Unusual Mucous Discharge

[pipermcgee]

I'm a 50 year old female who was diagnosed with very mild Crohn's disease at age 38.  Thankfully I have long periods of remission.  I also have type 2 diabetes treated with metformin, diet, and exercise. In May of 2004 I started to notice an unusual discharge with my stool.  I've noticed a pale yellow cylindrical object about one to one and a half inches long, the girth like that of an average woman's middle finger.  The outside is tough and resist pressure, but the inside is bright white and very soft.  There's usually more than one of these foreign bodies, and they typically are not imbedded in fecal matter.  I notice them most when I have diarrhea. They are present, on average, two or three days each month. Previous to this, my Crohn's has affected the last 20cm of my colon, and is evident by blood clots and some white mucous, and severe cramping very low in my abdomen.  My last colonoscopy in 2003 was negative.  I had problems last summer with severe pain underneath the sternum, lightheadedness, nausea,and loss of appetite.  (Very unusual for me - I'm obese, not much can keep me from food!)  A HIDA scan of the gallbladder, barium x-ray of the upper GI and small bowel, and a stress test/cardiac ultrasound revealed no abnormalities.  Every three months I have blood drawn to check cholesteral levels (all three), kidney and liver function, as well as A1C levels, as part of my diabetes monitoring.  Other than slightly elevated cholesteral and an A1C level of 7.3, everything else is normal.  I'm scheduled for a colonoscopy in July 2005.  I'm stymied as to what this discharge is, it's cause, and if it could be related to Crohn's disease.  As stange as it sounds, I have photographed these objects to take to my doctor this summer.  I'm perplexed, curious, and a bit worried.  Any help you can give me would be much appreciated.  For you time and consideration in this matter I offer my sincere thanks.

[Kevin Pho, MD]

Tough to say what it is without looking at it.  Mucous certainly leads the list of possibilities.  This can be a result from the Crohn's disease, or may be due to fat malabsorption syndrome.  

The colonoscopy is a reasonable study to evaluate what the discharge is.  You can also consider fecal fat tests to evaluate for malabsorption as well as blood tests looking for celiac disease.

Discussing these options with your personal physician or gastroenterologist is recommended.

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.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[surgeon]

It indeed sounds like mucus, which can become inspissated (dehydrated) and solid. Crohn's is certainly a possible cause, as are infections, other inflammatory conditions,  polyps or other tumors (not too likely to have appeared since your last colonoscopy, but not impossible.) Mucus mostly comes from the colon. I'd suggest letting your gastroenterologist know about it.

[nurse555]

A related discussion, hemorrhoids or more serious was started.

[Al86]

A related discussion, possible causes for clear odorless colonic mucous discharge was started.