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What Causes Smelly Mucous And Blood From Anus?
Question: Hello i do hope you will be able to help me and shed a bit of lighton my situation. I have been poorly now on and off for the past 2 years, it all started with muscle aches and pains and feeling very tired. I also had trouble opening my bowels and i had a considerable amount of weight loss going from 8st 13 to 7st 10in 4 weeks. I have had Crohns disease since i was 18 and was in remission at the time i became ill. i was referred to the coloretal & gastrology team where i had tests and they failed to find out the cause of my illness and symptoms as it wasnt my Crohns. They put me on all medication and laxatives possible with no effect and i just became more poorly and weaker. Eventually the plan to do a defunctioning loop ileostomy was made bypassing my colon but leaving it intact inside. By the time my operation date came 24th XXXXXXX 14 i had dropped to 6st 8, they were having trouble taking blood from my veins as they seem to collapse everytime blood is drawn, also although my blood pressure is not high there was a slight difference and still is in each arm. Since the operation i am eating better and have managed to put weight back on very quickly and currenty weigh 8st 8 but im still poorly and blood results show some things which are being looked into as i still have no diagnosis for my illness. My symptoms currently are aching which feels like its in the veins, low back and pelvic pain quite freuently, seem to be swelling up on my legs quite a bit (almost like water retention). Lots of smelly mucus and blood from the back passage although i have a end ileostomy ( which is permanent). Itchy spots randomly come up on my ribs and hands and leave scasr ( only 2-3 at a time). Palpatation very frequently. feeling cold all of a sudden and waking up some nights with a cold sweat. Veins on arms are very prominent especially the left arm and sometimes ache. Soreness quite often in the lymph region on the front of the neck, Headaches more often than ever before. And now this morning i have noticed on my gum just above my front tooth i have a small grey/black spot appeared which has not been there before. It is not raised and is not sore. I understand some of these symptoms may be no relation to me being poorly but i have been refered urgently to the hospital following repeat blood tests my doctor had done which has made me wonder if they might have a idea.
Also forgot to mention im not sure if its of any significance a have a bony raised area which aches sometimes on my chest above my left breast, bottom left ribs feel tender when pushed on and have a boney raised lump on left hand also.
Also forgot to mention im not sure if its of any significance a have a bony raised area which aches sometimes on my chest above my left breast, bottom left ribs feel tender when pushed on and have a boney raised lump on left hand also.
Brief Answer:
Iron deficiency and Vitamin D deficiency
Detailed Answer:
Hi
Welcome to Healthcare-Magic
Greetings of the day
Dear Ms XXXXXXX
Being experienced in management of Crohn' s disease I would like to take up your question.
Let's go step by step analysing your symptoms and investigation
1 . Smelly mucous and Blood from anus: Even though you have end illeostomy. The colon which is left intact inside the abdomen secretes the secretion which it normally secretes. This leads to accumulation of mucous. This retained mucous may cause inflammation of colon lead iron to bloody mucous discharge from anus.
Solution: Thorough evacuation of colonic contents either by using Enema or using catheter washes through the colonic opening in abdomen. This will take care of retained secretion.
2. Lesion over the gums: lesion over the gum is of very short duration and very small for it to have any significance.
3. Low back pain/pelvic pain: Individual with Illeostomy have decreased calcium absorption because of diversion of stool contents. This leads to Illeostomy induced bone disease ( Osteoporosis) which could explain your Back ache. Laboratory investigation clearly reveal low Vitamin D level which substantiate the possibility of bone disease due to Vitamin Deficiency induced.
Solution: Confirmation of bone density by using Bone densitometer
You may require Injectable Vitamin D injection in consultation with your Physician
4. Palpitations and night sweat : As your Thyroid profile is normal it's unlikely to be due to Hyperthyroidism.
These could most likely be due to Iron deficiency anemia, which produces volume overload in circulation to compensate for reduced Iron in blood. Volume overload is most likely the cause for palpitations. Even then it will require further investigation in order to avoid missing out any cardiac condition.
I would suggest you to get 12 Lead Electrocardiogram with long lead II and 2D Echocardiography in consultation with your Physician.
Analysis of laboratory investigation
1. Laboratory investigation reveal the following abnormality
1. Low Serum Iron level, Low ferritin (ferritin is storage form of Iron): These all suggest the possibility of Iron deficiency anemia. Iron deficiency anemia is less likely in individual with Illeostomy.
Serum Vitamin B12 is also in low normal range. It's quite common in individual with illeostomy.
You will require a thorough Hematology assessment
I would suggest you to get the following investigation done in consultation with your Physician
1. Complete Blood count
2. Peripheral smear to know the blood picture
3. Bone marrow biopsy: based on finding of peripheral smear you may require bone marrow biopsy.
4. Serum total protein and albumin level: Decreased albumin level or hypoalbuminemia has to be ruled out as the cause of leg swelling (water retention).
I would suggest you to get the above investigation done
At the same time you can plan Injectable Vitamin D , Vitamin B12 and Iron supplements in consultation with your Physician.
It would be helpful if you could provide me with clinical photograph of swelling over hand and chest for further assessment.
Do get back to me if you need any further assistance, will be glad to assist you.
Take care
Best Regards
Dr Deepak Kishore
MBBS, MS, MCH
Consultant Surgeon
Iron deficiency and Vitamin D deficiency
Detailed Answer:
Hi
Welcome to Healthcare-Magic
Greetings of the day
Dear Ms XXXXXXX
Being experienced in management of Crohn' s disease I would like to take up your question.
Let's go step by step analysing your symptoms and investigation
1 . Smelly mucous and Blood from anus: Even though you have end illeostomy. The colon which is left intact inside the abdomen secretes the secretion which it normally secretes. This leads to accumulation of mucous. This retained mucous may cause inflammation of colon lead iron to bloody mucous discharge from anus.
Solution: Thorough evacuation of colonic contents either by using Enema or using catheter washes through the colonic opening in abdomen. This will take care of retained secretion.
2. Lesion over the gums: lesion over the gum is of very short duration and very small for it to have any significance.
3. Low back pain/pelvic pain: Individual with Illeostomy have decreased calcium absorption because of diversion of stool contents. This leads to Illeostomy induced bone disease ( Osteoporosis) which could explain your Back ache. Laboratory investigation clearly reveal low Vitamin D level which substantiate the possibility of bone disease due to Vitamin Deficiency induced.
Solution: Confirmation of bone density by using Bone densitometer
You may require Injectable Vitamin D injection in consultation with your Physician
4. Palpitations and night sweat : As your Thyroid profile is normal it's unlikely to be due to Hyperthyroidism.
These could most likely be due to Iron deficiency anemia, which produces volume overload in circulation to compensate for reduced Iron in blood. Volume overload is most likely the cause for palpitations. Even then it will require further investigation in order to avoid missing out any cardiac condition.
I would suggest you to get 12 Lead Electrocardiogram with long lead II and 2D Echocardiography in consultation with your Physician.
Analysis of laboratory investigation
1. Laboratory investigation reveal the following abnormality
1. Low Serum Iron level, Low ferritin (ferritin is storage form of Iron): These all suggest the possibility of Iron deficiency anemia. Iron deficiency anemia is less likely in individual with Illeostomy.
Serum Vitamin B12 is also in low normal range. It's quite common in individual with illeostomy.
You will require a thorough Hematology assessment
I would suggest you to get the following investigation done in consultation with your Physician
1. Complete Blood count
2. Peripheral smear to know the blood picture
3. Bone marrow biopsy: based on finding of peripheral smear you may require bone marrow biopsy.
4. Serum total protein and albumin level: Decreased albumin level or hypoalbuminemia has to be ruled out as the cause of leg swelling (water retention).
I would suggest you to get the above investigation done
At the same time you can plan Injectable Vitamin D , Vitamin B12 and Iron supplements in consultation with your Physician.
It would be helpful if you could provide me with clinical photograph of swelling over hand and chest for further assessment.
Do get back to me if you need any further assistance, will be glad to assist you.
Take care
Best Regards
Dr Deepak Kishore
MBBS, MS, MCH
Consultant Surgeon
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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