Discomfort Around My Anus: Swelling and White Spot
I’m a 25-year-old female currently taking Isotretinoin at a dosage of 50 mg each day, in addition to iron and omega-3 supplements. Some relevant background: I’m not sexually active and was diagnosed with HSV-2 a few years back, but I rarely experience outbreaks, which typically occur on my clitoris. Two weeks ago, I had a sore that has since healed, which I suspect was triggered by stress or an increase in my isotretinoin dosage. Currently, I’m experiencing discomfort in my anal area, especially when passing stool. The soreness has also persisted while sitting and walking. Upon inspection, I noticed an inflamed fold with a white spot located inside my anus; it required some pushing to get a clear view. Should I be worried about this? What might it be, and is there anything I can do to alleviate the pain, or should I leave it be? Thanks for any insights you can provide!
Answers (1)
3/22/2025, 12:50:41 AM
OpenHealth AI
It's understandable to feel concerned about discomfort and unusual findings in such a sensitive area, especially while on medications like isotretinoin and having a history of HSV-2. The symptoms you describe—discomfort, inflammation, and a white spot—could be due to several non-serious conditions, but it’s important to monitor the situation carefully.
Explanation
- Causes: The symptoms you're experiencing may be related to:
- Hemorrhoids: Swollen blood vessels around the anus can cause pain and discomfort, especially when passing stool.
- Anal Fissures: Small tears in the lining of the anus can occur due to strain during bowel movements, leading to pain and some bleeding.
- Skin Irritation: The use of isotretinoin, which can dry out the skin and mucous membranes, may make you more prone to irritations and infections.
- Infection or Cysts: The white spot could potentially be a small cyst or a sign of infection, especially given your history of HSV.
Next Steps
To address your discomfort effectively, here are some prioritized steps you can take:
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Gentle Hygiene: Keep the area clean and dry. Use warm water to gently cleanse the area after bowel movements, avoiding soaps that may irritate. Pat dry with a soft towel.
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Pain Relief: Over-the-counter pain relief medications like ibuprofen or acetaminophen can help alleviate discomfort. Additionally, topical treatments may soothe inflammation. Look for creams or ointments designed for anal discomfort or hemorrhoids.
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Diet and Hydration: Ensure you're drinking plenty of water and consuming a high-fiber diet to prevent constipation. This will help reduce strain during bowel movements, which can worsen pain or irritation.
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Avoid Straining: If you’re experiencing constipation, consider using fiber supplements or gentle stool softeners to help ease the passage of stool without straining.
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Monitor Symptoms: Keep an eye on the spot and any changes in your symptoms. If you notice increased pain, bleeding, or any new symptoms, it would be beneficial to seek medical advice.
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Consider Stress Management: Since you suspect that stress might have triggered your initial sore, consider techniques such as deep breathing, meditation, or gentle exercise to help manage stress.
If symptoms persist for more than a week, worsen, or if you have significant pain or bleeding, please seek medical advice promptly. It's important to prioritize your health and comfort, especially in sensitive areas. Let me know if you have any more questions or need further clarification!
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - 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7 Months Old) - **Weight:** 9 kg (good growth rate in spite of condition) - **Jaundice:** Continues to be present (yellow skin) - **Stools:** Remain pale/clay-colored - **Development:** Achieving appropriate milestones - **Energy:** Appears to have a good energy level - **Feeding:** Normal appetite --- ## QUESTIONS FOR r/AskDocs We have been informed this is **Type 2 Abernethy malformation** (portal vein present). **Three treatment avenues have been proposed:** ### Option 1: **Endovascular Coil Embolization** (minimally invasive approach) - A catheter is inserted via the leg vein to access the shunt and deploy coils/plugs to close the abnormal vessels - Pros: No surgical incision, minimal discomfort, short hospital stay (2-4 days), no scars, enhanced safety - Duration: 1-2 hours - Recovery: 2-4 weeks for jaundice to show improvement ### Option 2: **Open Surgical Intervention** - An incision in the abdomen to ligate abnormal vessels and redirect blood to the liver - Pros: Direct visualization, effective results - Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.