Hi. Thanks for your query. Noted the history and understood your concerns. Multiple problems of different specialities like Ovarian endometrioma that vanished, pile to start with but gradually slimy brown discharge from rectum, spasms due to MIrena and so on indicate a proper clinical evaluation by a Gastroenterologist or a Gastro surgeon by the following ways: First of all get a proper per-rectal digital examination, ano-proctoscopy so that the grade of pile and any rectal polyp or sulcer or proctitis can be known, to be followed by a colonoscopy and biopsy to know the primary cause so that a proper management can be done. Tests of stool and blood do help a lot in proper diagnosis. If there is any infection or so, get a course of an antibiotic and metronidazole along with probiotics. Sitz bath in a tub with warm water ives soothing of the anal region. Laxatives helps in smooth passage of soft stools. Avoid the foods and beverages that increase the problems. Gynecologist;s opinion will help further for the Gyne issues. CT scan of the whole abdomen does help. Further management will be as per the reports and clinical evaluation.