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Have Little Lump Near The Opening Of Anus With Blood Discharge. Suggest?

Posted on Mon, 28 Oct 2013

Question: I have a little lump/boil near the opening of my anus on the left side. There is discharge from it and sometimes bright blood stain. What could it be?

Answered by Dr. Dr.P.Ratnakar Kini (2 hours later)

Brief Answer:
It could be hemorrhoids or fistula in ano.

Detailed Answer:
Hi,
Thanks for posting your query.
I am Dr.Ratnakar Kini and I am pleased to assist you.

I had a look at the image.

You have external hemorrhoids (piles) at 8 and 9 o clock position.
At 1 o clock position, you have a fleshy thing which could be the external opening of fistula in ano.
The image is not very clear. The other possibility is grade III XXXXXXX hemorrhoid.
Only by direct clinical examination, we can differentiate between these two as the two dimensional image which is also not clear is not helpful.

Consult a surgeon for clinical examination.
I hope that answers your question.
Let me know if I can assist you further.
Regards,
Dr.Ratnakar Kini

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Dr.P.Ratnakar Kini (3 days later)

Thanks.. I visited a local gasteroentologist on friday and he has scheuled a sigmoidoscopy in a couple of weeks.. He said that the little lump at 1o clock position could me a skin tag and the sigmoidoscopy might give more information on whether it could be a fistula.. If it is a fistula, would it require a surgery? If so how complex is the surgery? Would it take a long time for me to return to daily activities?

Answered by Dr. Dr.P.Ratnakar Kini (20 minutes later)

Brief Answer:
Fistula in ano requires surgery

Detailed Answer:
Hi,
If it is a fistula, surgery may have to be done.
It is a simple surgery.
You can return to daily activities in 7-10 days.

I hope that answers your question.
Let me know if I can assist you further.
Regards,
Dr.Ratnakar Kini

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr.P.Ratnakar Kini (17 days later)

Hey Dr.. I finished my colonoscopy last friday and there were no fistulas found. However a few ulcers as well as inflamation were found in both the small and the large intestine and biopsies have been taken. I am awaiting the results of the biopsies which would be available by second week of october. Also the gasteroentologist has started me on medication for inflamatory bowel disease... I take 4 apriso tablets each day..

Answered by Dr. Dr.P.Ratnakar Kini (10 hours later)

Brief Answer:
inflammatory bowel disease is a possibility

Detailed Answer:
Hi,
Thanks for updating me about the tests done.

Yes, inflammatory bowel disease is a possibility.

Once the biopsy report is ready, we shall discuss again.

Regards,
Dr.Ratnakar Kini

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Dr.P.Ratnakar Kini (3 days later)

Doctor, got my biopsy report... Here goes the findings... Please help me interpret this...

Date:9/27/2013 12:00:00 AM Type:PATH: RECTUM, BIOPSY Result:RECTAL MUCOSA WITH MILD ACTIVITY AND MILD CRYPT
ARCHITECTURE DISTORTION. Negative for granulomas, dysplasia, and malignancy. COMMENT: The findings could be compatible
w ith inflammatory bow el disease, particularly Crohn's, if infection and medication-related mucosal injury are excluded, and in the
appropriate clinical and endoscopic setting. As part of our routine quality assurance program, Dr. XXXXXXX Carpenter also review ed
this case and agrees w ith the above interpretation.
Date:9/27/2013 12:00:00 AM Type:PATH: LEFT COLON, BIOPSY Result:COLONIC MUCOSA WITH MINIMAL
NEUTROPHILIC ACTIVITY AND PROMINENT BENIGN LYMPHOID AGGREGATE. Negative for granulomas, dysplasia and
malignancy.
Date:9/27/2013 12:00:00 AM Type:PATH: RIGHT COLON, BIOPSY Result:CHRONIC COLITIS WITH SEVERE ACTIVITY.
SEE COMMENT. Negative for granulomas, dysplasia, and malignancy.
Date:9/27/2013 12:00:00 AM Type:PATH: TERMINAL ILEUM, BIOPSY Result:MODERATELY ACTIVE ILEITIS. SEE
COMMENT. Negative for granulomas, dysplasia, and malignancy

Answered by Dr. Dr.P.Ratnakar Kini (33 hours later)

Brief Answer:
You do not have IBD.

Detailed Answer:
Hi,
As per the biopsy report, you do not have inflammatory bowel disease.
It says there is just inflammation and no other findings suggestive of Crohn's disease. It has ruled out cancer also.

Let me know if I can assist you further.
Regards,
Dr.Ratnakar Kini

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Above answer was peer-reviewed by : Dr. Shanthi.E