Wet anus with foul smell of stool

Wet anus and smelly stool are mainly caused by symptoms of anal fistula, which can lead to anal abscesses and difficulty in defecation. It is recommended that everyone should receive treatment in time. If the anus is wet and has a foul-smelling stool, it is easy for bacteria to grow in the anus and cause gastrointestinal diseases. Therefore, the symptoms of anal fistula should be treated in time and the hygiene problems of anal suppuration should be cleaned up.

Anal fistula is the abbreviation of anorectal fistula, which is a sequelae of abscess rupture or incision drainage around the anorectum. Anal fistula is the post-abscess stage, two stages of a disease. The English name is Anal fistula, and it is called anal leakage in traditional Chinese medicine. A typical anal fistula is a clear, complete tube with one end in the anal sinus and the other end outside the anal margin or in the rectal wall. Atypical anal fistula usually has only an internal opening but no external opening, or has both an internal and external opening but the middle fistula tract is blocked, or has only an external opening and the internal opening cannot be found, or there is simply a hard lump.

Clinical manifestations

1. Purulence occurs periodically, sometimes not, and the amount of pus is small.

2. The swelling and pain are generally not painful. When pus accumulates in the lumen and drainage is poor, there will be local swelling and pain. When the pus flows out, the pain will be relieved immediately.

3. Lump: Most patients can feel a cord-like lump at the anal margin, which causes mild pain when pressed.

4. Itching Pus often irritates the skin around the fistula, causing itching or eczema of the anal skin.

5. Systemic symptoms

(1) Generally, there are no systemic symptoms.

(2) Complex or prolonged symptoms often include difficulty in defecation, stenosis, anemia, weight loss, mental depression, neurasthenia, etc.

(3) Secondary infection may cause systemic symptoms such as fever of varying degrees.

examine

Anal fistula is difficult to treat, primarily because of the difficulty in diagnosis. Only by accurately locating the location of the fistula and the internal opening before the operation can we provide the most powerful guarantee for the success of the operation. There are generally two ways to locate the internal opening: directly finding it and finding it along the fistula. Only a few cases can be found directly. During digital rectal examination, a hard nodule or depression may be felt at the dentate line inside the anus, or pus may flow out when the fistula is pressed. In most cases, the internal opening is very hidden or closed, so it is necessary to find the fistula or external opening first, and then follow the clues to find the cause. There are six methods: look, touch, probe, irrigate, illuminate and cut. These methods have different scopes of application for different fistulas. Sometimes one method can be found, and sometimes several methods need to be coordinated.

1. First divide the anus into two parts, the outer opening is in the posterior half, and the inner opening is basically at the 6 o'clock (posterior midline) tooth line. The external opening is in the front half, and there are two situations. If the external opening is within 5 cm from the anal verge, the internal opening is at the tooth line corresponding to the external opening. If the external opening is more than 5 cm away from the anal verge, the internal opening will go around to the posterior side at 6 o'clock. The accuracy of this law is about 80%, and it is generally used as a preliminary judgment before other examinations.

2. Touch is digital diagnosis. Generally, anal fistula can be diagnosed by "touching". However, if the fistula is located deeper, or has not been fully formed, or is intersphincteric, the following measures need to be taken to continue the examination.

3. Use a probe to probe into the external opening of the anal fistula. As long as the fistula is unobstructed, the probe can be used to probe to the internal opening. During the operation, the fistula is cut open along the probe. When using a probe to locate the internal opening, two situations must be ruled out: the fistula cannot be blocked in the middle, and the fistula cannot be bent.

4. For curved fistulas, neither touching nor using a probe will work. In this case, you need to inject liquid into the external opening to see where it flows out. The place where it flows out is the internal opening. The liquids used include methylene blue and hydrogen peroxide. The prerequisite for using this method is that the fistula is unobstructed.

5. Ultrasound, X-ray, CT, and MRI examinations all fall into the category of "examination", especially B-ultrasound, which has been widely used in clinical practice in recent years. Some experienced doctors can accurately describe the location, range, relationship with the sphincter and the location of the internal opening of the fistula. It has important reference value for deep fistula, CT and MRI examinations. It should be pointed out that these physical examinations can only provide reference, because in the end the lesion must be felt by hand before surgery can be performed.

6. If the above methods still cannot locate the internal opening, you can only cut open the fistula and search along the scar and necrotic tissue.