Hi
First of all let me begin by asking you a few questions.
I suppose you got a Lower GI endoscopy done recently - why was it done?
I presume it is only clear discharge or it is blood tinged at times? Is there associated pain?
Also important is your sexual history.
To elaborate further let me proceed point wise :
1. In case you are getting only clear discharge from anus and is not associated with pain or itching:
Most probably it might be inflammation of wall of the rectum also known as proctitis.
At your age I do not think of the probability of anal sphincter incontinence unless someone very frequently practises anal sexual intercourse. Anal sphincter incontinence usually occurs in the elderly.
Also Sexually Transmitted Diseases ( STD) and Inflammatory bowel disease ( IBD ) may cause such problems. In case of IBD you also need to know if you have family history of IBD .
2. If the discharge is mixed with pus then it indicates infection. In that case you might get itching as well.
3. But if you get pain and blood streaked discharge then you shall have to rule out Haemmorhoids, anal fissure and anal fistula.
Haemmorhoid commonly known as piles may or may not be painful depending upon whether it is external or XXXXXXX haemmorhoid. In this case bleeding per rectum is usually associated with defecation.
Anal fissure causes severe pain and minimal blood on toilet paper after defecation.

Investigations suggested:
1. Complete blood count ( To look for leucocytosis and raised ESR in case of infection. Also it would show any drop in haemoglobin provided you have rectal bleeding as well )
2. Rectal swab culture
3. Stool for clostridium difficile toxin and stool for culture and sensitivity
4. STD screening tests including VDRL test.

However for proper evaluation you would need a per rectal examination . Then the doctor has to see the detailed report of endoscopy . Following that he might want to repeat an anoscopy or procto-sigmoidoscopy . For detailed clinical evaluation, I would suggest you to get in touch with a Surgeon.

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Hi
Thank you so much for the valuable information on your endoscopy.
See the endoscopy that has been done is Upper Gastro -Intestinal Endoscopy and it visualises oesophagus to proximal duodenum. But the present complaints that you are mentioning are of the lower gastro - intestinal tract for which you might need to an anoscopy or procto-sigmoidoscopy which is a lower gatro-intestinal endoscopy.
Anal fissure requires early management as it might lead to an anal fistula .
Anal fissures are superficial tears in the anal canal and usually respond to conservative management . Anal fistulas on the other hand are are tracts formed through the fissure from the anal canal to skin and often requires surgery.
Do not worry it is not body expelling fat.
Suggestions:
1. Stool softeners.
2. High fibre diet .
3. Sitz bath twice daily (especially after motion ): Sitting on a tub of warm saline water for 15 minutes. Your anal region should be inside the water.
4. Local anaesthetic ointments for pain and local steroid ointments to reduce inflammation usually helps.

I am so sorry to hear about the issues you are facing in your personal life.
You must be completely stressed out and me tell you that stress can aggravate any health issue including the one that you are facing.
Do get back in case of any further that you might have.

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Thank you too.

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