Question: Hello, the results of a resent colonoscopy turned up nothing unusual other than the Dr. telling me I have external hemorrhoids. I have been battling hemorrhoids since my 20's. I am in my mid 50's. They have always been a problems and are getting worse. I exercise about 6-8 hours a week playing tennis, weight lift and long walks. I am 5'9" and weigh 195 lb's. I have little belly and most would say a muscular physique for my age. I have tried high fiber diets and alternated stool types (soft to solid) without any relief. My mother has issues with them as well so I would surmise it to be a family history. Now the symptoms. After every bowel movement, I have a large release of fluid that last at approximately 12 hours. The hemorrhoids are inflamed and uncomfortable but not painful. The issue is the large volume of fluid that is released. I will wear a wash cloth under my underwear and the fluid will soak to reach my outer clothing and cause a large wet spot at the anal area of my pants. Extremely embarrassing. I always take showers and clean the affected area after the bowel movement but the affects are lingering. I have talked to my family physician and the Dr. whom completed my colonoscopy and all agree it is a fiber issue. I am doubtful as having read about prolapsed and thrombosed hemorrhoids, they may require specialist and medical treatment. However, I do not know if I suffer from either of these conditions since I do not have the dexterity to see them. Also, I failed to mention, blood release occurs approximately 1 in 4 bowels movements. Question: I have tried diets, taken supplements visited doctors without relief. Is this something I have to live with or is there any relief in the form of surgery? Thank you for your time.

Hello Dr. R.K.

Additional information as requested.

Average frequency of bowel movement is once every 3 days. The lingering affects of the bowel movement is a liquid release that last up to 12 hours afterwards. It appears to take this long for the hemorrhoids to subside.

This has been going on since my 40's but the volume of the fluid release has significantly increased within the last few years.

I am a controlled diabetic. Insulin dependent, latest A1C was 6.9. Strong family history of diabetes. Both grandfathers were insulin dependent. Both parents are diabetic (not insulin) sister is pre-diabetic. I have no other health issues and am otherwise healthy.

I have visited nutritionist and attended diabetic seminars. I feel at a loss of what further I can do to treat my hemorrhoids and more importantly the linger effect of them.

Thank you for your review.

Prescribed daily medications are:
Humalog 3 x 8 units/mL
Lantus 1 x 25 units/mL
Xigduo 2 x 5mg/1000mg
Astorvastatin 1 x 40mg

Daily Supplements:
Fish oil 2 x 1200 mg
B12 1 x 1000 mcg
Meta-mucil 3 x 5.8 g

Hi Dr. R.K.

I was not familiar with fistula in ano and completed a quick Google review and I can see why you inquired. Is the next step to see a specialist and have the colon transit study completed? And if so, which type of specialist do you suggest? Also,
would a colonoscopy results not show fistula in ano? Thanks, .....