Moisture around anus, seems to be secreted by skin

My problem is similar to that of "Booya" (March 18, 2004), although I'd describe my symptoms slightly differently: There is moisture around the anus, near the exterior of the anal opening, not inside the anus. Sometimes it's just moist, and on other occasions there is a brownish film. I know it doesn't make anatomical sense, but it seems like this brownish moisture is secreted directly from the skin around the anus – it's not a substance that's passing through the rectal opening itself. The wetness is a horrible disgusting sensation, and driving me crazy!

I'm a 49-yr old male. My usual routine is to defecate in the morning, and then take a shower. These symptoms seem to be at their worst 3-to-9 hours after defecation. Stools are normal and there are no other symptoms. In summer 2002, I was on topamax for headaches, and during that period I had exactly the same symptom, and the symptom ceased abruptly when I stopped topamax. In August-September 2003, I was on tetracycline for rosacea.

This latest bout of symptoms began in mid-March 2004. At that time, there were two big changes in my diet: My workplace cafeteria started serving sushi, and I had been eating a lot of it. A second change was that Coke introduced Lime Diet Coke (delicious!), and I started drinking about 2 liters a day of it. For the past few weeks, I have been dealing with this by not consuming sushi, citrus, and certainly not Lime Diet Coke, but the symptom continues. For the past several days I've been using an antifungal ointment down there and eating yogurt, just in case it's a fungal problem (but I have no other symptoms of fungal infections). There has been no pain, no bleeding, no itching, and no other irregularities. The sense of wetness down there creeps me out. What could be causing this? Is the connection with topamax significant? Many thanks, doctor!

[Kevin Pho, MD]

One possibility would be a type of fecal incontinence.  There are several causes for this, one being a weakness of the anal sphincter.  Anatomical abnormalities in the rectum as well as the distal colon also result in incontinence.  

An endoscopy (flexible sigmoidoscopy or colonoscopy) can be considered to evaluate for this.  Other tests to consider can include anorectal manometry (which would test the anal sphincter) as well as endorectal ultrasound, which can evaluate for anatomical damage.  You may want to discuss these considerations with your personal physician.

Another consideration would be an anal fistula.  This can be evaluated by a surgeon and if present, can be treated surgically.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[surgeon]

one possibility is a fistula-in-ano, which is a tract under the skin, starting inside the anal canal and draining through the skin near the anus. It's not serious, but usually requires a small operation to correct it. The only way to find out what it is is to see your doctor. Online, it's just a guess.

[hall75950]

I have a similar problem, Mositure around anus, plus itching.  I have had this for 20 years or more.  It seems that feckle matter seaps during the activity of the day.  It appears that this is the irritation of the itching.

Could this be a result of a hemroid operation?  What other suggestions will be in order? Thanks

[saskatchewan]

Because this symptom had begun and stopped abruptly when I was on topamax (an anti-convulsive med), it seems unlikely that the cause is an abnormality of my anatomy. In response to "Hall," I have never had problems with hemorrhoids. As far as a leaky sphincter is conserned, I don't have any physical sensation of involuntarily passing any liquid or substance.

I am leaning toward some sort of obscure chemical cause, or more likely, it's psychosomatic. (I tend to have a lot of physical symptoms, such as headahces, that seem to be due to "nerves.")

[bo skelector]

I suffered from mucus that secreted around the anus and seeped out, it wasn't always itchy but when it was it drove me insane, this lasted about 2 years. I put it down to using drugs of the recreational nature. I've changed a lot of things from the way things used to be. Like relaxing, eating a balanced diet, training, walking and running a lot, stretching. All of the above...  Now the symptoms are slowly becoming a distant memory.
Hope this may help.