Patient: I’ve felt that my anus has been quite itchy, at first I thought it was worms as I’ve had it before but hoping it wasn’t, I wanted to see if I could maybe just stop the itching by inserting a cotton tip into it, and I noticed very small amounts of blood and I was quite concerned. I’m not sure whether it could be a cut, but I have no idea how that could have happened as I have not inserted anything ever in my life. The blood is bright red and noticed at around 5cm deep. I don’t think it is any deeper. I’m obviously very embarrassed and do not want to go to the doctors immediately as it has only started to be itchy the other day. I’ll also note that I can feel the specific area of the itch, and it isn’t deep.
Doctor: Hi.Read your detailed history and understood that you inserted the cotton tip inside anus and got it blood stained.I would advise you the following in such a condition.- First of all be assured that there can not be anything very serious unless proved otherwise.- I can understand your hesitation, but this does not help in diagnosis and I hope you understand the importance of getting a proper diagnosis to have proper treatment and you have history of itching anus.- I would do a per-rectal examination, proctoscopy to see for the cause if any local which can be like a pile mass, polyp or fissure as due to itching the skin becomes friable due to pre-existing problems.- I would give you 5 -day course of an antibiotic and metronidazole with probiotic.- After that a colonoscopy to see for any high up diseases.All these exercises will help you to get a disease-free period and get a proper treatment as we are going to get a diagnosis.