Hey not diagnosed but having investigations and scared

I think it was 5cm. It was right at the top of my anus so I couldn't feel anything. I could feel what I thought was a fissure at about 8 o'clock which I now understand is not a typical place for a straightforward fissure - think they are usually straight, like yours. I am not medical in any way so don't take this as fact, though. I had it for months and only had phone consultations with GP (covid)  until I also went private, so at least you have been seen by someone who knows what they are doing. It sounds like docs are investigating but are not overly concerned. Good luck, keep us posted.

I should add that I have had radio and chemo therapy and my tumour has responded well - it has gone, doc says. They will keep monitoring, but so far so good - so even if you have anal tumour, treatment is very effective.

Thanks and glad your treatment is going well 

• I was confused as he said originally a few weeks for EUA then he said something about 6 weeks. I asked his secretary and he mentions a few weeks on the tape but she says it's normally 4 to 6 

Hi 1in1500 i hope you are well. I still have had no appt dates through. Do you think I should chase.

Hi 3565 yes I would definitely give them a call. It’s annoying that you should have to chase this up but I’m afraid that sometimes you have to. Bev. 

Thanks. I will but not sure how. When I spoke to consultant private secretary last week she said if I hadn't heard anything in a month then call her and she will chase nhs secretary.  I haven't got nhs secretaries details.  

Hi 3565 do you know the name of the Consultant who you have been referred to? If you do you could call the hospital switchboard and ask for his/her number. Alternatively, if you don’t know this call the switchboard and ask for any of the Colo-Rectal doctors’ secretaries numbers. I’m sure one of them will be able to help. Bev 

Thanks for getting back to me 1in1500 called private secretary today and she said letter has gone out from my appt last Monday. The surgeon is now on AL for 2 weeks and has handed the appts over to his NHS secretary.  I didn't receive letter as they had incorrect email address for me.  So just got it. She said he will be doing the sigmoidoscopy and EUA but nothing will be booked until he returns... my letter is below

Dear Miss Joel

It was a pleasure to see you today.  You self-referred because you have been worried about a variety of aspects to do with your health.  You have been through a difficult time in the last few months having had a breast lump, an abnormal cervical smear and anaemia attributed to heavy periods and fibroids.  

Specific to today, you have come along because your bottom started to sting a lot for the last number of weeks. You previously had haemorrhoids and you were told that this episode was related to haemorrhoids, but it felt more like a cut.  You have also been aware of some slightly enlarged lymph glands in the left groin which your family doctor believes are reactive. You have been aware of a swelling or lump on the right buttock close to the anal verge.  About 10 days ago you noticed some bright red rectal bleeding on the paper only. Since then the bleeding has stopped and on one occasion you think you passed some pus through the back passage. 

Your bowels have tended to work daily or twice a day for years. However, recently, perhaps on account of iron therapy, the motions have become harder, still twice a day but you have had to strain more. You have been aware of growling noises from your abdomen over a 4 day period which have now settled. You have not actually had abdominal pain or bloating. You lost weight 18 months ago perhaps related to a relationship coming to an end. You have no ongoing weight loss. Your appetite is good; you have no dysphagia, no nausea or vomiting.  You have an aunt and an uncle who have had bowel cancer in their 60’s.

You have previously been healthy. You work as a Programme Manager for a Charity managing drug and alcohol dependence.  You found the past few months very stressful mentally and you certainly come across as anxious.  You have no major ongoing medical problems such as asthma, diabetes or heart problems.  You are on iron on account of the anaemia which has been attributed to heavy periods and fibroids. You have been started on Sertraline, but stopped it as it was not suiting you.  You have been started on Propranolol. You are on Flucloxacillin on account of the swelling near the back passage.  I am not certain if you have had a TSH level done.  Examining you with one of our nurses present you appeared anxious, you were thin, there were no abdominal masses or enlarged organs. You had slightly enlarged lymph glands in the left groin, but I do note that you shave your groin area which might contribute.  Inspecting the perianal area there was slight dusky redness to the right of the anus with a ring shaped area of induration and softening in the centre, something typical of an infection with pus.  There was no significant tenderness in that area, there was no opening.  Inspecting the anal verge there was slight irregularity, but nothing more. There was no visible fissure that I could identify.  Digital rectal examination was possible, a little uncomfortable, but no more than that. There was irregularity in the anterior anal canal, no mass and 

I suspect you have had a fissure in the anterior anal canal and this has allowed development of infection at a little distance from the anal canal and may be responsible for the lymph glands that you have been aware of in the left groin.

I aim to bring you into hospital as an NHS patient into the Queen Alexandra Hospital in the next few weeks for examination under anaesthetic, flexible sigmoidoscopy after enema preparation to investigate the bleeding. If there is any abscess present I aim to drain it with a cut near your back passage and if there is a fistula connection between the abscess and the back passage this will be managed by a Seton or plastic loop in the first instance. 

I will also arrange for you to have an ultrasound scan of the groin nodes and of the abdomen and bowel which is different from the scan you have already had for the gynaecology purposes. 

Meanwhile I would be grateful if you could start yourself on Lactulose to keep the motions soft and reduce symptoms. 

Best wishes.

Yours sincerely

Hi 3565 that is a very detailed letter and is reassuring in that it does not suggest that there are suspicions that something sinister is going on. The Consultant’s view is that there may be an abscess and infection present which will become apparent on further investigation.  He suspects this may be the reason for the lymph node issue. The further investigations and scans will hopefully confirm this view. I know it’s easy for me to say but I would try and concentrate for now on the fact that the Consultant doesn’t think there are any red flags raised. I do appreciate that you need the tests doing and the results through as soon as possible before your mind is completely at rest.   Propanolol are extremely helpful with anxiety but must be taken regularly for the full benefit. Also, taking iron can definitely make you constipated so taking lactulose is a good idea. Bev. 

Thanks;bev you have been really kind responding.  I'm trying to stay positive now. Going to book a spa say for the 29th as I know even if it's an abcess I won't be doing any spas for the foreseeable.  My mental health is not great I think the diffetent scares since Sept just chipped away at my resilience so need to try and get myself out  of that hole.  You ladies give me hope though. As no matter what I am not alone and that makes me feel assured

Thank you again - LouLou