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Hello. About A Week Ago, I Tried A Vegan Diet

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Posted on Sat, 3 Oct 2020
Question: Hello. About a week ago, I tried a vegan diet which resulted in a great deal of extra bowel movements and flatulence. It caused rather severe hemorrhoid symptoms(burning, itching, pain down there, especially after wiping), which are gradually getting better. However, I'm a little concerned because I noticed something growing at the edge of my anus. It's kind of cylindrical and part of it I can move around, but the other part is attached to me. I also experience painful bumps on one of my buttocks at the same time(also feeling better with time). I've read this could all be external hemorrhoids but, from what I've read, the growth could also be anal cancer. The oncall nurse for my hospital recommends going to the ER(because it's a holiday and the rest of the hospital is closed). But I have some questions and concerns about that: would they have the facilities to diagnose it right there? Are they usually able to take a tissue sample at the ER if needed? On that subject, what do you expect would be the usual diagnostic procedure in this case(eg. would they be able to tell by looking at it what it is? If not, what should I expect to occur? If they need to take a biopsy, how long does it take to get results usually?).
How likely is it that it's anal cancer instead of hemorrhoids, based on the information I've given you?
BTW, I took a Cologuard test 2 years and 10 months ago. Should that give me some kind of assurance it's probably not anal cancer?

Thank you so mucn,
XXXXXXX
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Follow up: Dr. Dr. Ivan Romich (0 minute later)
Hello. About a week ago, I tried a vegan diet which resulted in a great deal of extra bowel movements and flatulence. It caused rather severe hemorrhoid symptoms(burning, itching, pain down there, especially after wiping), which are gradually getting better. However, I'm a little concerned because I noticed something growing at the edge of my anus. It's kind of cylindrical and part of it I can move around, but the other part is attached to me. I also experience painful bumps on one of my buttocks at the same time(also feeling better with time). I've read this could all be external hemorrhoids but, from what I've read, the growth could also be anal cancer. The oncall nurse for my hospital recommends going to the ER(because it's a holiday and the rest of the hospital is closed). But I have some questions and concerns about that: would they have the facilities to diagnose it right there? Are they usually able to take a tissue sample at the ER if needed? On that subject, what do you expect would be the usual diagnostic procedure in this case(eg. would they be able to tell by looking at it what it is? If not, what should I expect to occur? If they need to take a biopsy, how long does it take to get results usually?).
How likely is it that it's anal cancer instead of hemorrhoids, based on the information I've given you?
BTW, I took a Cologuard test 2 years and 10 months ago. Should that give me some kind of assurance it's probably not anal cancer?

Thank you so mucn,
XXXXXXX
doctor
Answered by Dr. Dr. Ivan Romich (52 minutes later)
Brief Answer:
See next

Detailed Answer:
Hi XXXXXXX and welcome.
First of all, you should not worry since anal cancer is the last thing to think of and these are not typical signs of it. Anal cancer is rare, it develops over several months, it is manifested with blood in stool, and painful, tender ulceration painful bowel movements. Considering your description, this is more likely to be trombosized external hemorrhoid, anal polyp or skin tag. If this is more like painful swelling then it may be abscess or fistula. In case of abscess, ER visit may be helpful since incision may be required but if there is no pain then doctor will just examine perianal area and as I know, no emergency biopsy is done for that. Biopsy must be taken under general anesthesia and only when malignancy is suspected. In case of hemorrhoids which is probably your case, biopsy can't be taken. So if there are no symptoms such as bleeding, pain or fever I suggest to apply antihemoridal cream, have sitz baths and rest. Visit proctologist regularly to see if further diagnostic tests are required. Wish you good health. Regards
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. Dr. Ivan Romich (0 minute later)
Brief Answer:
See next

Detailed Answer:
Hi XXXXXXX and welcome.
First of all, you should not worry since anal cancer is the last thing to think of and these are not typical signs of it. Anal cancer is rare, it develops over several months, it is manifested with blood in stool, and painful, tender ulceration painful bowel movements. Considering your description, this is more likely to be trombosized external hemorrhoid, anal polyp or skin tag. If this is more like painful swelling then it may be abscess or fistula. In case of abscess, ER visit may be helpful since incision may be required but if there is no pain then doctor will just examine perianal area and as I know, no emergency biopsy is done for that. Biopsy must be taken under general anesthesia and only when malignancy is suspected. In case of hemorrhoids which is probably your case, biopsy can't be taken. So if there are no symptoms such as bleeding, pain or fever I suggest to apply antihemoridal cream, have sitz baths and rest. Visit proctologist regularly to see if further diagnostic tests are required. Wish you good health. Regards
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Dr. Ivan Romich (8 days later)
Hello Doctor, and thanks for your answer. Sorry for the delay - I had difficulties accessing your site. I'm relieved to hear it's probably not something serious.
My doctor recommends a FIT test to help with the diagnostic process. But I do have a possible concern about it showing a false positive, because it detects bleeding in the colon, and since I probably have hemorrhoids(which cause bleeding), and I also tend to bleed very easily(eg. when flossing, shaving,etc).
Do you think the 2 health conditions I just mentioned would make it significantly more likely I will have a false positive on this test(the average false positive rate on this test is 25%, which to me sounds very high).

Thanks so much!
default
Follow up: Dr. Dr. Ivan Romich (0 minute later)
Hello Doctor, and thanks for your answer. Sorry for the delay - I had difficulties accessing your site. I'm relieved to hear it's probably not something serious.
My doctor recommends a FIT test to help with the diagnostic process. But I do have a possible concern about it showing a false positive, because it detects bleeding in the colon, and since I probably have hemorrhoids(which cause bleeding), and I also tend to bleed very easily(eg. when flossing, shaving,etc).
Do you think the 2 health conditions I just mentioned would make it significantly more likely I will have a false positive on this test(the average false positive rate on this test is 25%, which to me sounds very high).

Thanks so much!
doctor
Answered by Dr. Dr. Ivan Romich (42 minutes later)
Brief Answer:
hi

Detailed Answer:
Hi again.
Yes, hemorrhoids would increase rate of false positive FIT test which is generally not very sensitive for detecting colon cancer, but in every case it could be good to do FIT since it is simple and if negative, it may ease your mind. If it would be positive, then you can do CEA marker or colonoscopy. So I dont see a reason why not to do the test, no matter it has such false positive rate since it is generally recommended fo age +55 to have FIT every 3-5 years. Warm regards
Above answer was peer-reviewed by : Dr. Kampana
doctor
doctor
Answered by Dr. Dr. Ivan Romich (0 minute later)
Brief Answer:
hi

Detailed Answer:
Hi again.
Yes, hemorrhoids would increase rate of false positive FIT test which is generally not very sensitive for detecting colon cancer, but in every case it could be good to do FIT since it is simple and if negative, it may ease your mind. If it would be positive, then you can do CEA marker or colonoscopy. So I dont see a reason why not to do the test, no matter it has such false positive rate since it is generally recommended fo age +55 to have FIT every 3-5 years. Warm regards
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Kampana
doctor
Answered by
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Dr. Dr. Ivan Romich

General Surgeon

Practicing since :2008

Answered : 13889 Questions

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Hello. About A Week Ago, I Tried A Vegan Diet

Hello. About a week ago, I tried a vegan diet which resulted in a great deal of extra bowel movements and flatulence. It caused rather severe hemorrhoid symptoms(burning, itching, pain down there, especially after wiping), which are gradually getting better. However, I'm a little concerned because I noticed something growing at the edge of my anus. It's kind of cylindrical and part of it I can move around, but the other part is attached to me. I also experience painful bumps on one of my buttocks at the same time(also feeling better with time). I've read this could all be external hemorrhoids but, from what I've read, the growth could also be anal cancer. The oncall nurse for my hospital recommends going to the ER(because it's a holiday and the rest of the hospital is closed). But I have some questions and concerns about that: would they have the facilities to diagnose it right there? Are they usually able to take a tissue sample at the ER if needed? On that subject, what do you expect would be the usual diagnostic procedure in this case(eg. would they be able to tell by looking at it what it is? If not, what should I expect to occur? If they need to take a biopsy, how long does it take to get results usually?). How likely is it that it's anal cancer instead of hemorrhoids, based on the information I've given you? BTW, I took a Cologuard test 2 years and 10 months ago. Should that give me some kind of assurance it's probably not anal cancer? Thank you so mucn, XXXXXXX