Anal Issues: Fissures, Fistulas, Hemorrhoids, and More - Surgery

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Understanding anal issues such as fissures, fistulas, hemorrhoids, and other related conditions can be quite complex, especially when symptoms like bleeding and discomfort are involved. Based on your description, it sounds like you may be experiencing a combination of conditions, which could include external hemorrhoids, anal fissures, or possibly a skin condition like eczema or dermatitis.


External Hemorrhoids
External hemorrhoids are swollen veins located under the skin around the anus. They can cause discomfort, itching, and bleeding, especially during bowel movements. The fact that you have a "small flesh bump" that has been present since college and that you experience bleeding when straining suggests that this could be an external hemorrhoid. The bleeding you describe, particularly if it is bright red and occurs during or after bowel movements, is typical of hemorrhoids.


Anal Fissures
An anal fissure is a small tear in the lining of the anus, often caused by passing hard stools or straining during bowel movements. The presence of a "broken skin" area that itches and hurts, especially after you mentioned a recent incident of tearing while trying to hurry during a bowel movement, could indicate an anal fissure. Fissures can be quite painful and may lead to bleeding, which might explain the blood you see.


Fistulas
An anal fistula is an abnormal connection between the anal canal and the skin near the anus. While you did not mention any signs of infection or pus, which are common with fistulas, it is important to consider this possibility if you notice persistent drainage or unusual symptoms.


Other Skin Conditions
The "broken skin" and itching you described could also be due to other dermatological conditions such as eczema, psoriasis, or contact dermatitis. These conditions can cause irritation and may lead to secondary infections if the skin barrier is compromised.


Recommendations
1. Consult a Healthcare Provider: It is crucial to see a healthcare professional, preferably a gastroenterologist or a proctologist, for a thorough examination. They can provide a definitive diagnosis and recommend appropriate treatment options.

2. Avoid Straining: To prevent further irritation or injury, try to avoid straining during bowel movements. This can be achieved by maintaining a high-fiber diet, staying hydrated, and possibly using stool softeners if necessary.

3. Proper Hygiene: Maintain good anal hygiene. After bowel movements, gently clean the area with water and avoid harsh soaps or wipes that could irritate the skin further.

4. Topical Treatments: Over-the-counter creams or ointments designed for hemorrhoids or fissures may provide relief. However, consult with a healthcare provider before starting any new treatment.

5. Monitor Symptoms: Keep track of your symptoms, including any changes in the size of the bump, the frequency of bleeding, and any new symptoms that arise. This information will be helpful for your healthcare provider.

6. Avoid Irritants: If you suspect a skin condition, try to identify and avoid any potential irritants, such as certain soaps, laundry detergents, or foods that may exacerbate your symptoms.

In conclusion, while your symptoms may suggest external hemorrhoids and possibly an anal fissure, a proper evaluation by a healthcare professional is essential for an accurate diagnosis and effective treatment plan. Taking proactive steps in your diet, hygiene, and lifestyle can significantly improve your symptoms and overall anal health.