Hello, before I rant on. Sorry for my bad English
I am 29 year olds, no family history of any cancer. I cannot go to a specialist since I don't have health insurance.
This morning, I went to the Emergency Room hospital. For symptoms of extreme painful bowel movement with lots of fresh blood, and a painful lump like stick out of my anus. I swear, all my symptoms are leaning toward anal fissures, but doctor said I have thrombosed hemorrhoid
Due to I have rectal bleeding, they order a blood test, they took out a lot of my blood. Doctor said test result come out normal, no blood loss, kidney function also normal.
The Emergency Physican M.D. (who is not a gastroenterologist) he examined my anus. The nurse help shine light and the doctor do the exam. He said I have external hemorrhoids, swollen too. Just hemorrhoids and a skin tag.
I asked him if the lump was a cancer mass. He said: No, it just thrombosed hemorrhoids.
Since blood test also show no blood loss. He prescribed me stool softener medicine, and hemorrhoid cream for pain. Then discharge me home. He said if I still worried, he or my family doctor can be refer to a gastroenterologist.
So my question are: Since he is just a M.D. Physican in E.R room, can he really tell the difference between thrombosed hemorrhoid, and anal cancer mass? Should I believe the E.R doctor?
Should I see my primary doctor, who is just a family doctor. Should I get a second opinion?
Since I don't have health insurance now, I find it hard to go to a specialist.
E.R doctor did say, he can only see what is outside. Inside need to be see by GI doctor.
Maybe I just worried too much.
Any advice is greatly appreciated, thank you.
And if anyone suffering from hemorrhoid, please give me some tips, thank you.

Tearingpain,
The fact that you mention extremely painful BM's & bleeding all lean more towards a fissure than hemorrhoids. You very possibly have both?
An external thrombosed pile will give you pain and bleeding but it sound's like you have more going on there internally? I
Is the pain stabbing like a knife cut? Is the external lump deep purple in colour? Internal piles can also bleed too.
I'm not an expert in any way, but do feel that you really need to see someone and get a second opinion by a CRS. I'm pretty sure you probably do not have a cancerous mass from what you describe. Anal cancer is very rare and your symptoms really do sound more like thrombosed piles/ fissure-related.
External piles are very painful when they flare up but I have always been able to manage the odd one I get with Anusol (with Zinc Oxide & Lidocaine) and through careful toilet habits (NO straining at all!!!!) and a soft diet & lots of fluids and it disappears within a day or too. I wonder if you also have issues with internal thrombosed piles??? I'm also wondering if you have a fissure whether you are getting some aggravation from a Sentinel pile, which happens.....
All I would say is, don't think the worst - I think it's highly unlikely you have anal cancer. Treat the issue as if you do have a fissure with all the great tips and advice on this site (soft stools, fissure friendly foods, sitz or hot water baths, NO straining, no wiping, stool softener etc.) as these will all help relieve piles as well as fissures and try to walk/ lightly exercise too as this helps with blood flow to the area and helps in the digestive process too.
It's natural to be worried and fear the worst when confronted by all these issues and we've all been there - but if you can get referral to a CRS, I think that would greatly put your mind at rest and give you a real diagnosis of what's truly going on.
Take Care, try not to stress yourself too much as that makes things even worse & all the best to you.......

Thank you, I swear I feel like I had fissures too.
But most in here said fissures don't have a lump sticking out of your anus.
I have a lump sticking out of my anus, painful too.
I remember someone in here said that if you feel a lump like bump stick out of your anus, then most likely it is hemorrhoid.
The E.R doctor said what he saw as swollen external hemorrhoid. I scream ouch ouch when he touch the lump, so I'm pretty sure he touch the right lump.
He tried to expand my anus futher to see if there any tear, but I scream ouch ouch a lot so he stop look futher. He still said the bump I have is swollen hemorrhoids.
Wait, I thought thrombosed pile is thrombosed hemorrhoid. Can anyone tell me the difference?
For sure I do not have internal bleeding, since all my blood test come out normal. The whole blood test of chemical balance and metabolism all normal, including kidney function come out normal too.
Even if I go to an G.I they will just look inside for colon abnormal growth, and colon cancer stuff. But I am sure I it is not the colon, I don't feel any pain in the colon. I feel pain in the anus.
I check the doctor, he is board certified physican M.D. who work in the Emergency room. So he can't be that stupid, LOL!
But I still feel like I have anal fissures And a painful lump sticking out of my anus.

Hi,
Sorry hemorrhoids are the same things as piles - just different words for the same thing (and easier to type!)
No, fissures are tears in the lining of the anus. It will undoubtedly be a pile that is the thing sticking out of some form (whether a thrombosed exterior pile, prolapsed thrombosed internal pile (an internal pile that "drops" out of the anus and can also become thrombosed) or a Sentinel pile/ skin tag (which forms around the fissure to "protect" it)
The first two are likely to be more painful that the Sentinel pile - although they can be painful for some people and painless for the majority.
If it is the bump that is painful alone (and any bleeding is coming from this directly) then it could well be as the MD has diagnosed - an extremely painful thrombosed pile, which they will treat as you describe before taking any further action if required. If the pain feels internally raw and knife-like, it could be a fissure - also very painful but a different type of pain.
I really do feel that you need to see a CRS though for a proper diagnosis and that would determine exactly what you have going on.

External hemorrhoids with thrombosis are very painful and his diagnosis would explain your pain. It is also possible you may have a fissure but those are often hard to see. If there is a thrombosis in the external hem, then it can often take about 36 hours for the acute pain to wear off and about a month to completely resolve. If it is within 72 hours of development a CRS will lance the hemorrhoid and this will bring you instant relief. You will have just a little bit of soreness. I would not recommend anyone other than a CRS to do the lancing because often times other physicians do this the wrong way. It is always important to compress the hemorrhoid as it is a venous plexus and not just a single vessel. Whatever the case I would recommend that you see a CRS for this. If there is a money issue you can try the hydrocortisone cream which will reduce some of your symptoms. Sitz baths will also help.
Bottom Line:
You need to take more fiber, water, stool softener.

Hi I have a fussure for so long I needed to get 2 blood transfusions from so much blood lood over a year . Its sharp stabbing psin like glass burning swelling etc I use diltziam ointment which is working . I also have a skin tag which normally comes with fissures . 4 days ago I get the stomache flu with severe diarea . Now I have a large such painful lump outside . Prob prolased or thrombosed hem . I do sitz baths and tske advil and tylenol .
And tslk myself out of strsining .
See a specialist .to ease youf mind . Goodluck

Hey guys,
I've had an issue with af and hemmies for a while now and with the usual symptoms heavy blood loss painful bm and so on.
I tried all the usual remedies and omg what a circus.
They just keep on coming back. 
I decided to try 100% Pure Pine Oil or 100% pure gum spirits of turpentine.
What can I say it has helped from painful bloody stools to no pain no blood in a week.
I used 2x sugar cubes each with 5 ml Pine Oil. 3 times a week orally. Just drop the Pine Oil onto the cubes and chew them up and swallow. Wash it down with water and thats it.
No diet change and no regimes to follow. How simple and effective.
I feel like a new man.