I'm a 21 years old female. I have extra skin around my anus for an year now it used to go back last year when I pushed it in. I bled while passing out stools so consulted my doctor for. He told it was an anal fissure and have me a cream without any external examination. Problem subsided after a week. But from 2 months I'm having extreme pain while passing out stools, stool has blood lining sometimes. The skin around anus is itchy and uncomfortable while sitting. It has changed texture now .It doesn't go back in. There is little pain if I touch it. I visited my doctor again and he gave me fiber husk supplement and asked me to increase fiber intake. Im on a bland not at all spicy diet, eating lot of fiber and fruits and drinking so much water from past 2 weeks but I see no difference. The stool has softened but pains a lot when passing out. The external skin is not reducing even after soaking it in warm water everyday and applying apple cider vinegar. Please help me.

Dr. Shriniwas DeshpandeGeneral Surgeon25yrs exp

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Three to four common possibilities can be considered when person feels the tag near the anal verge. The most common possibility is the anal tags which can easily be ignored and never cause any problem. Second common possibility is a sentinel pile accompanied by the fissure in ano. It is a guarding pile which develops just at the lower end of the fissure. When the fissure is acute it causes severe pain. I consider this to be strong possibility in your case. Local examination will clinch the diagnosis. When local anesthetic like Lignocaine jelly does not help and pain is unbearable it is better to undergo Lord's procedure which is a surgical procedure under general anesthesia and doesn't involve any knife or stitching work. Purpose of the procedure is to give dramatic pain relief to the patient by releasing the internal sphincter muscle spasm. Other possibilities like prolapsed piles and skin lesion like condyloma can be considered. Local examination will help in getting the accurate diagnosis. Pinpoint diagnosis will help you get the relief. 

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