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Thick brown discharge. Have polyps, fibroid, PCOD, IBS. What could be the cause of the brown discharge?

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Practicing since : 1999
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I am very distressed at present, as I have a number of issues occuring. I am a 41 year old, and am awaiting a hysteroscopic D&C as I have a small polyp and a small fibroid. I also have polycystic ovaries. Recently I have been having brown discharge (only when I wipe myself mainly), period like pains and this past week, the onset of a very sore, red, itchy vagina. I had been treating this with thrush treatments, but the soreness of my vagina continues. What is really frightening me now, is that twice during a bowel movement (quite loose stools also) I have had a thick, brown discharge when I wipe at the front. I am very, very scared that this is a seperate issue - like a fistula - and is unconnected to my gynaecological problems. I am actually due to start my next period in 3 days time. Could this possibly be connected to the brown discharge I have had before, and the current irregular discharge I have been having? I must also add that I have not had children, or any kind of vaginal trauma to explain a possible fistula. I do suffer from Irritable bowel Syndrome which may explain the diarrhoea, but it is the brown discharge that disturbs me most. Any help is very appreciated. I am very scared.
Posted Tue, 23 Apr 2013 in Vaginal and Uterus Health
Answered by Dr. Timothy Raichle 45 minutes later
Hello, I would be happy to help you with your question.

First of all, I appreciate your concerns, as it seems as though everything is "hitting the fan" at once. Let me summarize your complaints:

1. You have been identified as having polyps and a submucous fibroid
2. You have a new brownish discharge
3. Pelvic cramping this week
4. Vaginal redness (erythema) and soreness
5. Brownish discharge seems worse with bowel movements
6.. You have a history of IBS

First of all, without ever having had children before, the chance of a recto-vaginal fistula is virtually zero! Get this out of your thought process. Also, polyps and fibroid within the uterine lining (especially around the time of your period) can be associated with bleeding, which can make its way out as a brownish discharge! So this can all be confusing, but if I were to summarize what I think is going on, it would go like:

1. You have abnormal discharge and bleeding that is exacerbated by what is in your uterus - and there is a plan to remedy this.
2. You do not have a fistula
3. You have a poorly treated vaginal infection (you probably need combined treatment for yeast and BV). BV is another common infection that you can discuss with your doctor. The treatment for BV is only prescription, thus the recommendation to call your doctor.

I hope that this helps. Please ask if you have any followup questions.
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Follow-up: Thick brown discharge. Have polyps, fibroid, PCOD, IBS. What could be the cause of the brown discharge? 22 minutes later
Oh Doctor, thank you so much. I am so frightened that a fistula would be an addition to all else that is occuring. I am a nurse myself, and I am driving myself crazy with picking diagnoses out of nowhere. I am very nervous of so much right now, including the GA I will need for the D&C that I am struggling to think straight. Your advice had helped me so much, and I do appreciate it. I have a long history of BV, and I suspected that this could be a possibility. It was just the brown discharge that has confused me, as the usual discharge I have had with BV is thick and fishy smelling, rather than brown, but I guess with all else that is going on this is feasable.

Thank you so much Sir.
Answered by Dr. Timothy Raichle 21 hours later
You can ask you doctor or the Anesthesiologist how comfortable they might be doing 'moderate conscious sedation', but in many cases, the hysteroscopy goes much better with you completely asleep.

BV sounds like a good possibility, especially given your history.

Good luck to you! Please remember to rate my answer / give feedback!
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