Massive anal pain, cannot sit and bleeding.

Patient

Q: Hey,

Have been having some anal difficulties for a few months now, wherein whenever I need to defecate I've had some sharp pain and often some level of blood. However, almost suddenly within the last few days, it became a billion times worse, with pooing barely impossible at the moment and beyond painful and producing a large quantity of blood. It's also so sore and bruised now after straining that it is incredibly painful to even sit down, making day-to-day life pretty impossible right now. Closest thing I can find that it may be online is anal fissures? Any help would be appreciate, I can't really do anything at the moment! Thanks!

Symptoms:  Bleeding, intense pain, unable to sit down
Images: 
Massive anal pain, cannot s...-1
Doctor

A:   Hi.
Thanks thanks for your query and clear picture.

You have the complaints of bleeding, intense pain and unable to sit down. Read the remaining history related to redness, pain, difficulty to pass a stool.

My thoughts:
Your history and the photograph are classical of the following:
You have anal fissures with infection of the skin around the anus.

The treatment:
High fiber diet.
Avoid all the foods and beverages and stress-like conditions which gives constipation.
Laxative for softening the stool- never allow the dose too much to cause liquid stools.
Sitz bath- very important- just before passing a stool and after passing a stool.
Clean the area very clear of the fecal soiling that remains after cleaning; use cotton soaked in the same water to clean.
You can apply liquid povidone iodine locally. Apply nothing else.
5-day course of an antibiotic and Metronidazole on prescription of a local Doctor.
Add probiotics and multivitamins.
Avoid stress and mental tensions at any cost; this is a very important factor.

Continue this for 3 weeks and most probably you may not need surgery.
If the results are positive you have to continue doing all this and take proper care.

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