mucous and discharge

I am currently experiencing a lot of IBS symptoms (chronic constipation that results in diarhea (diarrhea), gut rumbling, lots of gas, cramping, and anxiety).  I had a diagnosis several months ago and was told to watch what I eat.  About two years ago I had a flexible sigmoidoscopy and barium enema.  The doctor found a few internal hemorrhoids but other than that everything seemed fine.  I suffer from IBS-constipation.  Over the last six months I have experienced a lot of mucous in my stool and when passing large amounts of gas.  More troubling to me, I have a discharge of nearly clear, odorless fluid after a bowel movement or after passing lots of gas.  There is enough discharge to leave a water spot the size of a plum.  Sometimes the discharge will last for 20 minutes after I have the bm.  Is this normal for IBS or internal hemorrhoids?

[Kevin Pho, MD]

I cannot be sure what the discharge is.  It may be a manifestation of malabsorption - in which case further tests with fecal fat tests or workup for celiac disease may be considered.

Irritable bowel syndrome is associated with increased gas and bloating - which may partially explain your symptoms.  

If you had a sigmoidoscopy two years ago and you continue to have symptoms, I would consider a full colonoscopy to better evaluate for diseases such as inflammatory bowel disease.

If the cause is truly determined to be constipation-predominant IBS (and if you are female), you may want to consider a trial of Zelnorm - which is used specifically in these cases.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[spikew]

I take dialantin & phenobarbital. I have done so for the last 35 years. Recently, after a blood level check, my levels were almost non exsistant. so the doctor checked my other medication levels and they were also lower than they should have been. my doctor said i had a hungry liver??? ive also noticed that when i have a movement, that occasionally its white and brown with discharge.  i wonder if the two are related? any comments would be appreciated.