Should i trust my doctor ??

[Please Help Me - Really Depressed]

Hi Dr. Rockoff,

First of all I think you're doing a great job on this site, where people can ask a very educated doctor questions.

I am a 24 year old heterosexual male; I had anal warts and was referred to proctologist. He told me I had some inside me too, about 2cm in and have to really spread the bum cheeks to see them.

He told me to leave the ones inside for now and treat the others with podophylin. I didn't use it as they started to go away on their own.  It’s been a year since they all went away on their own.

Last month, I was curious to look down there and saw 2 bumps inside the bum hole (one is a small tag thingy, and the other is bigger and sometimes has a white tip on it, just on the inside of the anal verge opening) and was referred back to him again.

He did a thorough check and said anal warts are not my problem everyone’s bum is different and to move on with my life and to stop spreading my bum cheeks checking for things. He even said if I had them biopsy isn’t needed he can tell without it.

Since he didn't tell me what they were, I got confused and went to several other regular docs. All of them about 5 of them said they are not warts, but just part of my anal mucosa. One doctor even said he's seen tons and tons of them and they are absolutely not warts and to get it out of my head.

Only one doctor was not sure if they were or not, but was willing to rely on the proctologists opinion since he's an expert.

1. Do you think I need to see another proctologist?

2. Last doctor told me that both internal and external warts all look the same is this true?

3. He said that both of the bumps are just tags, and one of them is an anal papillae and I am stretching the tissue to give it a blanching white tip.

4. I just hate feeling something being misdiagnosed and want my old self back? I can't do this anymore its not healthy?

Please advice.

Thanks so much.

[Alan Rockoff, MD]

I think you've seen enough doctors.  If they think these aren't warts but are just normal variants, then I think you should accept their opinion and forget about warts.

Best.

Dr. Rockoff

[Please Help Me - Really Depressed]

also i forgot to mention, the only doctor that did get my report back from the proctologist was the one that said they might be residual warts as they were suspicous, but was confused as Dr. Pezim would not have missed anything important, and said that they might just be tags.

when the report came back he read it out, it said patient has an anal fissure and a small sentinel pile. after reading this he didn't even know what a sentinel pile was and i've researched my self that its just a skin tag common to some fissures, which leads me to believe he might not know much, and the fact that he told me to use podofolyn inside? i know not to use that inside too? can i conclude that he doesn't know much about the anal anatomy.

1. with mixed answers from the doctors is it okay to accept any answer and just move on as it is like trying to prove a false negative.

again thanks so much Doc.

[Alan Rockoff, MD]

No change in my opinion.

Dr. Rockoff

[Jonnyincentx]

In regards to your seeing this: <i> saw 2 bumps inside the bum hole one is a small tag thingy, and the other is bigger and sometimes has a white tip on it, just on the inside of the anal verge opening</i>

apparently your obsessive fear of anal warts is causing you to go to great lengths to look up your anus. As a result are actually pulling forward the inner skin of the anus, and viewing something that a Dr. would use a special tool to view. They'd rarely see what you are seeing, because of your unusual efforts.

Pulling the interior skin of the anus so far forward, is exposing your rudimentary anal glands. Everyone has them, but considering their location few people know, and even fewer ever see them exposed like this. Pulling the interior skin of your anus so forward and out, flattens the internal anal skin. This causes the normally recessed anal glands to stand out a tiny bit against the surface, and yes they do indeed look like tiny skin tags. The white tip you describe is the little gland doing its job. It secretes a sort of milky colored lubricant. The white stuff will seem to disappear if you touch it, but will re-appear given a minute or two.

Anal glands are not easy to observe in situ, and observing them this way is very unusual. So very few people will have any idea what you are talking about.