What could be the reason for the burning sensation after passing stool even though I was completely cured from piles?

Hello,

Welcome to icliniq.com.

I understand your concern.

This is a typical anal type of pain. Well, I think this is a fissure, and given your last surgeon's evaluation that this is an external pile, it is possible that it was chronic anal fissure or sentinel pile. External hemorrhoids and chronic anal fissures look the same. However, the condition is treated with the same medicines. So I would suggest:

1. Sitz bath at least twice daily, which will help soothe the area, relaxes the muscles of the anal canal and will help with the pain.
2. Local application of Diltiazem gel (calcium channel blocker) or Glyceryl trinitrate (nitroglycerine) cream twice daily will relax the muscles of the anal canal.

To answer your concern:

1. Yes, masala and outside meals cause problems. In addition, any excess of spices can cause this type of pain since they precipitate spasms of the anal muscles.
2. No, they are not signs of cancer. Cancer causes severe constipation, per-rectal bleeding, and weight loss.
3. No, you should go for a colonoscopy since your last colonoscopy did not reveal anything significant.
4. You need to consult another surgeon to resolve your issues permanently.

I hope this will help.

Kindly revert for more queries.

Thank you.

Hi,

Welcome back to icliniq.com.

I would be able to tell you the treatment option only if I had the diagnosis in hand. Since the diagnosis is still in doubt, the best course of treatment would be to start with medicines and surgical fissurectomy if the anal fissure is non-resolving. Surgery is also an option for hemorrhoids and external piles, but usually, they get resolved by avoiding constipation and with tablet Daflon (Diosmin and Hesperidin) and sitz bath.

Thank you.

Hello,

Welcome back to icliniq.com.

I have seen the reports of MRI (magnetic resonance imaging) fistulogram and doctor's prescription (attachments removed to protect the patient's identity). I agree with the diagnosis of anal fissures with some internal hemorrhoids. I also agree with the treatment plan and suggest you follow these measures.

1. Do not strain while passing stools.

2. Drink a good amount of water daily.

3. Apply cream for local pain relief and healing.

I suggest you continue using a Sitz bath (water and baking soda) with warm water at least twice daily. The anal fissure is not dangerous, although painful, but it should resolve with two to four weeks of treatment. As far as you give pressure on stools, this will cause pain. But once your stools are soft and easy to pass without straining, the fissure will start to heal. Ideally, acute fissures take variable time depending upon patient factors and treatment. The treatment you have mentioned is justified and looks perfect.

Thank you.

Hello,

Welcome back to icliniq.com.

In that case, you can take the cream separately and use it. It is better to talk to a local pharmacist and he or she will help you fetch the same medication possibly with a different brand name or they can compose it in their dispensary.

Thank you.