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Swollen spot near anus
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posted
At the risk of TMI I have a question. I have had jpouch for 9 years. I have hemmorrhoids
And recently noticed a swollen spot near anus.the spot is mildly tender. I saw my doctor today and will be following up with GI. The doctor I saw today is a general practitioner. He felt the lump and as soon as he recommended me see a GI I felt an overwhelming sense of anxiety. Not helped by hours of online research. Given my jpouch and ongoing symptoms (gassy, frequent BM's, etc) I was convinced this is just more hemmorrhoids issues. Since I have jpouch I have not worried about cancer, until today. Has anyone else experienced the same?
 
Posts: 30 | Location: Virginia | Registered: January 06, 2005Report This Post
Picture of rachelraven
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I've never had hemorrhoids. In December or 2012, I found a tender small lump near my anus. Doctors threw around abscess and hemorrohoid... ended up being an abscess that burst on its own and developed into a fistula.

I currently am back with my old CRS doctor. He's placed a seton. I had UC, and he's not ready to change my dx to Crohn's, because I have no other symptoms of Crohn's, and biopsies of my pouch didn't it, either. My pouch is pretty ok, apart from a quick bout with pouchitis earlier this year, that wasn't awful, but a one month run of Cipro put it in check.

I would talk to the GI about a potential MRI to check for an abscess or fistula, especially if it gets worse. Mine would cycle... the bump would drain, the skin would begin to heal over... then it would fill and hurt and sting til it would burst and start over again. It was never a ton of stuff... scant to small amounts of old blood, mostly.

I have an intrasphincteric fistula that now has a seton in it. It eliminated that fistula cycle. I don't currently have a long term plan, but for the seton. He wants everything to finally chill out there, I guess. We shall see as time marches on, I guess.

Just something to keep in mind. The GIs I saw at first just called my bump a "cyst," but that's such a generic term for some bump somewhere. Hope you get a correct diagnosis.

This message has been edited. Last edited by: rachelraven,


UC diagnosed at age 11, 1982
Total colectomy, J pouch and loop ileostomy, January 10, 1991
Takedown May 15, 1991
Many healthy years!
Pouchitis December 2012
Perianal abscess then fistula 2012-2013
Draining seton March 27, 2013
Outlet anastamosis narrowing dilated under anesthesia April 16, 2013
Seton broke and out April 22, 2013
New seton and outlet dilation April 29, 2013
Outlet dilation May 21, 2013
Daughter dx with Crohn's colitis February 14, 2014 (age 11, like her mama)

I ask not for a lighter burden, but for broader shoulders.
- Jewish Proverb
 
Posts: 454 | Location: USA | Registered: December 08, 2007Report This Post
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Thanks for the info. Was your fistula tender? My swollen spot is a bit tender but not not painful. I noticed it on Sunday after a BM. On Saturday I threw my back out so had to sit/strain differently to empty pouch. Not certain if straining could cause swollen spot. I had an MRI last June and a Camera endoscopy (I swallowed a camera/pill) after concerns with pouch. Last March I had a perforation in pouch which required emergency surgery.
At this point I am trying to rule out anal cancer. After all of these health issues I tend to overreact a bit to medical concerns.
 
Posts: 30 | Location: Virginia | Registered: January 06, 2005Report This Post
Picture of rachelraven
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Yes it was tender. At first, I just thought I was irritated, til I felt the bump. It also followed a lot of straining (probably had simmering pouchitis and didn't know it). Also, I ended up needing outlet dilations, so that surely contributed to straining. Went from tender to worse, to bursting (sat on sitz bath with Epsom salts to soothe it). Then started the cyclicAl fistula heal over, fill, burst cycle.

I'm cool with my seton at this time. I don't even know it's there. My mind went to cancer at first, too, but from what my CRS said, that's more rare.


UC diagnosed at age 11, 1982
Total colectomy, J pouch and loop ileostomy, January 10, 1991
Takedown May 15, 1991
Many healthy years!
Pouchitis December 2012
Perianal abscess then fistula 2012-2013
Draining seton March 27, 2013
Outlet anastamosis narrowing dilated under anesthesia April 16, 2013
Seton broke and out April 22, 2013
New seton and outlet dilation April 29, 2013
Outlet dilation May 21, 2013
Daughter dx with Crohn's colitis February 14, 2014 (age 11, like her mama)

I ask not for a lighter burden, but for broader shoulders.
- Jewish Proverb
 
Posts: 454 | Location: USA | Registered: December 08, 2007Report This Post
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I had this on 2 occassions. They were both abcesses. I had surgery to remove, and setons placed.


complete colectomy March '08
Peritonitis April '08
Step 2 March '09
take down August '09
pouch failure, reversal Dec '09
2nd take down March '10
multiple adhesions surgery July '11
removal of Jpouch and permanent ileostomy Aug '12
Oct '13 bowel resection due to narrowing/obstruction caused by adhesions.
 
Posts: 186 | Location: Florida | Registered: February 06, 2012Report This Post
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Thanks for the info. I just got back from my GI, he said he didn't feel a mass and said it was a hemmroid. I am scheduled for flex sig next week. My only concern, and this is because I am naturally anxiety ridden, is that he wants a flex sig done in the next week. I tried for July but he said that is too late. I aksed him if there was something about the exam that he feels requires a quick scope and he said no. I asked him specifically if I should feel relaxed and happy and he said yes. I know I should be feeling relieved and happy but I cannot get this nagging feeling out of my head.
 
Posts: 30 | Location: Virginia | Registered: January 06, 2005Report This Post
Picture of rachelraven
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The first CRS I saw before I went back to my original one kept wanting to call it a hemorrhoid, but I'm a nurse, and I've seen many hemorrhoids, and that wasn't a hemorrhoid. I'd be more inclined to think abscess/fistula like i had vs. cancer, though, and it COULD be a hemorrhoid, with straining. My abscess never got huge, the bump got to the size of about a thumbnail before hot sitz baths let it burst. Just for your own piece of mind, the scope may be helpful to get now, though the scope I had at first did nothing to help my diagnosis. Only the MRI and my original surgeon's expertise in fistulas was what got me on the right track.


UC diagnosed at age 11, 1982
Total colectomy, J pouch and loop ileostomy, January 10, 1991
Takedown May 15, 1991
Many healthy years!
Pouchitis December 2012
Perianal abscess then fistula 2012-2013
Draining seton March 27, 2013
Outlet anastamosis narrowing dilated under anesthesia April 16, 2013
Seton broke and out April 22, 2013
New seton and outlet dilation April 29, 2013
Outlet dilation May 21, 2013
Daughter dx with Crohn's colitis February 14, 2014 (age 11, like her mama)

I ask not for a lighter burden, but for broader shoulders.
- Jewish Proverb
 
Posts: 454 | Location: USA | Registered: December 08, 2007Report This Post
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My GI did perform a digital rectal exam and from what could feel it was pretty thorough. After the DRE he said he did not feel a mass. I then pointed to exactly where the lump was and he felt it again, from the outside. The nurse said that if they suspected anything serious (like cancer) they would have sent me immediately to the colorectal surgeons office that is located on the same campus. I was probably being a pain to the Dr. And Nurse but I kept asking for reassurances. I even walked past thee Dr. In the hallway and asked for further clarification.
My anxiety stems from the entire UC/Jpouch surgery. In March of 2012 I had emergency surgery to repair a perforation in my pouch. I thought I had kidney stones until it became an obvious emergency. Now, every tingle, lump, bump, tummy ache turns into anxiety.
Thanks so much for the info!
 
Posts: 30 | Location: Virginia | Registered: January 06, 2005Report This Post
Picture of Scott F
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Maybe the time pressure is for your benefit. The GI might want to be able to fully reassure you (given your anxiety), although it's briefly having the opposite effect. OTOH, it doesn't sound like he's paying much attention to the bump that concerned you. In any case, the vast majority of bumps are not cancer at all. A headache can be a brain tumor, but usually it's just a headache.


--Scott

Crohn's Dx 1980
Single-stage J-pouch 2002 - Dx changed to Indeterminate IBD
 
Posts: 914 | Location: Towson, MD | Registered: December 10, 2012Report This Post
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Great point, thank you. The GI took his time with the digital rectal exam and followed up with additional touches after I pointed out the spot in question. He said he felt the blood vessel but not a mass. I do have visible external hemhorroids as well. He asked me when I had my last flex sig and I said that it had been several years. Last March I had pouch repair surgery due to perforation and the surgeon said my pouch looked great. I also had an MRI in August and a camera endoscopy in September. All jpouch related issues. All tests looked good. I know I am causing my own anxiety.
 
Posts: 30 | Location: Virginia | Registered: January 06, 2005Report This Post
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This is pry TMI too. I on the second step of the j-pouch surgery. I am still having quite a bit of leakage( mostly at night. Recently I developed a pimple of some sort. It stings badly especially if I touch it. The area of this pimple is just by my anus. Anything, I should be concerned about? Thanks a bunch for the response!!
 
Posts: 125 | Location: akron | Registered: June 11, 2013Report This Post
Picture of rachelraven
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That's how my issues started, a sore bump about the size of my pinky nail, just thought it was an irritation at first, then found it when wiping. It got to thumbnail size, then hot sitz baths let it burst nd drain. Unfortunately, it turned into a fistula, and I had to have a seton placed.

Show it to your surgeon. That's my best advice to you. They need to be aware of it.

If it gets worse, ask for a pelvic MRI, especially if it starts a "fill, drain, burst" fistula cycle.


UC diagnosed at age 11, 1982
Total colectomy, J pouch and loop ileostomy, January 10, 1991
Takedown May 15, 1991
Many healthy years!
Pouchitis December 2012
Perianal abscess then fistula 2012-2013
Draining seton March 27, 2013
Outlet anastamosis narrowing dilated under anesthesia April 16, 2013
Seton broke and out April 22, 2013
New seton and outlet dilation April 29, 2013
Outlet dilation May 21, 2013
Daughter dx with Crohn's colitis February 14, 2014 (age 11, like her mama)

I ask not for a lighter burden, but for broader shoulders.
- Jewish Proverb
 
Posts: 454 | Location: USA | Registered: December 08, 2007Report This Post
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Thanks for the advice Rachel, I see her 8/8 and I will mention it to her. It does seem a little better though.
 
Posts: 125 | Location: akron | Registered: June 11, 2013Report This Post
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