This is Dr. David
it sounds like you have a bit of rectal prolapse.
Hi Dr David
you need to be doing kegel exercises to help strengthen your lower pelvic muscles.
I have a photo taken today after a bowel movement if that is helpful.
it could also be a hemorrhoid which is protruding out.
you might need a steroid suppository to help calm down internal hemorrhoids which are swollen and inflamed.
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After replacing with a finger the anus appears normal
this looks like a large internal hemorrhoid which is trying to come out.
you need to soften your stools with a stool softener.
this is not rectal prolapse.
and you need to see a GI surgeon who can look inside with an anoscopy scope and perform hemorrhoid surgery to cut those internal hemorrhoids out.
I exercise regularly and eat a high fibre diet, so mostly my stools are soft
so you don't have this problem.
soft stools are good.
hard constipation can worsen this.
but you do need to see a surgeon about this to fix this surgically
or else it will continue to be a problem.
What are the treatment options for this? I have heard of rubber band ligation?
yes, that is what a surgeon would do on the inside.
but it would be a procedure through an anoscopy scope
since these are internal hemorrhoids.
also steroid suppositories can be tried for a period of time to help decrease swelling.
but these seem quite large.
and most likely will need surgery.
Okay. I would ideally like to avoid full haemorrhoid surgery if possible as I have heard the recovery time is extensive and very painful. In your opinion would rubber band ligation be effective as a less intensive alternative?
recovery is not long and painful
it is usually quick.
that is what the hemorrhoid surgery would be
ligation of the veins with sutures to tie them off
sutures are better than rubber bands.
the recovery is quick and easy.
do not try to do this yourself with rubber bands.
you have to see a surgeon about it to get it properly cut out.
and tied off
No I definitely would not do that! I intend to see a surgeon. What I mean is that there is hemorrhoidectomy versus rubber band ligation. I am hoping a surgeon would opt for the ligation method in my case?
yes, I'm sure the surgeon would do ligation for you.
I'm glad you are willing to see surgeon about this.
ligation is the preferred way
you will do fine.
best of luck to you
let me know if you have other questions.
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Thanks - finally I assume ligation would be done as a day case and not under general anaesthesia?
you can always reach me as Dr David if you have other questions.
thanks for using JustAnswer.com
most likely no general anesthesia
most likely conscious sedation or a spinal below the waist anesthesia would be fine.
spinal or epidural below the waist anesthesia
like they give to pregnant moms.
it depends on the surgeon and anesthesia team.
does that help?
any other questions?
I was under the impression it could be done in a doctor's office. Like this : http://www.webmd.com/a-to-z-guides/rubber-band-ligation-for-hemorrhoids
yes, this can be done in the doctors office.
that might be how the surgeon will do it.
so no anesthesia for these methods
You don't think they are too large?
only an exam with anoscopy will be able to tell.
you can't tell by just a photo.
Okay. I will make an appointment. Many thanks for your help and I will leave good feedback.
you are welcome
let me know if you have other questions