instruction: hello doctor suffering from mild is since last four years noticed a tender lump beneath skin near anus three years ago swells and shrinks itself mild throbbing and pale yellow fluid discharge from anus when pressed during swelling proctoscopy was done in a piles hospital the doctor said no piles fissure and fistula mri was done in another hospital 17 my to hyperintense linear tract with no abscess no overt fluid signal as well the doctor said nothing and discharged me what is this tender lump I am a healthy 35 years old male working in a office
output: hi after reviewing the information shared and your pictures it appears you are suffering from fistula in ano tubular interconnection between anal canal and outside skin near the anal opening the swelling you are talking about is called perianal abscess it is a swelling because of infection of some anal glands around 30 40 perineal abscesses are associated with a fistula in your case having a couple of good quality pictures of the anal region can help in suggesting further treatment your mri report reported presence of around am size fistula with no abscess at the time of imaging and no higher up extension this is a good prognosis type it will need either of two things there are many treatments possible but for you I would suggest these thread insertion in the fistula a tightening it every week this treatment is called cutting sexton you can use shar sutra or silk thread surgery to take the fistula out and let the area heal by itself over time weeks this can lead to loss of incontinence as well control on stool holding what to do now you need to followup with a surgeon to do any one of the above two suggested treatments do sit bath take lukewarm water in a tub put a half a teaspoon of ordinary salt in it now sit in this water and try to make the water clean and sooth your anal region sit for around 15 min to times everyday try to do at least twice per day it will decrease itching and help to heal the fissure as reported by you in your info provided avoid constipation with a large platter of salad sprouts or sat isabgol teaspoon three times per day take to litres of water measured by a bottle measuring cup everyday in case you need more information and help regarding what to choose and why kindly followup with a couple of good quality pictures of the fistula site or discuss it with your local doctor