# Wet anus syndrome - uncommon term with no fixed definition =(



## moor_91

I did some searching for this term. Google has 10 results for the key words "wet anus syndrome"

Some of these are just weird... http://pregnancy.tre...id Leakage.html
mentions wet anus syndrome as a symptom of hemorrhoids. Looks like mentioned by a patient.

"natropathy digest" ... normally this kind of site not worth reading. While discussing prolapsing and non reducing hemorrhoids, it mentions wet anus syndrome:


> If the protrusion is constant (4th degree hemorrhoids) mucosal leakage and fecal soiling are more common (wet anus syndrome). This frequently causes persistent pruritus/itching as a common symptom.


mucosal leakage = mucous discharge or minor fecal incontinence manifesting as a leak of mucus? There is a slight difference because mucous discharge can refer to excessive mucus, but continence is not necessarily reduced.

fecal soiling can also mean many things, but usually means passive (as opposed to urge), minor FI of small amounts of liquid stool, leading to underwear staining but no solid incontinence. It also used with the term encopresis in children. Another definition of fecal soiling is "leakage after defecation but continence of flatus and liquids most of the time".

Itching/pruritus = pruritus ani
So according to natropathy digest, wet anus syndrome is mucous leak, fecal soiling and pruritus ani

2 hits are from a private Rectal clinic, self written by a surgeon. He mentions wet anus syndrome as side effect of traditional anal fissure surgery,


> The obvious side effect from this procedure is a condition called "wet anus syndrome" or anal leakage. This is a very annoying condition, which could and should be avoided.


so here, wet anus syndrome = anal leakage. Technically a syndrome has to be a group of symptoms and signs that occur together (i.e. more than one symptom/sign), otherwise it is not a syndrome, its just a symptom. Again a term that is used by different people to mean different things ... "anal leakage" can mean steatorrhea, keriorrhea, FI generally, fecal leakage (liquid FI), encopresis or rectal discharge.

later:


> there is an alternative to the typical "lateral internal sphincterotomy" and its attendant probability of some loss of proper anal sphincter function (wet anus syndrome)


so wet "anus syndrome" result of IAS dysfunction

A textbook, takling about anal ectropion (eversion) syndrome mentions wet anus syndrome, as postoperative complication of hemorrhoid surgery



> Anal ectropion defnes the abnormal position of anal mucosa into the anodermal junction or more distal into the perianal skin. Classically, it isseen after hemorrhoidectomy [...] later reports [...] had no ectropion using such technique [23]. General complaints include discomfort with seepage, pruritus, bleeding, pain, and occasionally, tenesmus. This gets translated into the ''wet anus''
> syndrome


so wet anus syndrome = discomfort, seepage, bleeding, pain, tenesmus (which is another word for discomfort and difficulty evacuating)

Hit which is poorly translated from chinese so ahrd to understand http://en.uuuwell.co...-1404737-1.html
but it essentially a discussion about rectal discahrge



> wet anus, accompanied by itching, mainly to leaking, and there are a variety of skin lesions


so here wet anus syndrome = pruritus ani, leaking

A paper mentions wet anus syndrome when describing surgical treatment of hemorrhoids


> ... to prevent mucosal ectropion and a "wet anus" syndrome


Most importantly, pubmed yields no results for "wet anus syndrome" just like you only get 35 environmental toxicity type papers from "leaky gas" and nothing about intestinal gas or anorectal conditions.

I feel now after this quick search that "wet anus syndrome" is a very uncommon phrase, and usually means the same as mucous discharge / "mucous incontinence". Others add minor liquid FI, itching, pain, bleeding and skin irritation, result of IAS dysfunction. I think we should avoid these terms and say what we actually mean

"I have leaky gas" means nothing,
better "I have reduced sensation for the passage of gas" (gas incontinence +/- rectal hyposensitivity) or "I have no control over gas" (gas incontinence), or "I am unaware of passing any gas, but a smell comes from my anus" (??? rectal odor/anal odor... call this what you like because there is no research discussing this problem so we need a proper term)

Same for "wet anus syndrome", better "I have mucous coming from my anus" (mucous discharge/"mucous incontience") or "my anus feels wet" (types of rectal discharge and liquid FI)

Same for "I have fecal body odor" where is odor coming from, your body or anus? Fecal odor* not *coming from anus might be bromhidrosis or blood borne body odor/halitosis like TMAU, or similar. If odor is coming from anus, better to just say this for clarity


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## Intothewild

Wet anus syndrome is a term coined by someone on this site. Its not recognised as an illness and theres no information on it, the closest being what you said, mucus discharge etc. Its a symptom rather than anything else. I suffer from it too, as i have already said, i think its to do with mucosal prolapse with me, the research ive done correlates that.​
What is your actual symptoms and what have you done about it? Also have you had any procedures to identify what the problem could be?​


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## moor_91

no i dont think coined here, has been used before...maybe difference of translation. Maybe mucous discharge/rectal discharge in another language could become "wet anus syndrome" into english

type "mucosal prolapse" into pubmed, you get data about somthing different about what we are talking about on this forum.








A is external, complete, full thickness, circumfrential prolapse. Most would call this external or complete rectal prolapse
B is external, partial thickness, segmental prolapse. Most would call this mucosal prolapse

If you say mucosal prolapse unqualified, doctors will think of B, something that looks like non reducing prolapsed hemorrhoids. That is, those doctors who don't believe that it is a different condition from hemorrhoids. We seem to be talking about an *internal*, mucosal prolapse. Nothing shows on the outside. The internal equivalent of A is internal rectal intussusception, again, nothing shows on the outside, which is why it goes undiagnosed maybe?

you asked about my situation, my symptoms-
rectal odor, gone for a variable time after bowel movement, sometimes only minutes without odor before it comes back, other times hours before it returns
incomplete evacuation
intermittent mucous discharge
feeling like rectum has fallen down onto anal canal
small area of burning/warm tingling sensation at level of belly button, superficially on front abdominal wall, and over to the left, probably over where sigmoid colon is
investigations-
sigmoidoscopy - small bleeding area in anal canal, probably internal hemorrhoid
manometry & endoanal ultrasound - resting pressure, rectal sensitivity and compliance within normal range, length over which IAS exerts pressure shortened, likely anismus
SIBO +ve
defecography= anismus + incomplete evac
what I am finding helps me:
strict low FODMAP diet - get no gas when I am strict on this diet
(psyllium) bulking agent - no D, no C. Easier to evacuate. Makes you drink lots of water, makes you eat 3 meals a day with no snacking
water enema, i use after i have got everything I can get out without straining. gets more stool out, but often leaking of fluid which also smells. Water enema will not "make the muscles lazy"... this only happens with long term overuse of stimulant laxatives like senna.
TENS/electrical stimulation of anal sphincter. EAS now feel much stronger & more chunky. Anal canal feels longer and tighter. No more "urge" FI, much stronger pelvic floor now. If I eat FODMAP foods, and there is gas, I get bloating again now, before TENS exercise was no bloating, gas leak out slowly. The fallen feeling of the rectum is also improved
Solesta worked for about 1-2 weeks, then swelling went down, odor came back. There was even no odor as I was really constipated after the painful operation. Normally if i had C odor would be terrible. Seal was temporarily improved, but then odor came back. Some fluid drained out (?infection ? solesta gel before it stabilized), discomfort gone.
The way I interpret my results is that I always had incomplete evacuation and bloating, but the seal could hold it for an hour or too at a time for class. Used to get embarrassed about the rumbling noise of holding gas in class, but better that than farting and everyone hear and smell it. Also used to strain for a long time to get as much out as possible. I think years of holding things in too long and straining too much when I did go, has caused damage to continence mechanism caused damage, maybe stretching of nerves with weakened IAS, maybe direct damage to mucosa like hemorrhoid or mucosal prolapse (although surgeon say defecography only show anismus, no intussusception). I was very convinced I had internal mucosal prolapse or internal rectal intussusception before this. I read a lot about obstructed defecation, and I would like to see the x ray myself, since some of the things might have been missed, like excessive s-shaped sigmoid, prominent internal rectal valves. Also they need to give barium meal to highlight the small bowel and show any enterocele, I didn't get this. Maybe that weird burning area is to do with a enterocele or sigmoidocele? Surgeon said to ignore it because it was likely irrelevent to main complaint of odor. Said it might be neuropathic pain (pain felt along the length of a nerve, possibly result of nerve damage). I could tell they hadn't done that x ray before, maybe the radiologist reporting it doesn't have experience of mucosal prolapse. I don't even know if defecography is best to diagnose mucosal prolapse. Maybe it needs to be diagnosed by an expert in obstructed defecation (http://www.obstructed-defaecation.com/ ) just by feeling the anal canal and rectum ... rather than a normal colorectal surgeon who hasn't studied this relatively modern stuff...

Can I ask how you know you have mucosal prolapse, or you feel it matches your symptoms?


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## Intothewild

The symptoms absolutely match. There has also been testimony of various people being diagnosed with or curing themselves of mucosal prolapse who have suffered the odor problem so that has led me to believe i have a mucosal prolapse. Ill just have to see if thats actually the case, i know there is something physically wrong though. its now up to me to get myself diagnosed and treated. The only way im gonna be able to do that is to go into the surgeon armed with all the stuff ive learned and maybe try and push something through(pardon the pun). We need to keep at it. the seal in my opinion isnt the problem for me. Why do i think that? Well two reasons. One because i dont smell like i have gas incontinence, i smell like ive shat myself sometimes which is a huge difference more like hot #### than gas. Two, i watched an episode of embarrasing bodies on tv a few months ago and there was a guy whos anus was so lax that he would often #### himself, whenever he felt the need for the toilet he would have to get himself there within seconds or he would #### himself. The doctors were saying that the seal was exteremely weak and lax. He never complained of smelling like #### on a regular basis. He said the only embarrasment for him was when he was caught short and would have an accident in a public place. I think since we all have variations in our bowel movements etc that you can assume he had diarehaa, stomach problems on at least a few occassions but no he never complained of an odor. This leads me to believe that its the physical defect thats causing this for me anyways, There is obviously other ways that odor can manifest itself, bloodborne etc have you ruled that out?


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## moor_91

Intothewild said:


> The symptoms absolutely match. There has also been testimony of various people being diagnosed with or curing themselves of mucosal prolapse who have suffered the odor problem so that has led me to believe i have a mucosal prolapse. Ill just have to see if thats actually the case,


this is true that a few people reported rectal odor being caused by (presumably internal) mucosal prolapse and odor resolved by surgery for mucosal prolapse like rectopexy. However, there are many, many causes of odorous rectal discharge



> the seal in my opinion isn't the problem for me. Why do i think that? Well two reasons. One because i dont smell like i have gas incontinence, i smell like ive shat myself sometimes which is a huge difference more like hot #### than gas. Two, i watched an episode of embarrasing bodies on tv a few months ago and there was a guy whos anus was so lax that he would often #### himself, whenever he felt the need for the toilet he would have to get himself there within seconds or he would #### himself. The doctors were saying that the seal was exteremely weak and lax. He never complained of smelling like #### on a regular basis. He said the only embarrasment for him was when he was caught short and would have an accident in a public place. [...] but no he never complained of an odor.


I know, this is surprising that FI patients even with incontinence to solids not always complain about odor. Makes me conclude that other factors increase the odor of flatus and feces in some persons:
Variations in the gut microbiota, with a tendency towards greater production sulfides, maybe more sulfate reducing bacteria
transit time, and "reservoir stagnation" in the rectum and distal sigmoid, longer time stool spends inside, the more time for bacterial fermentation, more VSC release, worse odor
dietary factors, mainly sulfur compound/thiol intake. More sulfur available for bacteria to convert to VSC
I think there may be other reasons, but these are the obvious that I can think of.

Really important point you mention when people say "smells like feces" instead of "did someone fart?" etc. Stronger smell from some open feces in the room compared to someone just passing gas...this is more transient. However, this is not really proof that the seal is not the problem. There are 2 different concepts here:
fecal incontinence (mostly seal problems) and

obstructed defecation/incomplete evacuation.
Conditions can cause* both FI and obstructed defecation/incomplete evacuation*, (rectal prolapse conditions are examples) and this is where the odor is likely to be bad. Not only is mucus leaking out (seal compromised) but there is a reservoir stagnation of stool in the rectum. Do you follow? When both problems combined, odor is much worse than FI or obstructed defecation/incomplete evac alone.


> There is obviously other ways that odor can manifest itself, bloodborne etc have you ruled that out?


 I take the way that odor was cured temporarily by solesta as proof that odor is coming from anus. I had fecal halitosis long before this, which was superimposed on my general odor. Ppl used to say "his breath smells like ######". I also notice now that it takes longer for people to detect me, where as before as soon as I opened my mouth or spoke they would reel back. This was due to tonsil stones, after tonsils removed, breath was fine (as long as not on any meds which cause dry mouth). Sweat smells like normal sweat. Urine doesn't smell. I don't think I have blood borne body odor/halitosis


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## NoFuture

Wet Anus Syndrome is an illness. Information about it is very difficult to find, but this doesn't mean that is not an illness.

Symptoms WAS:

- Rectal mucosa inflammation. Almost impossible to check by a doctor (ocular test)​- Almost constant fluid discharge. Exacerbate because of movements or certain positions​- Rectal odor. Partial gas incontinence. This is not a must​- Incomplete evacuation sometimes. This is not a must​- Diffuse pain in the rectal area or on the buttocks. This not a must​
Possible causes WAS:

- Hemorrhoid surgery​- Reduction tonus anal sphincter​- Allergy​- Long term straining. Constipation​- Other causes not official known​
Treatment WAS:

- Medicament with antiinflamator and astringend properties. Vitamin E, suppositories Hamamelis + Vitamin E, mesalazine...​
The next step to this illness would be Mucosal Prolapse Syndrome. When some parts of the mucosa which is with inflammation prolpase. (something similar to hemorrhoids.


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## moor_91

NoFuture said:


> Symptoms WAS:
> 
> - Rectal mucosa inflammation. Almost impossible to check by a doctor (ocular test)​- Almost constant fluid discharge. Exacerbate because of movements or certain positions​- Rectal odor. Partial gas incontinence. This is not a must​- Incomplete evacuation sometimes. This is not a must​- Diffuse pain in the rectal area or on the buttocks. This not a must​


TY for clarifying what you mean by wet anus syndrome.

All but one of these points were mentioned by some of the sources i found on google, except one adds pruritus (itching).



> Rectal odor. Partial gas incontinence. This is not a must


If you have found a source referring to rectal odor directly, I would be very interested to read it. Or this aspect is constructed from your own experience?


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## NoFuture

moor_91 said:


> TY for clarifying what you mean by wet anus syndrome.
> 
> All but one of these points were mentioned by some of the sources i found on google, except one adds pruritus (itching).
> 
> If you have found a source referring to rectal odor directly, I would be very interested to read it. Or this aspect is constructed from your own experience?


It depends which source do you use, I usually look for results in google in 4 different languages when I really need a information. The results obtained are so much bigger. I have found documents where WAS is mentioned as an illness (not in english) and other ones where is mention as only a symptom.

Usually it should be a symptom of a mucosal prolapse syndrome (or other diseases). When the mucosa is with inflammation but there are no parts in prolapse, all the symptoms that this inflammation of the mucosa produce are known as WAS, but not every doctor will reconize it.

The rectal odor is not a direct symptom of WAS or MPS or any problme with the mucosa. But, when the mucosa has a problem like these diseases the elevator ani muscles: PUBOCOCCYGEUS and ILEOCOCYGEUS may descend. This muscles are responsible of the ano rectal angle. When this descens happens,the ano rectal angle increase making easier odors and gases going out and producing the feeling of incomplete evacuation (it´s not only a feeling, sometimes rest of materia fecal are kept in this zone, where in normal conditions should be nothing kept after a bowel movement). The fluid discharge of the inflammation makes even more difficult the odor and gases continence.

That is the main reason of doing the famous Hipopressive Abdominals. With this exercises the elevator ani muscles come back to his normal position or even better making the close between ano and rectum better, permitting feeling the gases before they are in a no return point and helping to avoid the odors going out.


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