27M Concern About Anal Hole: Potential Fistula or Hemorrhoids/Prolapse Guidance Needed
I’m a 27-year-old seeking clarity regarding a noticeable hole near my anus. What could it signify? Additionally, how severe are my internal hemorrhoids and potential prolapse? I’m keen to learn about possible treatments or any specific medications I should consider. If anyone could direct me on the right specialist to consult or recommend appropriate treatment options, it would be incredibly helpful. Am I at a point where surgery might be necessary, or are there still non-invasive options available? Extended Perspective for Anyone Interested: Hello, I’m currently facing some challenging health issues and would like to share my experience briefly. About three months ago, I visited my general practitioner in the UK due to abdominal concerns and anal discomfort. I typically use the restroom upwards of 5-10 times daily, dealing with alternating episodes of diarrhea and constipation. There are times when I only pass mucus and gas, with occasional thin stools. I suspect I might be experiencing flatus incontinence because I often don’t notice when I pass gas until someone else points it out, which is incredibly distressing. The pain from my hemorrhoids contributes significantly to my discomfort and overall unhappiness. After examining me, my GP diagnosed internal hemorrhoids and mild prolapse. I received prescription cream and suppositories, plus a referral to a gastroenterologist for further investigation, including a colonoscopy. Blood and stool tests returned normal results, with one figure being slightly elevated but nothing significant. During a phone consultation, the gastroenterologist diagnosed me with IBS without ever meeting me directly and recommended I work with a dietician after I provided a detailed explanation of my symptoms. As our conversation neared its conclusion, I requested a colonoscopy, which the doctor initially dismissed as unnecessary. Eventually, he agreed, framing it as a means to alleviate my anxiety. When I inquired about specialists for my hemorrhoids and prolapse concerns, he mentioned that those issues would be reviewed during the upcoming colonoscopy, which is scheduled for three days from now. This entire experience has left me feeling uncertain. Had I not pushed for the colonoscopy, I wonder if I would have received further evaluation at all. Often, I am left questioning whether what I am going through is trivial or typical, feeling that I must advocate for myself to receive appropriate testing, and that such inquiries might be seen as burdensome. It is quite challenging to consult with a specialist in-person in the UK. Thank you for your time and support.
Answers (1)
4/2/2025, 5:01:25 PM
OpenHealth AI
It’s understandable to feel concerned about the hole near your anus, along with the discomfort from hemorrhoids and potential prolapse. This situation can be distressing, especially when accompanied by symptoms like alternating bowel habits and flatus incontinence. Let’s break this down and discuss options that may help you.
Understanding Your Symptoms
- Anal Hole: The noticeable hole near your anus might indicate a possible anal fistula, which is an abnormal connection between the anal canal and the skin. However, it could also be related to hemorrhoids or skin tags.
- Internal Hemorrhoids and Prolapse: Internal hemorrhoids can cause pain and discomfort, while prolapse (when hemorrhoids protrude from the anus) can lead to further complications. Your experiences with bowel habits like diarrhea, constipation, and mucus are often associated with conditions like IBS (Irritable Bowel Syndrome), which can complicate hemorrhoid issues.
Next Steps
Given your upcoming colonoscopy, which is a key diagnostic procedure, here are the prioritized steps to consider:
- Preparation for the Colonoscopy: Follow any preparatory instructions from your gastroenterologist. This may involve dietary changes or specific cleansing methods to ensure your bowels are clear for thorough evaluation.
- Symptom Tracking: Keep a detailed symptom diary leading up to your appointment, noting when you experience discomfort, changes in bowel habits, or any other symptoms. This diary can be valuable for your gastroenterologist to evaluate during the colonoscopy.
- Discuss Concerns: Be prepared to discuss your worries about the anal hole, the severity of your hemorrhoids, and any changes since your last appointment during your colonoscopy consultation.
Consider Non-Invasive Treatments
While awaiting your colonoscopy results, consider these initial self-care measures:
- Dietary Adjustments: Gradually increase fiber intake to help regulate bowel movements. This can reduce both diarrhea and constipation.
- Hydration: Drink plenty of water to prevent dehydration and promote regularity in bowel habits.
- Topical Treatments: Continue using prescribed creams/suppositories for hemorrhoids, as they can ease discomfort and inflammation.
Potential Future Treatments
After your colonoscopy, the specialist will be able to provide tailored recommendations based on findings. Options may include:
- Ongoing Medications: These might include anti-inflammatory or topical treatments for hemorrhoids.
- Minimally Invasive Procedures: If your issues persist after the colonoscopy, you may be advised to consider procedures like rubber band ligation or sclerotherapy for the hemorrhoids.
- Surgery: More invasive options, including surgical removal, could be considered if conservative methods do not alleviate your symptoms.
Emotional Support
It’s completely normal to feel anxious or uncertain about your health. Advocate for yourself, as you have been doing, and don’t hesitate to ask your specialist questions to ensure you fully understand your condition. Remember, you are not a burden—your health matters immensely.
Feel free to reach out if you have further questions or need more specifics about any part of your situation. I wish you the best with your upcoming consultation and hope you find relief soon!
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - 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Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.