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Forum Name: Gastroenterology Topics

Question: Yellow mucus in stool and rectal discomfort


 Comop - Sun Nov 15, 2009 9:38 pm

Hi,
I am a 25 year old male from the USA. Three months ago I had anal sex using a condom, the sex did not feel comfortable and caused ongoing discomfort in the anus (I did not have anal sex since). About a week later I traveled to Greece and felt some stomach pain while there for the first few days. After five days I returned home and felt nauseous every time I ate, and then few days later I had horrible diarrhea. I took probiotics and put myself on a dried toast and rice diet, and the diarrhea went away. For about ten days following this I felt nauseous every time I ate. My doctor prescribed me Ranitidine which i used for few days and stopped. I notice that I have yellowish mucus on the beginning of my stool which tells me that it is maybe accumulating at one spot. I also have very increased flatulence since then. Furthermore, I have anal discomfort on a daily basis and my anal area becomes very itchy and sore. I feel some pulsating sensation in my rectum at least once a day. I have been diagnosed with a small internal hemorrhoid in the past, but this feels much more serious and is been going on for about three months. I have scheduled an appointment with a gastroenterologist but the wait is awhile and I am worried. Please help.
 mrodriguez - Thu Jun 24, 2010 6:45 pm

I am a feamale 24 years of age. I have very similar symptoms as you and I don't know what to do. However I've notice that the symptoms are more often during the late afternoon than during the eariler part of the day.
 dave55 - Fri Jun 25, 2010 11:30 am

Maybe a rectal abscess forming secondary to a glandular infection or fistula development, seek definitive care as soon as possible. If for instance this were to be a high levator abscess the longer you wait the more progressive it becomes (horse shoe forming etc.)

Watch for other S/S such as elevated temp over 101.5 f, constipation and gerneral fatigue with low back or surpa pubic discomfort.
 Comop - Fri Jun 25, 2010 10:02 pm

Hi mrodriguez,

I must say that after months of seeing specialists I still have not definite answers. However, the mucus stopped several months since it started. I did have a sigmoidoscopy on which internal hemorrhoids were noticed along with chronic inflammation of a small part of the lower rectum. The biopsy of that tissue indicated some atypical cell changes (but nothing serious). I was recommended to take fiber supplements, because they suspected a mild case of IBS. Fiber supplements did not really help.

Since the gastroenterologist did not really help much, I have been seeing a colorectal surgeon. She did a biopsy of a skin lesion on my anus and it indicated a chronic skin condition. I was prescribed a steroid ointment which burned a lot when I applied so I was advised to stop it. I have an appointment with a dermatologist and again with the rectal surgeon, so I will keep you updated.

Now ten months after the symptoms first started here is the state of things. The pulsating pain is almost gone, it comes once in a blue moon. What I realized is because I do not like to use public restrooms, I was holding off going to the bathroom when I felt an urge to do so. This usually happened in the afternoon after those big lunches at work, and that's when the pain was the worst. Holding off going to the bathroom caused a lot of stress on the rectum and caused feces to dry. So I trained myself (with help of coffee) to go in the morning while I am at home, so I don't have to hold it at work any more. I also avoid holding flatulence. I believe this has helped stop the pain. I also started drinking a lot of water and try to exercise regularly. The exercise really helps. Try it. The itchiness has gotten better but it is still there. I noticed that my anus now is very dry and that causes some small breaks in the skin. Like I already said there is a skin condition there and I am waiting to see a dermatologist.

Have you had any trauma to the rectum or anus (like anal sex)? Ask your doctor to refer you to a colorectal surgeon. Go to the bathroom as soon as you feel the need. Do not hold flatulence. Try exercising. Drink a lot of water. Take enough fiber (not too much as it can cause even more flatulence). Let us know what happens.
 Dr.M.Aroon kamath - Tue Jun 29, 2010 8:56 am

User avatar Hi Comop,
There can be a number of explanations for your complaints. But on account of the following factors
- recent travel abroad &
- practice of anal sex,
a possibility of intestinal helminthiasis or other parasitic
infections must be strongly considered.

A common & important sexual practice in homosexual males is anal sex, which can be a significant risk factor for transmission of many diseases including intestinal parasitism.

You indicate that you had traveled to Greece.
[Although not very relevant to the discussion,i can't help mentioning the following chance 'associations' with Greece!!
- the word 'parasitism' comes from Greek!
- 'protozoa' -means "little animals" in Greek!
- the word 'helminthes' comes from the Greek word "helmins" for worm!]


Some studies indicate that the most prevalent species in Greeks are the protozoans B.hominis (Blastocystis hominis),Cryptosporidium parvum, Entamoeba coli and Giardia lamblia) and the helminth E.vermicularis (Enterobius vermicularis).In the immuno-compromised individuals,Cryptosporidium parvum and Giardia lamblia are found to be more prevalent.The following study from Greece deserves mention.
( http://www.annalsgastro.gr/index.php/an ... le/293/260 ).

I will try to present a few facts about one pathogen which is relevant in your context, which is rather not so well known.

Blastocystis hominis may be perhaps the most common parasitic infection of humans. Infection with Blastocystis hominis is called blastocystosis. Little is known about the mode of transmission to humans.

Some people who are infected are symptomatic while others are not. Some of the symptoms are abdominal pain, anorexia, nausea, vomiting, lassitude, dizziness, weight loss,flatulence, irritation/ itching in the anal canal, discharge per-anum etc.

Diagnosis: This organism is often missed on routine stool examination. Diagnosis is based on finding the cyst-like stage in feces. Permanently stained smears are preferred over wet mount preparations as fecal debris may be mistaken for the organisms.
The organism grows well in all the media used to cultivate xenic Entamoebae.

Risk factors: Diabetes mellitus, HIV seropositivity, alcoholic cirrhosis and those with chronic hepatitis B (HBV) infection.

Aassociations: studies have suggested that inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) are associated with B. hominis infection. An association between the presence of B. hominis and the presence of H.pylori in the stomach has been noted.

Awareness of this parasite as a possible cause of gastroenteritis, particularly when no other pathogen can be identified is important. I trust this information is of use to you.
Best wishes!

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