instruction: 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
output: hi after reviewing the information shared and your pictures 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 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 trust 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 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 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 sit 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 spoonful three times per day take to 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 trust 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