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Blood in stool, recurring fissure, hypertrophied papillae, mucus in stool. Is surgery the only way to rectify swelling?

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Gastroenterologist, Surgical
Practicing since : 1984
Answered : 922 Questions
For Dr.NanikSingh Kukreja (in conitnuation of last consultation)..
XXXXXXX, 27 years, female, 5ft 3 inches, 47 kg
Hi! doctor...
According to your last consultations i took paraffin and fluids, fibre XXXXXXX diet and used diltigesic gel, sitz bath. I Found deltigesic is very effective. I don't feel pain. But blood while motion is still going and i have to put stress for stool. This time blood is coming with the initial part of stool in a liquid form then along with middle part i found blood drops and also at last part i found falling blood dropps . Also I have to put stress for stool motions, many times even after taking the laxatives.

I again went to my doctor (colonrectal surgeon who used to give me flagyl). He again checked my fissure and found that i have no pain that much at mild fissure. He told me this fissure does't seems to be responsible for that much blood in stool. He told me for sigmoidoscopy and did it on that same day. (Report attached)
After sigmoidal examination he told me for surgery of hypertrophied papillae since i am having swelling at rectal part and becoz of this i have to put stress and thats why fissure reoccurs. (hypertrophied papillae as given in report).
Also this swelling is also responsible for mucus/ white fluid and blood that is coming from stool. (Pls note hypertrophied papilla is not in prolapsing stage right now)
Actually many times i noticed white mucus coming along with stool in non-negligible quantity so that i can easily see it. Although also he told me if mucus is coming from upper part, not from this swelling then he don't know about that.
1) So pls check my report and let me know about your views on this.
2) Is surgey only way for rectification of swelling ? Can't it be treated through medicine?. (Acc to my doctor if i go thru medicine then there are chances of reoccurence).
3) What causes this swelling in that part of body?
4) What type of surgery used for this? (my doctor did not tell it to me when i asked him) and which is better surgery for its treatment so that I can recover easily and early?
5) How many days it ‘ll take for complete recovery. My doctor told me after surgery i have to take dressing 5 days consecutively.
6) Can it be treated by infra red?
7) Is there any chances of reoccurrence of this even after surgery?
8) Shall I recover from constipation , hard stool and blood with stool problem after this surgery?
9) I had been taking lactulose solution in Oct-11- Nov-11 . Then started taking isabol on dec-11 to Mid XXXXXXX -12 and lactifbre for 15 days. But now again taking more lactibre so that I don’t need to put strain.
Is there any side effects of all these medication in body because I can listen different types of sounds from my stomach many time and sometimes pain? How can I come out of this.

Now doctor has given me flagyl for one week and told me prepare yourself for surgery. I AM Confused.
Posted Mon, 23 Apr 2012 in Digestion and Bowels
Answered by Dr. Ajit Naniksingh Kukreja 3 hours later

Thanks for posting your query

I can understand your concern but I will again reassure you and will clarify all your doubts with my reply

Your report is a handwritten report and not the images of sigmoidoscopy

Anyway Anal papillae occur as a result of chronic constipation and are known to give a sense of incomplete defecation

Surgery is indicated if it is diagnosed with symptoms as in your case, and It can very well be treated with Infrared Coagulation, You do not need to get hospitalized

But if you are planning surgery go for the treatment of your fissure alongwith

No dressing is actually needed

There are chances of reoccurrence if the constipation is not controlled, if you control constipation and get operated other problems will be relieved

Lactifibre is safe and gurgling sounds are normal in patients on laxative

If it turns to colic, you should change the medicine

Do not get confused and go ahead with surgery and get rid of the problems

In case you have any more issues apart from these revert back
Get Well Soon
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