So, I had multiple fissures over a year ago that have been "supposedly" healed for over a year. I say supposedly because I still get light irritation around the anal area after bm and it comes and goes throughout the day. Like a stingy feeling.

Anyway, so I notice that when I take a warm sitz bath after a bm I can feel a pea sized bump right at the opening of my anus. I can only feel it when I am taking a warm bath. Something about the heat makes it rise. What is this bump and could this be what is still causing me anal irritation/stingy feeling on a daily basis? Can i treat it? Is it possible I still have a fissure that cannot be detected when examined?

Thank you. This is not my first post btw. I seem to have lost my old password when the site moved locations. Take Care.

Hi goawaygoaway

It sounds like you have a sentinel pile, which usually form from a fissure
and generally gets better by itself. So when did you first notice this bump?

I'm not sure if you want to treat it other than with your sitz and some
fissure friendly creams. You may want to avoid hemorrhoid creams as
they can thin the skin.

Yes it's possible a can go undetected, especially if it hurts too much
to do a thorough examination as some CRS and or patients will back off
the more thorough examination to prevent further damage.

Did your DR. give you the healed status?

Hopefully others here will have some better advice for you. But it's
always best to get it checked out.

GL

buttastic wrote:Hi goawaygoaway

It sounds like you have a sentinel pile, which usually form from a fissure
and generally gets better by itself. So when did you first notice this bump?

I'm not sure if you want to treat it other than with your sitz and some
fissure friendly creams. You may want to avoid hemorrhoid creams as
they can thin the skin.

Yes it's possible a can go undetected, especially if it hurts too much
to do a thorough examination as some CRS and or patients will back off
the more thorough examination to prevent further damage.

Did your DR. give you the healed status?

Hopefully others here will have some better advice for you. But it's
always best to get it checked out.

GL

I first noticed the bump right around the time period my fissures were healing or were healed by nitroglycerin.

Yes I have seen two different CRS over the past year and half and both have said there is no more fissures. The second one suggested the idea of a fissure that cannot be seen when being examined with sigmoidscopy. This Dr wants to do botox. I am hesitant to do that because I doubt I have a fissure, there is no blood and my symptoms are minor.

If it is a sentiniel pile causing my irritation, would nitroglyercin help with that? Or what kind of cream?

Hi Goaway!
It does sound like a Sentinel pile you could be dealing with especially since it's at a time when your fissure(s) are noticeably healing but don't rule out a regular pile & I would say just keep a mild eye on it.
If your diagnosis is that you are healed from the fissures, I personally would be reluctant to undergo further treatment and Botox might not actually be necessary as this is really only used to help an open tear heal. On saying this, it wouldn't harm to go for an internal EUA just to see exactly what is going on internally and to check that everything has healed up as it should.....but it's unlikely a CRS would perform Botox if there is no real need.
If it is a Sentinel pile, they tend to reduce in size or settle over time, possibly leaving a little mound of fleshy skin that shouldn't be too bothersome. It does take time though and I really would avoid any hemorrhoid type creams - I find that natural Aloe Vera (straight from the plant) or Coconut Oil to be helpful in soothing and reducing some of the friction in the area and these can be used safely too. Nitroglycerin will not help a Sentinel pile - again, it only should/ tends to be used in helping an open fissure heal up.
The best course of action generally is, if they are doing you no harm and causing you no major irritation, leave them alone to settle, which they tend to with improved dietary & toilet habits & use more natural based creams.
It just takes time :) All the best :)