Hi doctor, I am a 24 year old female. I had an anal fissure a few months back due to constipation and it got healed with medication. For a week, I have constipation due to the change in my diet and lack of water intake. Whenever I had a bowel movement, I would get some prickly sensation in the anal area and itching. Two days back, I saw some blood and very tiny blood clots in stool. I took the same medicine, which was prescribed for anal fissure. My doctor told me to take the same whenever I had a fissure again. I have been taking that medicine for the past days and I did not see any blood or blood clot in the stool. The stool appears normal in texture and color. But still, when I pass motion, I feel a little swelling, slight pricking and itching in the anal area. Today, I read something called colorectal cancer or tumor. It has confused me. Many links say that the blood in the stool is the first symptom, there is a lot of bleeding and sometime bleeding cannot even be seen with the naked eye. Which is the truth? If the bleeding cannot be seen does it mean I still have a tumor or cancer in the rectal area? They also added up a lot of other symptoms like weakness, etc. I do not feel any of that. Apart from this, I am extremely healthy. I do not smoke or drink. My exercise includes yoga and dance. There is no history of cancer in my family as well. I am scared after reading that. I think even my normal appearing stool could have blood in it and there could be a tumor. I feel there is a little swelling or obstruction in the rectal area. I would like to go for colonoscopy. Will they do a colonoscopy to the patient of my age? I want to know whether my doubts are correct. Do my symptoms mean cancer?
Hi. Your symptoms of constipation associated with pricking pain and itching in the anal area as well as blood in stools lead to a unified diagnosis of anal fissure. An anal fissure is a small tear or crack in the lining of the anus. It may occur when passing large or hard stools or experiencing bouts of diarrhea. It can cause sharp pain and bleeding during and after bowel movements. It may also cause itching and burning in the anal area. It is usually a minor condition that goes away within six weeks. Its symptoms include a visible tear in the skin around the anus, a skin tag or a small lump of skin next to the tear, pain in the anal area during bowel movements, streaks of blood on stools or after wiping and burning or itching in the anal area. Please do not panic and get anxious. Colorectal carcinomas occur in later ages. Do you have any family history of the same or any polyps or any gastrointestinal complaints? In malignancy the symptoms are continuous and not episodic as in your case. Also, it will not subside by their own or respond to the treatment prescribed to you. In carcinomas, it is usually associated with iron deficiency anemia, weight loss, maroon colored and narrow stools. Still, if you have any iota of doubt, then go to your treating doctor and get your anal fissure re-examined. As per my view, you do not need any colonoscopy unless you have any positive family history or the above mentioned symptoms. For further information consult an internal medicine physician online -->