Here's my story:

I'm 26, male, in normal health. Three weeks ago, I had a hard BM (Bristol type 1), and at the end had some pain and found mucus and blood when I wiped. I immediately upped my fiber, started taking stool softeners, drinking water, etc, thinking it was hemorrhoids based on my research. (I do seem to have a couple small external hemorrhoids, but they don't seem to be bleeding or causing any pain).

For the first week, it was mild pain and some blood when wiping. After the first week, the pain started to increase as did the blood. By the middle of last week, it was pain that took my breath away during the BM followed by a terrible ache that left me writhing around on my bed for hours. This even after maximum doses of ibuprofen and acetaminophen. There was also tons of blood, completely coating the stool. Since last week, the pain has decreased somewhat, I think. Still bad, but I can ignore it as long as I'm not sitting, I have an activity, and I have some tylenol. Unfortunately the blood has increased. It colors the toilet water completely red and is totally mixed in with the stool.

This past week and a half I've been very strict with a high-fiber diet and tons of water and stool softeners (Colace), but they're not having any big effect. My stool still seems to come out Bristol Type 2 or 3 mixed with a few Type 1 nuggets.

I can't go to the doctor right now, firstly because I'm in NYC and COVID has everything shut down, and secondly because I'm currently uninsured and won't have coverage until June. So I'm just guessing as to what's going on. A family member is a doctor, and she at first said it was probably hemorrhoids, and now thinks it's proctitis. She's gonna give me hydrocortisone suppositories. I'm just worried that it's a fissure, not proctitis, and that the HC suppositories will make the issue worse.

Here's my main question on whether or not it's a fissure: there's a ton of bleeding. Other people here have mentioned having some blood when wiping, but no one has mentioned the amount I seem to have. Today, I noticed that the first round of stool came out with blood only at the tip. Unfortunately, I was not empty, and after some painful involuntary contractions pushed the rest out, there was blood in the water, coating the stool, and just everywhere. Is that normal? Is it possible I don't have a fissure, and it is proctitis? Maybe I have painless internal hemorrhoid that's bleeding a ton, plus a painful fissure? I really really wish I could go to the doctor to find out, but since this doesn't seem to be life-threatening and I don't have insurance, that doesn't seem possible.

I'm just asking for all your wisdom and experience, to either confirm that it seems like a fissure, or that you really don't know, or that it may be something else. Words of advice or comfort are also nice, because I'm worried that whatever is going on is gonna last for months or years and potentially cost me thousands of dollars and heaps of pain. Thanks for taking the time to read!

Hi there, what you're describing does not sound like a fissure issue, from what I've read on the forum over the years. Hemorrhoids are a likely cause or it could be a problem higher up in the rectum. I understand that you don't have insurance right now, but it could be something serious that needs medical attention soon. June is a ways away and I would encourage you not to delay a specialist visit. Most clinics are taking precautions to prevent the spread of covid. I hope you get a diagnosis soon. Also I would encourage you to go easy on the insoluble fiber, which can make BMs harder if things are moving slowly already. Try a more effective softener like miralax and have a few prunes every morning.

idk, it seems like a fissure to me. ¯\_(ツ)_/¯ . when mine was more active I had a lot of blood with every trip to the crapper. so much that it was frightening, even had drops of blood in the toilet at times. I think with both hemorrhoids and fissure you're likely to have a scary amount of blood. luckily you can gen. treat them similarly, try to lower the inflammation the best you can.