Examination will solve problems

                                          Last week  elderly   male patient aged about 76 years who is a known Diabetic on treatment was brought to my clinic around evening  by  his sons. Patient was looking dull , sick and I can make out he is in pain. When asked the patient to sit on the chair , his sons told me that he cant sit because pain in  his bottom area. I requested the patient to lie on the examination table. Later they showed me the prescription slips of three different hospitals which they had already visited for his problem. His pain in his anal area was started  a week back  and a small swelling . Patient told to the doctor in those hospital that he is having piles ( Hemorrhoids) problem and  doctors believed that he may be having hemorrhoids with thrombosed veins as small swelling. They did not examined the patient and prescribed sitz bath and antibiotics. He was taken to one of  the big hospital in Bangalore but patient was advised to undergo proctoscopy examination . they also did not examine him . patient refused examination and again he was given antibiotic and laxatives for easy motion passing.
                            when I  asked the patient that I wanted to see what problem is there in your bottom area , initially patient refused because of pain and he thought i might do some examination like proctoscope. I showed the torch and  I assured him that I will not touch and only look what is the problem there? he agreed to get examined. His sons helped me in removing his clothes. In a good light I found there was a pus discharging  abscess in the peineal area ( mid point between anus and  scrotum area) . It was not piles or fistula . It is a perineal abscess requires to be drained and dressed , to be treated adequately with antibiotics. Anyhow his diabetes was under control . After basic investigation  treatment was initiated for his problem.
                             Many doctors get biased with the patient complaints especially  when the complaint is related to anal area  because it embarrassing to show the area and get examined . In female patient it is much difficult to diagnose because of shyness and lack of other female attendant. It is unfortunate that  patients are wrongly treated and guided  because of  ignorance of getting examined properly. unnecessary medicines and other will waste in proper diagnosis and treatment.
                           It is always  get examined the  area if there is a problem  in the bottom area especially anal regions. I have seen a case of anal  cancer not diagnosed for months because of shyness in getting examined by the doctors. similarly ensure you will be diagnosed properly than just getting examined yourself.