Hello doctor,
First of all, I would like to describe my symptoms. For the past five months, I am suffering from constant pain in my rectal area. Earlier, it felt like a sharp knife-like pain tearing apart the perianal region. Still, as of now, it is turned into an intense burning discomfort severe during the bowel movement. And mild in the daytime. I use Anovate cream, and when I apply it, I feel a painful wound like a bump in the outer anus region and 3/4 cuts in the outer rectum, which I could think through gloved fingers and very painful to touch. Also, there is an occasional discharge of mucus (no blood).
History: I had a colonoscopy three months back, and it was done because, for almost two years, I have been bleeding from the rectum. (I have attached the report along with the biopsy). After the colonoscopy, I have prescribed Mesacol (Mesalamine) suppositories for one month, which I took as advised. I did not have any symptoms before five months.
Treatment:
I have been making rounds to my gastro doctor several times. In the first visit, I have prescribed Oxerute tablets, Cremafix, and painkillers. I took that, but no relief. Started Mesacol suppositories, which made all symptoms worst. This all went till four months back end.
Then, three months back, the pelvis and abdomen's MRI was advised as I started experiencing nausea and stomach fullness (reports are attached). After the MRI doctor earlier told me he would do sigmoidoscopy, but he did not do that.
After the MRI, I was given fiber powder and sent home for the next appointment two months later. I started using Anovate cream, which gave relief for some days.
Right now, I am very confused as to what to do. My main questions are,
1) What did my MRI report show, and does it correlate with the colonoscopy findings? I was not explained about it and just told it is all normal. But if everything is normal, then why I am my experiencing all these symptoms.
2) I have a family history of cancer as my grandfather died from esophagus cancer, so I am always worried that I may have cancer in my colorectal area. I read that MRI can detect cancer, but some protocol has to be mentioned in the prescription. In my case, the prescription did not say anything except for perianal pain. Would the radiologist miss out on ulcers or cancer if it is not mentioned why the MRI has been taken?
3) Is it necessary for me to undergo sigmoidoscopy? My city is reporting a hundred COVID-19 cases every day. And most hospitals are not willing to do that unless the COVID-19 test is done. My doctor told me that he would have done if MRI showed something but now no need and to stay at home and avoid exposure.
Shall I go to a bigger city and get it done? I do not want to live in this fear of having something sinister growing in my rectum.