Conflicting Diagnoses

Hey, so I've posted on here before about a long, difficult post-banding recovery (2 thrombosed externals that may or may not have been related to the banding and which appeared in the following two months, one after the other). Now that those have resolved, I've still got redness, swelling, and discomfort. What is going on?

Well if you believe my regular colorectal surgeon, I have pruritus ani (chronically irritated bum) likely from overzealous cleaning and all the craziness that's been going on back there. (That does jive with my recent behavior if I'm being honest.) He says I need to use a zinc oxide barrier cream for a few weeks to calm the skin and return it to a healthy, happy state.

Fine. Sounds good.

On a lark, I visited another colorectal surgeon just to see what a different expert would say. Full disclosure: she was very rude and dismissive, annoyed that I was asking her to "co-manage" my treatment. She said I had "engorged external hemorrhoids" even though I'd never had them before. She then went on to suggest the banding somehow caused it, and finally just for fun, she said there was nothing I could do about it. I asked about surgery. She said it was risky and painful. Wonderful trip.

I ran what she said by my regular guy over the phone and he said that's nuts, in no uncertain terms. I don't have some some brand new external hemorrhoids. Banding doesn't do that. He's seen me from the beginning of my treatment and has not noticed anything like that. Just plenty of irritation--something he sees regularly and is confident we can cure. He also said he couldn't even operate on me if he wanted to--there's nothing to operate on! I just need to stick with calming the skin down and I'll be fine.

In his defense, there is nothing on the internet anywhere to suggest banding causes external hemorrhoids. And I have looked long and hard.

In her defense, I did have those thromboses, though they did subside. And I am pretty swollen down there, no two ways about it. But pruritus ani does inflame the skin.

So, what do you think? Who is right?

I'm obviously inclined to believe my usual doctor since he's seen me a lot more and isn't a total jerk. Plus he bands people all the time and has never ever seen what the other doctor described (who doesn't perform banding FYI, just injections).

But just curious if people have thoughts. What a crazy day.

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