Comprehensive Papilla vs Internal Hemorrhoids Symptoms

Hello!

I am 31F and have had the distinct displeasure of having a hemmoroidectomy followed by five months of bliss before I developed an anal papilla (an internal skin tag that can grow over a chronic internal fissure). The papilla caused me severe pain on and off for 6 months before I was able to have it properly diagnosed and excised.

I am providing my experience on internal hemorrhoids vs papillae symptoms and surgery because there is little info out there on anal papillae, and I hope I can help someone else who finds themselves in my situation.

I’ll start by saying I think my experience was worse than most, so hopefully I’m the person you can look at and be like “hey, at least my symptoms and recovery weren’t as bad as her.”

Of course, this is only my own experience, and you should ask your colorectal surgeon instead of me for a proper diagnosis (notice I did NOT say GI - they cannot diagnose papillae and misdiagnosed mine as a hemorrhoids—I talked to other patients who had the same problem - trust me, you want a colorectal surgeon for a proper diagnosis).

Internal hemorrhoids symptoms - two months of constant pain sitting and/or pooping as my hemorrhoids grew from a grade 1 to grade 3 prolapsed hem (meaning it pops out during a bowel movement but can be pushed back in manually afterwards).

Once the hem was at the point of prolapse, it very rarely caused pain while pooping, though I did have occasional bleeding during BMs. It sometimes made me a little itchy. It was skinny, soft, and pink in color when it popped out. It looked kind of like a thick worm. I chose to have it removed for hygienic reasons because it was gross to push back in after every bowel movement. I was glad to have had the surgery even though it left me with skin tags the size of two raisins.

During my hemmoroidectomy, I also had a papilla I didn’t know about removed, so I think my recovery was extra painful due to both excisions, and it took over two months for me to feel normal again. I also didn’t eat much protein at the time and have since learned that protein is vital to healing, so definitely check you are getting protein AND fiber during recovery.

I’m happy to answer questions about the hemmoroidectomy, but since there’s so much info already out there, I didn’t think there was much I could say that hasn’t been said already.

Anal papilla symptoms - The papilla caused a tearing sensation when pooping, plus a sharp pain at the beginning of a bowel movement + notable pain when the papilla spontaneously popped back inside my anus after defecating. There was also occasional bleeding.

I had an indent in my poop that I discovered was in the shape of the papilla as well. If you Google “indent in poop,” it’ll tell you all kinds of crazy things. However, my papilla is gone, and the indent is gone too, so it can definitely be a reason.

Papillae can prolapse outside the anus for prolonged periods too, as I discovered when I tried to take Linzess as advised by my GI. The explosive diarrhea caused it to come shooting out of me, and it took 24 hours to be able to pop it back in. It was incredibly painful, and I was bedridden for the entire day. Avoid diarrhea because it will wreak havoc on you worse than constipation in my experience.

Personally I was able to get my papilla situation pain free for about two weeks at a time by eating super clean, and then I’d travel or go out to eat (or sometimes change nothing at all) and have a hard bowel movement, and the pain would escalate for weeks.

At that point, it would take around 30 days to get it back to pain free. Papilla are hard to tame once they are at the point of prolapsing during bowel movements. Mine was painful even before the prolapse, but it got much worse. When it prolapsed, I could see the papilla was hard and white-ish pink in color with a comet shape. It reminded me of the chest buster in Alien lol.

With my papilla, I would experience a consistent stinging sensation for up to 8 hours after a bowel movement that would be most pronounced when I was sitting. If you look at the medical literature, they describe it as a “pricking” sensation, and that’s about right. It’s like a tingling, pokey feeling inside your anus. Sitting and standing don’t help, only walking.

Another sign it may be a papilla is if hemmoroid cream and lidocaine don’t seem to work. Nothing really helped me manage my pain besides Tylenol. That is the best pain reliever as it is much less likely to cause constipation than other pain meds.

I could not find a topical cream that reduced my pain. However, I did insert coconut oil into my butthole rim before BMs to mildly reduce the tearing sensation. I also put it between my buttcheeks during the day to prevent skin irritation from the anal leakage that’s caused by the papilla (or maybe it’s just from having a busted butthole and skin tags after my hemmoroidectomy. I’ll never know!)

Including the surgery info in this post made it too long, so I made a separate post detailing the recovery.