Talk to General Surgeon on Anal Fissure Or Hemorroids
Asking For Self, Female 31, CB44-1 near barrier2 wahcantt Rawalpindi
mjy anal fissure ka issue hy 1 saal sy sae hu jata lekin constipation hny sy dubara hu jata or ab kafi ziada hu gya internally feel hta jb cream lgati hn hemmoroids wali kch phoola hua jgah kafi tng or sakht hu gi hy or ab kch din sy smell bi ati hy or kharish bi hti hy lekin blood kbi ni aya swelling hu jati pain hta
need examination to rule outthe real problem
Needs examination... visit nearby surgeon
get examined by near by general surgeon
Dr. Fahreyar Alam - General Surgeon
MBBS, MSc (CF), MRCS (Glasg), MRCS (Eng), FRCS (Gen Surg) | Lahore
23 Positive Reviews
Will have to examine to get the correct diagnoses and manage
need examination if diagnosis confirmed then laser surgery
Dr. Danish Ali Haider - General Surgeon
MBBS, FCPS (General Surgery) | Islamabad
31 Positive Reviews
Looks like you need examination and then Surgery.
This presentation is more suggestive of recurrent anal fissure with possible secondary hemorrhoidal changes, rather than primary hemorrhoids alone. The key features pointing toward fissure are the history of constipation triggered recurrence, pain, and a feeling of tightness or hardness (likely due to internal sphincter spasm or abscess formation). Hemorrhoids, on the other hand, more commonly present with painless bleeding, which you specifically deny. The swelling you feel after applying hemorrhoid cream may represent inflamed skin tags (sentinel pile) or associated internal hemorrhoidal congestion, which can coexist with chronic fissures. The recent onset of odor and itching raises concern for local infection, poor hygiene due to pain, or possible fissure chronicity with maceration. Management should primarily focus on aggressive constipation control along with topical smooth muscle relaxants to reduce sphincter spasm and promote healing. proper local hygiene is essential. If symptoms persist beyond 6–8 weeks or worsen (especially increasing pain, discharge, or persistent swelling), evaluation by a surgeon is warranted to rule out chronic fissure complications or mixed pathology, where procedures like lateral internal sphincterotomy may be considered.
Treating this patient empirically without proper anorectal examination carries several clinically significant risks. First, there is a real possibility of misdiagnosis conditions such as a chronic anal fissure, internal/external hemorrhoids, perianal abscess, fistula in ano, or even less common but serious pathologies like inflammatory bowel disease or anal malignancy can present with overlapping symptoms (pain, swelling, itching, discharge). Missing a perianal abscess is particularly hazardous, as delayed treatment can lead to sepsis or fistula formation or even incontinence. Second, inappropriate use of topical agents (e.g., steroid containing hemorrhoid creams) may worsen fissures, cause skin thinning, or mask infection, delaying definitive management. Third, the reported foul smell and itching could indicate secondary infection or dermatitis, which, if untreated or mistreated, may progress locally. Fourth, failure to identify a chronic fissure with sentinel tag or hypertrophied papilla may result in prolonged sphincter spasm and fibrosis, reducing the likelihood of healing with conservative therapy alone. Additionally, without examination, red flags such as induration, atypical location, or non healing ulcers suggestive of malignancy or systemic disease may be missed. Lastly, inadequate assessment may lead to under treatment of pain and constipation, perpetuating the cycle of trauma and delayed healing. Therefore, a focused anorectal examination (inspection ± digital rectal exam/proctoscopy if tolerable) is essential before committing to long term therapy.
You need an examination and decision can be made after that
![Homeopath in Karachi - Homeopathic Dr. Basit Chawla [Psychologist]](https://staticconnect.marham.pk/assets/doctors/65905/homeopathic-dr-basit-ibrahim-chawla-homeopath-karachi-26_80X80.webp){kind=small}
Thank you for your question. In homeopathy, medicine is selected according to the complete symptoms and patient constitution. For accurate remedy selection, a detailed case history is required. You may consult for proper homeopathic treatment.
Dr. Nasir Mumtaz - General Surgeon
MBBS, MCPS (General Surgery), FCPS (General Surgery) | Islamabad
5 Positive Reviews
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