Hello,

Thanks for your query.

By the history provided it seems that you might be having Anal fissures and associated anal or sebaceous gland infection.

An anal fissure is a crack or tear in the skin of the anal canal. Anal fissures may cause severe periodic pain after defecation but with chronic fissures pain intensity is often less.

Anal fissures usually extend from the anal opening and can involve the anal gland and results in infection. The anal glands are small glands found near the anus. Infection of the glands can produce a foul smell.

Treatment is by expression of the gland, lancing of an abscess, and oral antibiotics and antibiotic infusion into the gland in the case of infection.

You might consult your doctor for an examination and specific treatment of the underlying condition.

In the mean time, having sitz bath, and application of Preparation H ointment can help to relieve your symptoms.

I hope this helps.

In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.

Regards.

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Hello,

Thanks for the follow up.

In case, it is not painful on defecation, then it might be an enlarged sebaceous gland or a mucus gland of the anal mucosa.

The other alternative diagnosis would be a remnant of the external hemorrhoids.

To know the exact cause of skin related conditions, a physical look at the lesions is very helpful.

Since a physical examination is not possible online, it would help if you can provide images of the lesions in question.

You can upload images of the lesions in the right side of the query box, which after going through would help me in suggesting you better.

Please do confirm by writing here about the uploading of the photo as to suggest you at the earliest.

If you have problems in uploading images, please mail them to YYYY@YYYY with special attention to Dr. Deepak as the subject.

I would like to provide you with specific suggestions after going through the photo.

Awaiting your response.

Regards.

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Hello Again,

Thank you for the response.

The image provided, appears to be in thrombosed remnant of a external hemorrhoid (early stages).

Here is a diagramatic description of the same.

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External hemorrhoids are the ones that are present outside the anal verge. These hemorrhoids are at times painful and are often accompanied by irritations and swelling. At times itching is also a symptom commonly associated with external hemorrhoids. A condition that is commonly associated with external hemorrhoids is thrombosis. This condition occurs especially when blood clots develop in the vein resulting in swelling of the terminal portions of the veins.

You might consult a general surgeon or a gastroenterologist, who can examine you and treat your condition with a procedure called injection scleotherapy, where in medications are injected into the hemorrhoid, to induce fibrosis and resolution of the dilated veins.

I hope this helps.

Please feel free to ask any questions, if you have any additional doubts.

Regards.

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