemorrhoids and I told them no except what I have been feeling. So the doctor prescribes me some stool softeners to take for 10 days, proscribed me Hydrocortisone USP rectal cream to use externally, and told me that if the symptoms don't get better in 10 days to come and see a doctor, the doctor also suggested for me to take Magnesium Citrate to clear constipation. I was also told to eat a lot of fiber. Today would mark the 10th day.
The magnesium citrate worked well and in a few days I wasn't constipated anymore, I only took one bottle of it and had a lot of water and a fiber diet. Most of my stools are soft or not as hard but sometimes bulky and don't hurt much. But recently since last week, I've been feeling a bump or lump on my rectal area, with my hand. I did some research and saw that it could be a hemorrhoid or a lump from an anal fissure, or other issues which I hope I don't have.
Sometimes when I sit down I feel the bump there sometimes I do not without touching, and a bit uncomfortable too. A few times when I wiped just a small dot of blood was on the toilet paper but not pain or bad bleeding like before. The weird part is it sometimes feels like the bump or lump is never in the same spot as it was before, sometimes I don't feel it even with my hand.
So since as I mention going to the ER my diet for almost 2 weeks has been:
- Vegetables/Salads
- A lot of water, 3 to 4 bottle amounts daily.
- Fruit
- Yogurt
- Instant oatmeal/baby food oatmeal with probiotics, lentils, and vegetables in the mix
- Fiber and raisin bran cereal
So I'm not sure what is wrong with me as the doctors did not diagnose me with anything and they didn't even think to do a rectal exam to be certain. I don't have money or health insurance and was billed over $2k for the small amount of things they did at the ER that day. I don't have enough and nto covered for surgery.
So right now I'm taking home remedies and the cream the doctor proscribed me and at the last pill for stool softener.
I do not want this to be a chronic issue so is there any suggestions for what I should do?
Male | 23 years old
Complaint duration: 2 months
Medications: n/a
Conditions: n/a
2 Answers
Santa Nandi
Gastroenterologist
Your entire write up is too long for this site but it seems you likely started with an acute fissure which may turn chronic if not taken care of by the proper specialist. Please visit a specialist. Most importantly you should avoid constipation and use laxatives, and see a surgeon or gastroenterologist right away.
Christian Diaz Stone
Gastroenterologist
Yes, it sounds like you had an anal fissure and you treated it fairly well. The treatment is nitroglycerine ointment to relax the muscle, then laxatives to keep the stools soft. Avoid hard stools. This is what causes the fissure.
