Sigmoidoscopy - why?

[breathe]

To KaraBulut and others,

I went to a GI specialist today re: what seems to be an incorrectly healed tear at the front of my anus... I had really bad digestion (diarrhea almost every day) for at least a year or two, but now that it's gone, I'd like to get rid of this little patch of irritated, thickened skin that seems to always be leaving blood on the toilet paper and is very uncomfortable. I can even feel it when I walk sometimes. My family doctor said it looked to her like an incorrectly healed tiny little fissure or something but said she saw nothing anormal.

Skip forward to today- I told the GI specialist about the problem. He was polite and friendly. He asked if I was sexually active and if I had been the recipient of anal sex. I told him that I was but that the big problems seemed to start during all the diarrhea.

He quickly decided without examining me that I need a sigmoidoscopy and I booked one.

Is there a connection? Why a sigmoidoscopy, given that the irritation I feel is external, around/at the front of the anus?

Thanks! I feel sort of awkward and worried now, like did I cause myself damage and will need surgery or won't be able to have anal sex again, etc.

 

[breathe]

Also, not sure if it's relevant because doctors have never seemed concerned by it, but I have had a low white blood cell count each time I've had a blood test in the last couple of years.

 

[KaraBulut]

Usually at your age, they are usually looking for HPV or polyps. It also allows him to more closely inspect the tear to see how extensive it is. Considering how long this has been going on, a closer inspection with a scope would be warranted.

 

[breathe]

I'm just curious because it's right at the front of my anus, not up in my sigmoid colon. ???

As for HPV, I did have anal warts at one point, but I was treated and they disappeared. This was long before this troublesome little tear happened.

 

[KaraBulut]

I'm just curious because it's right at the front of my anus, not up in my sigmoid colon. ???

A sigmoidoscopy is just a colonscopy that is limited to the anus, rectum and sigmoid section of the colon.

A tear isn't just limited to the external anus and perineum. It can extend internally into the internal structures, too.

 

[breathe]

A tear isn't just limited to the external anus and perineum. It can extend internally into the internal structures, too.

Ahhh. That would explain it.

If the damage goes internally (which I expect it will be, given how long I've had this), is it possible to fix without surgery? Or given that I've had it for a year now, will I need surgery?

 

[KaraBulut]

If the damage goes internally (which I expect it will be, given how long I've had this), is it possible to fix without surgery? Or given that I've had it for a year now, will I need surgery?

It's going to depend on what he finds. If it's a superficial and small fissure, he might be able to repair it with a stitch. If it's deeper or it extends into the anal sphincter, then it could require a surgical repair.

 

[breathe]

I'm going to be scared to have receptive anal sex ever again, or at least nothing remotely rough.



It makes me wish I had a gay family doctor who I could ask these questions to... like after a surgery in the anal area, how long before I can have anal sex again, etc. Your help is greatly appreciated, KaraBulut, for all those questions that are difficult for us to ask out in the real world.

 

[rareboy]

^ You should not be afraid to ask these questions of your doc. If you do, you should think about searching out a new GP.

 

[KaraBulut]

It makes me wish I had a gay family doctor who I could ask these questions to... like after a surgery in the anal area, how long before I can have anal sex again, etc. Your help is greatly appreciated, KaraBulut, for all those questions that are difficult for us to ask out in the real world.

^ You should not be afraid to ask these questions of your doc. If you do, you should think about searching out a new GP.

In the cities, there are gay or gay-friendly doctors. I've even run into a few gay GI docs out there, too.

In the suburbs or rural areas, it's a lot tougher.

Not all fissures are related to anal sex. Far more are related to bowel habits- particularly lack of dietary fiber and constipation. Anal sex can aggravate the condition.

Your surgeon would have to tell you how soon you can resume anal sex after any procedure. There's too many variables to consider to give a single answer. It's going to depend on what he finds in the colonoscopy and what procedure (if any) is done to resolve the problem.

 

[palbert]

Breathe, you should not be afraid to ask these questions of any doctor; continue to examine this episode and see if you need to change doctors.

Speaking as a layman who has had a lot of GI problems, I am stunned that no mention was made or discussion had of one-year of diarrhea. Is there any explanation of the occurrence or cessation. You might consider a good conversation with a dietician or nutritionist. (My employer provides those thru store visitation weekly.) Maybe you could catch an out-reach program at your local hospital.

 

[breathe]

Hi palbert,

Thanks for your words and your concern.

The year or two of diarrhea was due to dietary problems (and a lot of anxiety/ fight or flight response) and since the fall I have almost completely tamed down my digestion.

This fissure is the last remaining vestige of my bowel-problem days. The diarrhea is long gone