I have a painful anal lump and anal fissure. What causes it?

Question

Hello doctor,

I am a 19-year-old male who is 5.11 feet tall and weighs about 190 lbs. I have severe pain in the anal canal that inhibits walking, usually sitting, sleeping, and excruciating bowel movements. I previously visited a gastroenterologist who said there was no internal lump but diagnosed me with an anal fissure due to my examination reaction.

He prescribed me to promote healing of the fissure with Analpram (Pramoxine) as a local anesthetic. However, I have not been able to get that from the pharmacy yet. In the time following the visit, a large external lump has grown behind the anus opening.

I have been using an over-the-counter ointment to reduce pain as well as Tylenol.

Kindly suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand how painful it would be for you.

This is an external hemorrhoid (external blood vessels), which seems to have thrombosed (clotted blood). They used to be very painful. I also want to recommend that you receive, which is a good medication. I do not have experience with Analpram (Pramoxine), but you should try it since it contains steroids that would work locally to reduce the inflammation.

Additionally, use the following tablet: Daflon, a generic medication (formula name Diosmin and Hesperidin) 500 mg twice daily. Take a sitz bath. Fill a bathtub with semi-warm water up to half, add 5 ml of antiseptic liquid (like Dettol), which is good for skin, mix it, and then sit in it for ten minutes. Repeat this at least three to four times a day.

Xylocaine (Lignocaine) 2% gel for local application. Use it with a nozzle. For now, every three to four hours, once pain settles, you can use it less frequently, like six hourly. Reactive for local applications should be used six-hourly for now. Use Isabgol husk two tablespoons full once daily with water to help soften the stools.

Irrespective of whether you have constipation or not. I believe your pain will settle within 24 hours of use of these above things. Let me know how you feel.

I hope this helps.

Thank you.