Fotographer001

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Bit of a health question here.... I know I can just go to the doctors, but I just wanted to know what your guys thoughts were.

So get ready for some TMI....

So I have a lesion running from my anus up my butt crack. Its red and painful to sit on. Any ideas as to what could have caused this? Did I rip my butt hole? Screenshot_20190623-013658_Gallery.jpg
 

Fotographer001

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Have you had any sexual contact in the past few weeks?

Yes, about a week before I was sexually active. I was fine afterwards, I didn't have the cut till about a week afterwards. Or atleast I didn't feel anything until a week afterwards.
 

Fotographer001

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Go see a doctor. I have ideas, but I don't see what telling you would accomplish other than psyching you out. Especially given that I'm not professionally qualified to advise on this.

Any comments or ideas would be appreciated. I don't currently have a family doctor, so I will have to go to a wall in clinic.
 

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Any comments or ideas would be appreciated. I don't currently have a family doctor, so I will have to go to a wall in clinic.

I really don't feel it's my place to suggest a diagnosis to you, but it looks like it could be an STI. I recommend you go get a broadly inclusive panel done at the clinic and discuss whatever comes up with the practitioner. The types of infections you want to be sure to be tested for include HIV, hepatitis, gonorrhea, chlamydia, herpes, and syphilis.
 

W4_Hung

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Looks like you have a fistula at the bottom there, just some antiseptic and should be fine.

Also, guessing you keep your ass shaved so the sweat and bacteria cling to the skin and can cause yeast growth and a rash.

I'd suggest getting it checked by a dr but in the meantime, make sure you keep the area clean and dry and moisturised.
 
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I think a fistula is inside the anus, this looks more like a fissure or skin tear. Whatever, I'd have it looked at.

ETA: if it is a fistula that may need surgery, unlikely to heal by itself.
 

W4_Hung

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I think a fistula is inside the anus, this looks more like a fissure or skin tear. Whatever, I'd have it looked at.

ETA: if it is a fistula that may need surgery, unlikely to heal by itself.
Fistulas can occur externally around the anus, and in the absence of infection can heal on their own, but not advisable to leave unchecked.

Student in this area.
 
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328982

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Fistulas can occur externally around the anus, and in the absence of infection can heal on their own, but not advisable to leave unchecked.

Student in this area.
You sure? Merck Manual says “spontaneous healing doesn’t occur”; Johns Hopkins Medicine: “Once you have an anal fistula, antibiotics alone will not cure it. You will need to have surgery to cure the fistula.” Cedars-Sinai: “Fistula tracts must be treated because they will not heal on their own”.
ASCRS: “Currently, there is no medical treatment available for this problem and surgery is almost always necessary to cure an anal fistula.” If it were a fistula in ano wouldn’t there be a draining abscess, pus and infection? Maybe history of a drained abscess. Most anal fissures don’t require surgery and usually occur in the posterior (back) midline of the anus.
 

OKCLane

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This is not my area but fissure and fistula are different conditions. Additionally, although this may be TMI, you can often smell an infection. The pic doesn’t appear to be a weeping wound but certainly needs investigation.
In any event, the patient would be referred to a GI colleague for evaluation and perhaps surgical intervention if warranted.
My initial advice stands. Go see a local doctor.
 

ZeusNotApollo

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Absolutely no creams, lotions, moisturizers etc.

In the meantime keep Fecal matter away from the area by cleansing the wound from the top to bottom with a single use, fresh wash cloth, the original Dial soap or Hibiclens. Lastly, purchase some mini or maxi pads feminine hygiene products and change them frequently to keep the area dry. Obviously, avoid any hand sanitizers or products containing alcohol.

Get to a PCP and maintain a relationship with him or her.

Just like an automobile health care generally gets more expensive only when you fail to maintain it.
 
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OKCLane

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Clearly there various views on what to do. Without an examination, a differential Dx is impossible to reach. Using Hibiclens in the genital area is generally contraindicated. Since the wound doesn’t appear to be weeping, a feminine pad would trap heat and exacerbate the problem imho.
The common strain from all posters has been to seek medical treatment as soon as possible. If there’s one takeaway, that’s it.
Good luck. I will hush on this topic. I’m not looking to pick a fight with anyone else’s advice.
 
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This is not my area but fissure and fistula are different conditions.
Absolutely, I was trying to make that distinction - my understanding is that fistulas almost never heal without surgery whereas most fissures do or can do with medical treatment. If it is a fistula (which I doubt) a dab of antiseptic is not going to do it.
 
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OKCLane

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Absolutely, I was trying to make that distinction - my understanding is that fistulas almost never heal without surgery whereas most fissures do or can do with medical treatment. If it is a fistula (which I doubt) a dab of antiseptic is not going to do it.

Totally agree. In either case, a local medical assessment is the answer.
 
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