rectal discharge

I am 35 ,and for the past 7 years i have been having annoying  rectal problems.my bowl movments seem to pass just fine ,but after is the problem.It seems after cleaning up my there is  a uncomfortable feeling around my anus.It's feels like a film or something,not really greasy but it leaves me uneasy.Then a little later there is kind of i guess a dicharge and have to go wipe again.It,s really annoying and it seems like i have to take a shower after i go to the bathroom just to clean up.My anus still feels like there is a film or residue on it.I have been to two doctors and have had a Colonoscopy.I have a mild case of hemrroids They found a few polupes,but the test seem to be fine.My stools are usually brownish but are sometimes lighter in color.Sometimes there is some itching after .what do you think th problem might be. help i am going nuts with this .......

[Kevin Pho, MD]

With a negative colonoscopy, this makes it less likely that cancer or polyps are responsible for the symptoms.  One consideration would be an evaluation of the anal sphincter muscle - either by manometry or an evaluation of structural abnormalities.

Anorectal manometry can measure parameters such as maximal resting anal pressure, amplitude and duration of squeeze pressure, the rectoanal inhibitory reflex, threshold of conscious rectal sensation, rectal compliance, and rectal and anal pressures during straining.

Another consideration would be structural abnormalities of the anal sphincters, the rectal wall, and the puborectalis muscle and can be understood in detail with endorectal ultrasound.

You may want to consider discussing these options with a colorectal specialist for further evaluation.

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.

Bibliography:
Robson.  Fecal incontinence.  UptoDate, 2004.

[booya]

would coffee cause that kind of problem....if so why? It's like food and liquid is not being broke down right......

[yoshi]

it could be yeast/fungal infection.
dont mean to be crude,but take some yogurt with live culture and apply it or you can eat some good yogurt ,not the **** from supermarket like dannon,the good one from health food store or health food section of a supermarket.

[Haroon]

I have had the exact same symptom you are describing for about 10 months.  Here are some things that I've observed and done with reasonable success at lessening the severity of the condition and to make it more manageable from a daily life standpoint.

1) Have taken anti-yeast non-prescription natural treatments for several months.  This seems to have helped somewhat although it has not gotten rid of the problem.

2) I use a "Toto Washlet" after going to the bathroom.  This cleans much better than toilet paper and allows me much more comfort after a bowel movement.  This is water washing system that easily installs over any toilet seat (see www.toto.com) for dealers near you.

3) I place a cotton ball against my anus after I clean thoroughly so that any discharge is caught on the cotton and keeps me dry and limits the irritation to my skin.

4) The problem depends on the "fluidity" or softness of my stool, which in turn depends on my diet.  If I eat soluble fiber type foods like pasta and bananas that helps the stool bulk up and the problem does not manifest itself anywhere near as badly.  Taking in large amount of insoluble fiber like cereal or anything that makes the stool loose creates/aggravates the discharge problem.

Let me know if you see any relief and figure out a solution.  Wishing you to get well soon.

[Outrajus]

I am 37 and have had this same symptoms as you for the past 8 1/2 years.  My complications started with the delivery of my son. I have constant diahria and can't control bowel movements. I have had numerous test including a negative colonoscopy but i did have six polyps.  I have had several anal sphincter surgerys and Chroans was ruled out.  My doctor has in my medical records that I have IBS but has never discussed this with me.  I only just found out about this being in my records.  I was at a point where my doctors didn't consider me a canidate for surgery anymore.  I went to Tulane University and was told that there wasn't anything that could be done.  My local doctor heard about a new surgery and it is limited to only a states in the US i think.  I had an artificial bowel sphincter implant, although this is the last resort....you might could do some research on this. I have had the implant now for going on 4 months now and mine was just activated two weeks ago because of some complications for which i seem to be the exception.  As of my surgery i was their 11th patient. I know this would be only as a last resort ......but so far it has made a tremendous difference in my ability to perform normal duties.  I have rectal spasms really bad and the doctor that did do the Artificial Bowel Sphincter did say that he didn't think the surgery would help my spasms, which it hasn't maybe even made it alittle worse....but i can at least get up walk to the bathroom without running and defecating on myself.  Good Luck to you.