Bleeding from Outside of Anus

[jet3356]

A year ago on the high protein diet I became constipated.  Straining created some bleeding.  I felt leaking and went to the doctor.  I had an infected sore and went through two courses of antibiotics.  The sore goes through cycles where it almost heals and then will begin again.  Having any kind of long bowel movement will create bleeding.  It will go for periods with almost no bleeding, then get started again.  Over the past week, it has been worse and I have blood stains in underwear.  I take baths to help it drain and to try and help it heal.  Just frustrated that I can't get it to heal.  How do you get it to heal for good?

[Mason11170]

A related discussion, Outside Anal Bleeding and foul smelling bowl movements was started.

[Jomalade]

Hello, I am a 30-year old male who has for the past year and a half suffered from as-of-yet undiagnosed symptoms. It began with anal discomfort and itching; I was haphazardly diagnosed with piles (not looked at) and began using prep-h. Steadily it worsened to affect my eating and sleeping habits, and I began to experience bright blood spots on the t-paper. Since, I have not had a 'normal' bowel movement and have forgotten the feeling of the beginning of one. I then developed pain mostly in my right side, but it also occured less frequently on the left and sharply at the top of my belly. This led to pain sporadically in my lower right and left back, and feelings of numbness in my limbs and chest, alongside pain. I was given a cortisoidal treatment called Proctofoam, which gave me brief relief after bowel movements in relieving some of the itch feel. However my GP (subsequent doctor) at the same time did not indicate I had piles at all. I have also visited an internal medicine specialist; who also saw no abnormalities in the anal surface nor cavity. I have had ultrasound, barium enema, cat scan and (frogive me for not knowing term) a test whereby I was xrayed after drinking liquid, all of which yielded normal results. I have had many blood tests, one of which revealed high cholesterol despite my extremely low appetite and penchant for vegetarian diet. I am at a crossroads as I know that what is happening is not normal. I still use proctofoam coupled with a skin cream I use on most of my body, which is treating an eczema condition I believe, but they are wasted and I still derive persistent discomfort from my anal area, which has visible little cuts and protruded lining with a nub at the top being most painful. The anal walls outside and just inside are usually raw and itched (worst at night); I have modified my diet as much as I could gather would be helpful. My normal b-movement is when I wake up; which is most times loose and strained, along with false alarms and feelings of incompletedness. If my sleep pattern was affected (almost always is) this can cause me to miss my chance first thing, and suffer constipation atop. I have become a belcher after eating and I mean seconds after, as well as through the day (I never belched at all for most of my life). I know I may be sharing alot of common symptoms, but I don't know what to do. The anxiety from this condition and loss of job due to it has become my doctor's only diagnosis (ie depresssion and anxiety) and I refuse to begin to take anti-depressants to solve what problems I already have.

My diet did change before this all began from vegetarian to some meat, as well I drank more at the onset coupled with smoking and life stress. I also worked in sitting-down environments: I know these may be contributing factors. But to what? Please help, especially to know which direction I should explore now.

Many thanks folks,

jomalade

[Kevin Pho, MD]

One consideration would be an anorectal fistula - which is caused by a "non-healing" anal abscess.  

A surgical referral is usually necessary, since medical treatment and antibiotics will not be helpful.  

If this has been ruled out, you can consider a flexible sigmoidoscopy to evaluate for other lower GI conditions that can lead to this - including hemorrhoids, diverticulosis, or a polyp.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[surgeon]

You need to see a surgeon: what you describe sounds like a "fistula-in-ano" or possibly a tear in the skin over the muscle (although that's usually pretty painful). In either case a simple outpatient procedure will take care of it. In the case of a fistula, no medication or other method will work.