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What Causes Yellowish Oily Rectal Discharge With Strange Odour?

Posted on Mon, 4 Jan 2016

Question: My husband has been having a yellowish, oily ,smelly discharge from the rectum for a while and it has been bad for the last 2 days. He has dropped from 133lbs. to 128lbs. in one week. The other dioctors he has seen don't seem to know the cause.

Answered by Dr. Rakesh Madhyastha (44 minutes later)

Brief Answer:
Needs urgent evaluation

Detailed Answer:
Hello

Thanks for the query

In order to help you I need a few more details

1. is the discharge associated with stools or discharge flows even while not passing stools ?
2. does it pain while passing stools?
3. any bleeding as well?
4. was a per rectal examination done ?
5. was any investigation sent

Please get back to me , I am awaiting your reply

Regards

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Rakesh Madhyastha (3 hours later)

There is no pain or bleeding. He had a colonoscopy about 3 months ago and they found nothing. They have run a complete blood panel and found nothing. Even the doctors at the Proton Center where he had his treatment for prostate cancer have no idea. His endocrinologist, he's diabetic, has no idea and doesn't know why he even has a sugar problem. He has none of the usual indications, he is definitely not over weight, no high blood pressure and no high cholesterol. we just can't figure out what this is or how to treat it.

Answered by Dr. Rakesh Madhyastha (20 hours later)

Brief Answer:
Treat with antibiotics

Detailed Answer:
Hello

Thanks for getting back. I am sorry for the short delay in my reply, I was on call at my hospital. From the history you have furnished it could be the following to possibilities

1. An abscess which is continuously draining.
2. fecal incontinence

I would still consider my first differential diagnosis to be most probable as fecal incontince can be detected easily by the content of it. This is how you should go about it

1. Culture of the discharge
2. Microscopic evalation of the discharge.
3. Emperically treat with broad spectrum antibiotics like Amox with clavulanate for 5 days and see for improvement
4. If there is no improvement then I suggest undergoing a contrast enhanced CT to look for any abnormality in the abdomen

I hope I was of help, if you have any further query please get back to me

Regards

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Rakesh Madhyastha (21 hours later)

Thank you, I will talk to his doctor about doing a culture on the discharge and maybe then we can get some sort of answer.

Answered by Dr. Rakesh Madhyastha (3 hours later)

Brief Answer:
Culture will yield answers

Detailed Answer:
Hello

I am happy about your decision. Please speak to your doctor about my suggestion, also get back to me about his thoughts.
May I remind you that you must send for culture and microscopy, not just culute

Regards

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Above answer was peer-reviewed by : Dr. Raju A.T