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What Does My Lab Test Report Indicate?
Question: The area mentioned in the report and the point of may pain match exactly.
I cannot understand that my fistula was at 2'o clock position according to the descharge summary , then how can scar tissue cause pain at 4'o clock to 7'o clock position.
Please explain
Also i think that my scar is not a big one like keloid , its just the scar tissue which is paining and i suppose scar treatment injection will be enough to treat the problem. Please suggest if the injection on this area will be safe and not cause any harm .
Or should i wait for some more time for the scar tissue to soften.
I cannot understand that my fistula was at 2'o clock position according to the descharge summary , then how can scar tissue cause pain at 4'o clock to 7'o clock position.
Please explain
Also i think that my scar is not a big one like keloid , its just the scar tissue which is paining and i suppose scar treatment injection will be enough to treat the problem. Please suggest if the injection on this area will be safe and not cause any harm .
Or should i wait for some more time for the scar tissue to soften.
Brief Answer:
As discussed in details below.
Detailed Answer:
Hi.
The possible cause of scar at 4-7 O'clock in spite the fistula at 2 O'clock may be as follows:
Fistula can be and usually is tortuous and hence can apparently be at say 2 O clock but while doing excision it would have been far wide inside and thus the scar is at a different position.
Since the scar is not like a big keloid but as a line as you had explained in the past, the most probably cause of the pain you are getting is sensory nerve entrapment.
The scar per se can not cause the pain as it is just a fibrous tissue. The nerve can be very small enough and hence may not be identifiable on MRI or even on re-exploration.
Hence Local steroid injection may soften that part of the scar that is causing pain and it is worth trying as it is now more than 9 months - of scar maturation. Please get this done.
Also effective can be Pre-gablin or gabapentin or Tryptomer or Tegritol. All these medicines need a prescription of your Doctor, please manage to get either of these and may help further in alleviation of pain.
Once we discussed about oral steroids like Deflazacort and you have a Doctor in your relation if I remember correctly.
I hope this answers your query and helps you further.
As discussed in details below.
Detailed Answer:
Hi.
The possible cause of scar at 4-7 O'clock in spite the fistula at 2 O'clock may be as follows:
Fistula can be and usually is tortuous and hence can apparently be at say 2 O clock but while doing excision it would have been far wide inside and thus the scar is at a different position.
Since the scar is not like a big keloid but as a line as you had explained in the past, the most probably cause of the pain you are getting is sensory nerve entrapment.
The scar per se can not cause the pain as it is just a fibrous tissue. The nerve can be very small enough and hence may not be identifiable on MRI or even on re-exploration.
Hence Local steroid injection may soften that part of the scar that is causing pain and it is worth trying as it is now more than 9 months - of scar maturation. Please get this done.
Also effective can be Pre-gablin or gabapentin or Tryptomer or Tegritol. All these medicines need a prescription of your Doctor, please manage to get either of these and may help further in alleviation of pain.
Once we discussed about oral steroids like Deflazacort and you have a Doctor in your relation if I remember correctly.
I hope this answers your query and helps you further.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I am taking Disperzyme twice a day for the last 15 days. And i feel that very slowly but there is some improvement. If i want to wait for some time for how long can i take disperzyme safely.
Can i also take other medicines prescribed by you with disperzyme.
Lastly if i decide to get the injection done , can i come to XXXXXXX to get it done from you as doctors here do not understand my concern.
Regards
Can i also take other medicines prescribed by you with disperzyme.
Lastly if i decide to get the injection done , can i come to XXXXXXX to get it done from you as doctors here do not understand my concern.
Regards
Brief Answer:
Deflazacort and local Xylocaine jelly.
Detailed Answer:
Trypsin 96 MG+Bromelain 180 and Rutoside is the combination of Disperzyme. 15 days is more than a sufficient time to see the results. I think you should stop this now.
Local injection is the last resort and when decided then we shall decide.
I would advise you to take Deflazacort as it will still work the same way as local steroid.
Please post fresh clear and focused picture of hte scar if possible. This may help me more.
Continue Lycopene and antioxidants.
Try local application of Xylocaine or Lidocaine jelly after getting pain and please let me know if this helps in reducing pain.
And one of the medications for pain as discussed above.
Deflazacort and local Xylocaine jelly.
Detailed Answer:
Trypsin 96 MG+Bromelain 180 and Rutoside is the combination of Disperzyme. 15 days is more than a sufficient time to see the results. I think you should stop this now.
Local injection is the last resort and when decided then we shall decide.
I would advise you to take Deflazacort as it will still work the same way as local steroid.
Please post fresh clear and focused picture of hte scar if possible. This may help me more.
Continue Lycopene and antioxidants.
Try local application of Xylocaine or Lidocaine jelly after getting pain and please let me know if this helps in reducing pain.
And one of the medications for pain as discussed above.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Doctor,
Pfa a recent picture in which i have pointed the pain point. I would like to mention by looking everything seems to be normal to me i.e i am not able to see the scar. I think my scar is hypertrophic.
And i have read that hypertrophic scar sometimes takes a long time to completely soften/heal. Do u also agree with this or do you think that it may be the time to intervene. I would like to mention that ithere is some improvement but the rate of improvement is really slow say 10% per month.
Please suggest.
Also would like to know if you have seen other patients having problem with scar tissue after fistula surgery and have u ever used scar treatment injection for the same after fistula surgery
Pfa a recent picture in which i have pointed the pain point. I would like to mention by looking everything seems to be normal to me i.e i am not able to see the scar. I think my scar is hypertrophic.
And i have read that hypertrophic scar sometimes takes a long time to completely soften/heal. Do u also agree with this or do you think that it may be the time to intervene. I would like to mention that ithere is some improvement but the rate of improvement is really slow say 10% per month.
Please suggest.
Also would like to know if you have seen other patients having problem with scar tissue after fistula surgery and have u ever used scar treatment injection for the same after fistula surgery
Brief Answer:
Pointing of finger and scar do not match.
Detailed Answer:
The picture you had posted in past and now also is pointing the finger to the area other than the scar.
Hence I think your pain is probably not much related to the scar.
The scar looks healthy and not hypertrophied or so. Hypertrophied scars itch but cause no pain.
There is small elevated part at 12 O'clock position suggestive of a sentinel pile and that is indicative of a fissure in ano in past or recurring from time to time and may be the cause of pain as it is usually caused by spasm of the anal sphincters and otherway too - the spasm causing the fissure.
I think continue Sitz bath, mild laxatives.
The amount of stress and/or anxiety adds on to the problems and should be controlled well at any cost to give you better results.
Get started with the medications I mentioned above.
Scar problems causing such a pain is very very rare and thus seen very rarely in day-to-day practice. I have seen and treated patients for scars but the body takes care of such things on its own assisted by medications if required.
So stop worrying.
You may come to me for per-rectal examination and ano-proctoscopy to get the exact diagnosis.
Pointing of finger and scar do not match.
Detailed Answer:
The picture you had posted in past and now also is pointing the finger to the area other than the scar.
Hence I think your pain is probably not much related to the scar.
The scar looks healthy and not hypertrophied or so. Hypertrophied scars itch but cause no pain.
There is small elevated part at 12 O'clock position suggestive of a sentinel pile and that is indicative of a fissure in ano in past or recurring from time to time and may be the cause of pain as it is usually caused by spasm of the anal sphincters and otherway too - the spasm causing the fissure.
I think continue Sitz bath, mild laxatives.
The amount of stress and/or anxiety adds on to the problems and should be controlled well at any cost to give you better results.
Get started with the medications I mentioned above.
Scar problems causing such a pain is very very rare and thus seen very rarely in day-to-day practice. I have seen and treated patients for scars but the body takes care of such things on its own assisted by medications if required.
So stop worrying.
You may come to me for per-rectal examination and ano-proctoscopy to get the exact diagnosis.
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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