Hello doctor,I am a 29-year-old female. I suffered from abscess when I was eight and a half months pregnant. After three months, it was diagnosed as fistula and gone under fistulotomy operation. Since the past few months, I feel some wetness in the perianal area. And today, I saw a blood spot on the tissue. Also, I feel itchy and I am not sure if the anus is completely cured after surgery. Please help me.
Hi. After reviewing the information shared and your pictures (attachment removed to protect patient identity), a few things come to mind. Wetness in the perianal area and itching are because of the small amount of seepage of stools around the anus. This stool causes irritation to the skin around the anus which causes the itch. Also, the irritation can erode the skin and cause a blood drop to appear. I would like to know a bit more regarding your problem. Did you have any pain along with the blood spot or any pain after stools? How frequent is this problem of itching? Did you ever feel a small amount of stool or gas passed without your control while coughing or laughing hard? When did it start happening? Did it start happening any time soon or was it there all along after surgery? Has it changed over time? Was it a normal delivery? Was anything done to assist the delivery? Was there any complication at the time of delivery of baby? From the picture, I can think of two possibilities. 1. There is a defect in your anal sphincter, the contracting muscle. Although to be sure, a thorough examination is required along with an ultrasound called TRUS (transanal ultrasound), a special type done from inside the anus. In this case, the trouble would be there all along after surgery. So, you may be right that it did not heal properly. 2. There might be a new fistula-in-ano developing, just in front of the anal opening and behind the vaginal opening. In this case, it would have started troubling for a couple of months. 3. If it was painful for you to pass stools or associated with pain after passing stools, then it could be an anal fissure. My advice as follows: Do sitz bath - take lukewarm water in a tub and put a half 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 minutes three to four times every day. Try to do it at least twice per day. It will decrease itching. Avoid constipation with a large platter of salad, sprouts or Sat Isabgol 2 spoonful three times per day. Take 3 to 4 liters of water, measured by a bottle, every day. Do exercises for building pelvic muscles and improving the tone or control of anal sphincter. It is best to discuss all the above with your local doctor, who can examine you in person, as a definite diagnosis is unlikely without examination. If there is a defect seen on TRUS and weakness of sphincter, some surgical repair may be possible. Otherwise, exercises can help. Kindly get back with the queries and follow up on icliniq. Thank you.