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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Suggest treatment for flatulence and external growth at the anal area

Answered by
Dr.
Dr. Klerida Shehu

Gastroenterologist

Practicing since :2006

Answered : 2265 Questions

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Posted on Wed, 24 Aug 2016 in Digestion and Bowels
Question: I am 31 year old male. When I was 14 year old,i met with an accident in which my spleen, large intestine, pancreas and column connecting lung were ruptured. I was operated upon post which i developed problem of flatulence. The problem aggraviated slowly slowly. For the last 8-9 years, i have to go twice to clear my stomach in the morning and some times during evening. During the day time i pass gas at least 20-25 times. I took ranitidine, then Omeprezole. But the stomach clearing issue is not solved. My ultrasounds were alright. I do not have diabetes or any other disease. I used to smoke, which i have stopped recently and i drink alcohol occassionally. Few years back i had external growth outside anus, which varies its size (i have to press it inside after the stool, but it does not pain). It protrudes during stool and i can put it inside with finger. (Photo att) Rarely it beeds also.
My stool is semi solid with scatterred small lumps.
I have spoken to various doctors (not specialists) and got few medicines which did not make the problem go permanently.
I do not eat spicy food and in case the food is spicy,my chest starts burning. The gas i pass are majorily odourless while stool is not (neither too pungent).
I have tried Kayam churan, Jhandu Pancharisht, but no success.
I am more troubled by the morning schedule and what i perceive is due to gas. Many a times i have to move out for work early, then it becomes very difficult for me. I also take around 15-20 minutes in first time and 5-7 minutes second time.I have got my stool culture done, as adviced by specialist. Report attached.
I do not have any abdominal pain. Only discomfort is there when gas is formed.
Also the fissure is not painful. It is a very small external growth which causes discomfort in sitting if not pushed inside.
According to me the main issue is gastritis which makes me go to the toilet again and mostly it is air which passes alongwith small portion of stool and then i am relieved, but after some time i feel that i have gas in the stomach.
I have attached the prescription which i took few days back, it didnt help much though.
doctor
Answered by Dr. Klerida Shehu 6 hours later
Brief Answer:
Please follow...

Detailed Answer:
Hi and thank you for asking on HCM!
I read carefully all your concerns and review your photos.
Regarding your issues I can say as follows :
1. What I see in your anal area is external hemorroids. It can explain the fact the it is bleeding some time and is not dolent.
Regarding this issue you should use preparation H to get relieve.
2. The other issue that you are asking is about abdominal discomfort, gas and flatulence.
These symptom may be due to :
- malabsorbtion ( you are reporting that after the accident you have removed spleen, large bowel , small bowel??may be??pancreas .
- IBS ( irrota ble bowel syndrome)
Otherwise to get a more accurate opinion you need to do :
- colonoscopy
- upper endoscopy
- fecal tests for food malabsorbtion
Meantime I suggest to use digestive enzymes like Creon and simethicone.
Creon capsule will help to improve digestion and absorbtion of foods . It will reduce gas forming and abdominal flatulence.
Hope it was helpful to you
Dr.Klerida

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Klerida Shehu 52 minutes later
Thank you Dr. Klerida. I think you need to be more specific. And i need to be more elaborate. My queries based on your reply:
1. I read about preparation H. It is majorily used where pain is there. But i do not have any pain.It comes out during stool and i have to press it inside after the stool, else it causes problem in sitting. Are you sure this will remove this issue.

I have to apply lot of pressure to empty the bowels and this part of anus comes out when i apply too much pressure.

2. I am fed up of going to toilet to empty my bowel twice in the morning. I beleive the medicines you have suggested is for gas and flatulence. But what about my stool problem. I have to travel and share room with people and i take a lot of time (20 mins at one time) in toilet due to this problem.

3. I did not say my spleen was removed. I said, my spleen, large intestine and pancreas were ruptured in the accident. Ultrasound states that all are perfect with normal growth. But once i had pancreatic ulcer also when i ate lot of spicy food in a party.
I generally avoid spicy and oily food.

So, primarily i have three problems:
(A). Going to toilet twice.
(B). Regular gas formation.
(C). Growth on anus.

4. Kindly tell the procedure to take the medicines also. I mean, before meal, after meal, morning or evening, etc

Regards
doctor
Answered by Dr. Klerida Shehu 18 hours later
Brief Answer:
Please follow..

Detailed Answer:
Hi back,
Thank you for giving me more of your medical data.
Let me explain again:
1. From what I see on the pictures You have external hemorroids . That is what you touch after defecation. Some times they are bigger and tensed and bleeding and some time the situation is more quite.
Preparation H helps to improve the situation but not to cure hemorroids.
The definite treatment of hemorroids is surgical ligation.
To my opinion you need to consult proctologyst specialist.
On the other hand you should avoid constipation and hard stools. Improving defecation will help to lower the pressure on hemorroids vessels and decrease the hemorroids size.
2.With regards to number of morning bowel movement to my opinion it may be related with IBS or malabsorbtion.
This is why I suggested to do the above exams to rule out malabsorbtion.
Creon will help to improve absorbtion and will reduce gas forming.
If all the exams are ok than I can say that your symptoms are related with IBS.
Hope it was helpful to you.
Dr.Klerida
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Klerida Shehu 2 hours later
Thanks a lot for details.
Please tell me how to take Creon..before meal or after meal and how many times a day.
And for how many days.
doctor
Answered by Dr. Klerida Shehu 16 hours later
Brief Answer:
Please follow

Detailed Answer:
Hi back
You will take Creon 15 minutes before meal , 3 times per day.
It will continue till.three month to see improvement.
Hope it was helpful to you.
Dr.Klerida
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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