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Swollen anus with irritation and drop of blood - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Excellent Posted in: Women's Health
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1764 Questions
User :   I have 2 issues that may or may not be related. 1st I have noticed for a few years that after a bowel movement, my anus is a bit swollen. If you look at it is is a bit blue but after a couple minutes, it all goes back into place. Dr. thought this could be normal (I've had 2 vaginal births, 1 cesarian). Second issue is with external anal irritation. I have had issues in the past (over many years) but recently, irritation seems to continue. One dr. thought it was fungal, and I used cream. Got better then it came back. Dermatologist now has me using a steriod cream. Again, it is getting better but concerned it will happen again. I do tend to have to wipe a lot when I use the bathroom. I don't know if that is irritating or if it is something I am eating? I am noticing an occasional dot (TINY) of blood that appears to be coming from either the external anus or around that area. Do I need to see a proctologist? I had a colonoscopy last July and all was normal. I am a 45 yr old female.
User :   Did you get my issue?
Doctor :   Please give me some time
Doctor :  
to read your query
Doctor :  
so that I can answer you better
User :   Ok...I had an error on my screen wanted to be sure you received my issue...thank you
Doctor :  
I received
Doctor :  
Ok let us start with first issue
User :   ok
Doctor :  
if it is blue then there is a venous blood accumulation
User :   it is somewhat blue
Doctor :  
which can be because of the impacted stool, constipation , hemorrhoids
User :   and as I said it like bulges out but then goes back to normal within a few mintues
User :   ok
Doctor :  
That is external hemorrhoids or mild prolapse of anal skin
User :   any reason to have this investigated further or to "fix" it?
Doctor :  
For this, you have to check with proctologist and follow my other advices that I give here
User :   ok
Doctor :   1) Regular and timely sticking to the stool
Doctor :  
Even though you do not have a pressure to go to loo
User :   what do you mean by "sticking"
Doctor :  
you have to follow the routine, as early morning get up from bed, drink 4 glasses of water, 150 ml each
Doctor :  
Go for a 15 minute walk
Doctor :  
and then loo
Doctor :  
This should become a part of routine
User :   what is Loo?
Doctor :  
Toilet
User :   ok..
User :   I go almost every morning...about the same time
Doctor :  
so this form a biological alarm for your digestive system
User :   ok
Doctor :  
I do not know if you drink 4 glasses a day
User :   well...usually not
User :   generally one 16 oz bottle of water
User :   occasionally two 16 oz bottles
Doctor :  
This stimulates the gut and easy passage of stool
Doctor :  
Remember you should not afford to have hard stool or incomplete stool
User :   ok
Doctor :  
You should increase the fibre intake of your diet
Doctor :  
by restricting the refined foods
Doctor :  
High fibre breakfast cereals,
Doctor :  
Whole bread instead of white one
Doctor :  
Increase consumption of vegetables and fruits
User :   ok...I assume I need to gradually add fiber?
Doctor :  
Dry fruit increase
Doctor :  
Yes
User :   ok...
Doctor :   You need a Dietitian help to plan your daily diet plan
User :   now my concern is the external irritation...I almost think it is worse the more often I go to the bathroom
Doctor :  
So hence take the help of a Dietitian diet plan which has atleast 25 gms of fibre per day in your meal
Doctor :  
I am sure this will greatly help you
Doctor :  
Now second issue, the irritation
Doctor :  
The irritation one has could be an external agent in the form of frequent anal wiping which can cause dermatitis
Doctor :  
2) Hemorrhoids with impacted stool pellets in the anus
Doctor :  
for which a procotologist shall help if that is the reason
User :   I don't think I have hemorrhioids
Doctor :  
Even a mild prolapse of anal skin can cause such irritation
User :   ok...what are the treatments for the prolapse of anal skin?
Doctor :  
Your history of occasional blood in the stool also points towards these
User :   and just to let you know that they blood has always only been on the tissue
Doctor :  
Mild anal skin has no active treatment, only high fibre diet and using a soft tissue and no hard rubbing
User :   and only notice after I have wiped a couple times
Doctor :   Yes my suspicion is right

Doctor :  
using a soft tissue and no hard rubbing
User :   ok this all makes sense
User :   I try to be gentle..
User :   but usually always have to wipe many times
User :   which maybe is due to the mild skin prolapse?
Doctor :   just dab on it
User :   ok
Doctor :  
Doctor also advice to use water instead of tissue for sometime till the problem is reduced
Doctor :   to clean the local area
User :   ok..that isn't always easy to do since I work in an office building...
Doctor :  
I know, but if you follow the timings properly then you do not have to visit the toilet in the office
Doctor :   except for urination
Doctor :  
Do you have a family history of colon cancer?
User :   no
Doctor :  
Good
User :   and I did have a colonoscopy last July
User :   no polyps
Doctor :   ok fine
Doctor :  
You are in line with the screening for colon cancer
User :   ok..so if I increase my fiber it may actually help both of my problems
User :   because they could be related
Doctor :  
Exactly
Doctor :  
Add some exercise for 20 minutes daily, 5 days a week
Doctor :  
your life would be as good as it was
Doctor :   Exercise can be in the form of Brisk walk
User :   ok
Doctor :  
You may want to take an expert diet plan here
User :   ok..
User :   the skin irritation has been the most frustrating
Doctor :  
I can understand
User :   since it is sometimes very sore
User :   it can get very red and irritated
Doctor :  
Remember, you should immediately cut short your nails if long to cause soreness]
Doctor :  
This is an effective measure
User :   yes - I do not think that is the issue
Doctor :  
*reduce
User :   I think the excess stool when I wipe is causing the irritation
Doctor :  
But long nails can contribute too
User :   ok
Doctor :  
You can cut them as they grow back again by the time your problem is solved
Doctor :  
Does not that make sense?
User :   yes...I do have short nails usually
User :   but I think the other suggestions are probably right on target
User :   would it be ok since I am seeing a dermatologist right now to continue with her for a couple weeks
Doctor :  
Water, high fibre food and active life style are the summary
User :   using your suggestions (water, fiber, exercise)
User :   and see if things are better in say 4-6 weeks
User :   if not then see a proctologist?
Doctor :  
yes
User :   would these symptoms be the same as with anal cancer?
User :   or would anal cancer cause other symptoms...
User :   that is what I have been concerned about
Doctor :   Anal cancer to start with shall have the same
User :   but have had a couple doctors that this isn't the issue
Doctor :  
but after some time it can obstruct the anal passage and intense pain and pressure
User :   ok...
User :   the dr who did my colonoscopy told me that he had done a thorough anal exam as part of the colonoscopy
Doctor :  
Ok
User :   ok..well thank you for you time
User :   I appreciate your knowledge and suggestions
Doctor :  
Please fill the feedback form
User :   I certainly will
Doctor :  
Thanks for consulting me.
Doctor :  
Bye for now
User :   bye
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