Freaking Out

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Freaking Out

Postby JonnyJ » 06 Feb 2015, 14:05

Hey everyone, been awhile since I posted. Not sure what is going on and I have been told conflicting things by two different doctors so hoping for some opinions here. I've had skin tags for some time now, or maybe you'd call them minor external hemorrhoids. Usually they're fleshy & pink & not overly painful or inflamed, but they're always there pretty much. There's about 3 small ones in a little bunch & sometimes they get very inflamed but usually they stay nonsymptomatic. But a couple months ago, in November, I had a very painful bowel movement and some spotting, and they got VERY inflamed and swollen. For several days I had the worst pain ever every time I had a bowel movement. Like severe, sharp, shooting pain. I went and saw my CRS and he had me bend over and looked and said I had thrombosed hemorrhoids and that they would not get better and should be removed. He scheduled me for a hemorrhoidectamy. Both my parents had this done too but they were much older than me. I was a bit freaked out. But this CRS is one of the best around so I assume he knows his stuff. Well, I wanted to see how I did so I tried diet changes and stool softeners and olive oil with every meal and 2 sitz baths a day, and the swelling went down and the pain went away. I saw another CRS more locally a few days later and he said he was more cautious when it comes to hemorrhoid removal. He said see how I do on my own first and go from there. Now granted he is a CRS too but not as highly regarded as the first one I saw. So the first said to have them removed, the second said to wait for now. I was fine for a couple months basically with home care. Also used witch hazel pads. Although I was still kind of walking on eggshells and afraid to lift much, etc.

Fast forward to this week, had a routine bowel movement, and bright red blood on toilet paper again. No pain at all though. And no visible change in the external hemorrhoids appearance. Just the bright red blood on the toilet paper. I had a couple other bowel movements since, and they didn't have bleeding, but one today did again. I should also add that I had an anal fissure about a year ago, that I assume I healed from. So I don't know if the blood is from the hemorrhoids or the fissure coming back. I had a rectal scope done as recently as July of 2014 and the CRS said it looked boring, his words. In other words ok. A couple years ago, I did have an internal inflamed polyp that bled a lot and I had to have it removed. But I don't think something like that would come back so soon, would it? I also had an anal pap test done this past summer and it was normal.

But this continued spotting freaks me out are the chances it is just the hemorrhoids acting up? They are tender to the touch but not painful like they were 2 months ago.

Maybe I should have taken the first CRS's advice and had the hemorrhoidectamy. I'd just like to avoid something that drastic if I can. What are my other options? What about banding or ligation? I have anxiety disorder and also Asperger's and this is really freaking me out. Im doing all I can in terms of home care but I'm almost to the point of wanting to just have the surgery if thats what it comes to to be over all this. I know this is a long post I apologize.Thanks for any suggestions.
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Re: Freaking Out

Postby JonnyJ » 06 Feb 2015, 14:15

I still wonder why the first CRS was so certain I needed a hemorrhoidectamy. It would have seemed he would have wanted to try more conservative methods first like maybe ligation or banding but I guess he knew his stuff. Im going back to see him in a week I'll be sure to ask a lot of questions this time.
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Re: Freaking Out

Postby JonnyJ » 06 Feb 2015, 14:49

If he says I need surgery still after this visit, then I guess I'll do it. He wanted to do a EUA months ago for my then-active fissure, and had me scheduled for hemorrhoid surgery two months ago but my anxiety got in the way and I cancelled both. I hate to keep going to see him and then not going through with the procedures he wants me to do, but I am so scared of hospitals I can't help being leery. I know he's a great CRS and this issue seems like it's not going to get any better but Im nervous about going back to see him I'm sure he'll be nice as always but still I'm nervous.
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Re: Freaking Out

Postby Scientist2516 » 06 Feb 2015, 15:22

A small spot of bright red blood with a BM isn't uncommon at all, even in people who've never had a fissure. If it's just spotting, and no pain, I would not have surgery. By all means go back and get it looked at again - blood is scary, and should be checked to make sure it's nothing serious.

Personally I much prefer my doctors and dentists to be conservative "wait and see" people, because if you can recover on your own, that's much preferable to being cut and having to heal. Especially in a sensitive area like the anus.

Really, if there's no pain, I would get checked but not agree to surgery!
Nifedipine/lidocaine, no help
Diltiazem, effective, but caused major rash
Nitroglycerine, effective.
Topical estrogen for final healing.
Gentle heat to bottom - pain relief, muscle relaxant
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Time - lots of time.
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Re: Freaking Out

Postby JonnyJ » 06 Feb 2015, 15:48

Thanks for the comment. My inclination is to avoid surgery if I can. And I don't think my hemorrhoids are that bad right now, I can sit with no problems they aren't even that big. They sting a bit sometimes but only if I touch them. My dad worked in construction for years and he got really bad ones he would soak through his pants sometimes with blood. I bleed a little with bowel movements, that's it. I did have the thrombosed one a couple months ago but I thought they had healed. The local CRS told me to not do surgery now he said there wasn't a need for it. But the other CRS is supposed to be one of the best around. The only symptoms I have are some bright red blood on the tissue with BMs the last few days. Guess I'll see how I do and seek the CRS opinion again but I thought the threshold for hemorrhoidectamy had to be much more than just bleeding. If just bleeding and no pain, is that a good sign that this is just a temp blip and maybe I'll heal?
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Re: Freaking Out

Postby owmybum » 06 Feb 2015, 16:01

My CRS wasn't concerned with a bit of spotting after a bm. He said the area is very vascular, just like your gums... Which can bleed during teeth brushing.
If you are having just spots of blood with a bm then I think you just need to be seen... Not operated on...it sounds like you are healing yourself without surgery.
Please don't worry about putting off surgery when it has been suggested to you... It's your body... It's your right to do as you choose. No one will mind either way.

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Re: Freaking Out

Postby JonnyJ » 06 Feb 2015, 16:31

The CRS who looked at me in the fall when I was in pain and had a thrombosed hemorrhoid didn't even scope me he just looked at the outside and said you need a hemorrhoid removal. I thought he would have examined me more thoroughly before wanting to do something as drastic as surgery. Granted, hemorrhoid removal isn't open heart surgery, but still..He said it wouldn't heal itself, yet I felt better for a couple months. I still am in virtually no pain at all now. Even with the spotting. I guess there's a chance the blood could be coming from somewhere else and not the hemorrhoid but I've had a colonoscopy two years ago and a scope this past summer, so I guess it's the roids where the bright red blood comes from. I did have a small polyp inside the rectum that bled a lot a couple years ago, but I had it totally removed. What are the odds that it would have come back this fast? It seems to be with the stool when I wipe, and then after I dab a couple times, it gets less and less then stops. Mostly it's just spotting on the tissue, I had a couple times where a bit was in the water too. so it's only with a bowel movement. And not even every time I go. So I'm just not sure. If I go back to the CRS, shouldn't I ask for a scope first to determine what is going on and the extent of it, and then at least I'll know where I stand. I just find it odd that a doctor would want to do surgery without doing a scope or more thorough exam first.
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Re: Freaking Out

Postby JonnyJ » 15 Feb 2015, 14:33

The two incidents I've had recently were with a bowel movement. One a couple weeks ago, I had no pain, but bright red spotting on the tissue and also a bit in the toilet in the toilet it seemed to be a trickle or so on top of the bowel movement. I had a span of about 2 weeks in between and then I had another incident with spotting/small blood. No pain and stool was pretty soft. So not sure what to do. The one CRS told me to have a hemorrhoidectamy and the other said I didn't need to if it could be avoided. My inclination is to avoid it but I already have anxiety disorder and this is freaking me out. The spotting on tissue wouldn't concern me but both times there has been a bit in toilet too not a whole lot I can't gauge how much but maybe a teaspoon or slightly more. Then as soon as I dab a couple times after movement with tissue, it stops. No pain. I did have the thrombosed hemorrhoid a couple months ago which was terribly painful but interestingly with it I had no blood. I am doing all the right things sitz baths, water, fruits, veggies, etc. What should I do? I'm scared its cancer or a polyp but I doubt it because I had a scope last summer and it was fine and a colonoscopy 2 years ago. And 2 years ago I had to have surgery to remove a bleeding inflamed internal polyp. Could it have come back that quick? My hunch is that this is hemorrhoids.
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