Hi everyone,

Its been about 7.5 months since my fistulotomy...it healed in about 3 months. All has been going well, but today when I had a bowel movement every time I wiped there was bright red blood. I haven't had anything like this since before the surgery (although, to be honest, it as fairly frequent for years before the surgery when I had hemorrhoids). Now I'm freaking out thinking my fistula is recurring. The area where the wound was feels fine and there is no bump or any other sign on the outside of a recurrence. The skin around my rectum and on the scar feels just like it always has since it healed. There's no pus (as far as I can tell) but the amount of blood scares me. Keep in mind, it wasn't dripping and there was none on the feces itself. I used a bidet and then wiped again and there was nothing. I have since put in a Prep-H suppository and it has soothed the mild ache a bit. What do you guys think? Fistula recurrence or just my first hemorrhoid flare up since surgery? My BMs the past few days have been consistently solid, I'm not sure if that is to blame...I have been eating plenty of fiber (maybe too much fiber?) and taking metamucil.

In my opinion it sounds like an internal hemmie, especially if your BMs are solid. You aren't having any pain down there right?

I don't know a lot about fistulas but I don't think I have heard of bleeding being the first sign of one....

Thanks msimon...I'm praying its just a hemmie too. There is some mild aching...but the aching is on the opposite side from the where the fistulotomy was strangely enough. I keep panicking that another anal gland is clogging on the opposite side, but I know the odds of that are extremely low. I'm not sure why my BMs are solid consistently the past few days...I've been eating plenty of fiber. I did just return from working in a remote part of Indonesia for a month and I did get one mild case of traveler's diarrhea (which I kicked in the butt with antibiotics after only 2 loose BMs). I also had to go sometimes 8 hours holding in a poop because I was working in the field (doing crocodile surveys). Needless to say, in my line of work rectal problems are not welcome haha

Did you just come off of antibiotics? Sometimes they can actually cause constipation afterwards because you actually need good bacteria to facilitate BMs. Do you take a probiotic supplement?

Yeah I bet having butt problems is very tough in your line of work. Crocodiles, yikes!

Hi cporosus,
I don't think it's another fistula, you'd see an external opening of it. With some pus too.
I had a fistula recurrence, though it never healed after surgery (it formed before the whole wound closed), so it just kept bleeding, sometimes a lot + pus and it had an outside opening. Yours doesn't sound like that.
I hope for you it's just a hemmie (as awkward as it sounds), and something you can deal with easily.
cheers

Thanks Garrod,

Yeah there is no external opening at all and there's no pain on the skin where the fistulotomy was done. There is mild aching pain after bowel movements but its on the right side for some weird reason. I just had another BM this morning and there was only a VERY tiny (like pin tip size) spot of blood on one wipe. I put a Prep-H suppository in yesterday and another one this morning and I've been raising the amount of soft-stool food (apparently fiber alone does not make stools soft, the KIND of fiber is what matters). Also, apparently holding poops for a long time can cause hemorrhoids. While I was in Indonesia I couldn't "go" in some of their toilets (we were in remote areas and some of these things were just horrific) so I ended up holding it for hours until I reached my hotel....I feel this may have contributed. I have been taking a probiotic since I returned and I also take metamucil. I am seeing my CRS this afternoon anyway, just to put my mind at ease. I will update later.

Nothing softens BMs like a stool softener. I will probably take one for life :)

Hope your appointment goes well.

UPDATE- back from appointment with my CRS. He says he thinks its hemmies. He can't be 100% certain but he doesn't see any sign of infection or inflammation and he can see a "mild-moderate" hemmie from the outside, but he cant say how much worse it could be on the inside. He said if pain worsens then he will have to do an actual rectal exam but he doesn't think its anything more.

Who would've thought a hemmie would be good news ;) Glad to hear he doesn't think anything more sinister is going on. Hope the bleeding stops soon.