ASK DOC: There’s mucus in my stool. Is this normal?

Dr Flo, I constantly have mucus coming out after a long call or short call and involuntarily at any other time. Sometimes I have mucus instead of stool. Most times the mucus is clear, but sometimes, it is yellow. I have been put on amoeba medication several times but nothing changes. I read about irritable bowel syndrome and I wonder if that’s what I’m suffering from. Please help me.

Mabea.

Dear Mabea,

A small amount of mucus in stool are normal. However, having large amounts that are visible regularly, or are accompanied by other symptoms like pain, bleeding, diarrhoea or constipation is an indication of an underlying problem.

It could mean that you have an intestinal infection, Crohn's disease or ulcerative colitis, malabsorption of food, food allergies, cystic fibrosis, irritable bowel syndrome, anal fissures (tears), anal fistula, or even colorectal cancer. Dehydration and constipation can also increase the mucus found in stool.

You need to visit a doctor, so that the underlying problem can be identified and treated. This may require a physical exam, a stool analysis and culture, blood tests, endoscopy and colonoscopy (where a small tube with a video camera at the end is passed into your gastrointestinal system from your mouth and from your anus respectively), or other imaging tests like X-ray, ultrasound, CT scan or MRI scan.

Apart from treating the underlying problem, you should also take adequate amounts of water and roughage, avoid acidic and spicy foods to reduce inflammation, and take probiotics.

If you are found to have irritable bowel syndrome (IBS), you will need to manage it, since it is a chronic condition with no known cause, and no known cure.

The symptoms include abdominal pain, bloating, either or both diarrhoea and constipation, mucuc in stool, indigestion and poor appetite. The symptoms come and go, and may be triggered by particular foods or by stress or anxiety.

The symptoms can be managed through a balanced diet, taking adequate amounts of fluids and roughage, avoiding spicy and acidic foods, limiting intake of caffeine, stopping smoking, and managing stress. If there are any specific foods that trigger the symptoms e.g. dairy products, wheat, etc, avoid them.

Medication can be given to manage the symptoms. Sometimes anti-anxiety medications and/or anti-depressants are also prescribed.

Dr Flo, I gave birth to twin boys three years ago (vaginal birth). I was not stitched up since the midwives said the tear was small, but the father of my kids says that my vagina is loose. What can I do to make it smaller?

Monica

Dear Monica,

Most of the changes in a woman’s body after childbirth resolve on their own within six months or so. However, in some women, the vagina may continue to feel loose, with reduced sensation, which reduces sexual satisfaction for both partners.

This can happen due to advanced age, multiple vaginal deliveries and injury or tears to tissues during delivery.
Pelvic floor (kegel) exercises to strengthen the pelvic muscles around the vagina help to reduce the feeling of looseness and can help with sexual satisfaction. To do them, contract your pelvic muscles as though you are stopping urine from coming out. Do it quickly 10 times, then slowly, tightening the muscles for about 10 seconds before releasing, and repeat 10 times. Repeat this exercise four to six times a day.

There is also the option of radio-frequency (RF) treatment or vaginoplasty, which is surgery to help tighten the vaginal tissues.

Dr Flo, I need urgent help. Where and how can atrophic vaginitis be reversed?

Wambui

Dear Wambui,

Atrophic vaginitis is also known as vaginal atrophy or genitourinary syndrome of menopause (GSM). It refers to the thinning, drying and inflammation of the vaginal walls due to reduced amounts of oestrogen in the body. There can also be atrophy within the urinary system.

Most commonly, this occurs after menopause. It can also happen in the years leading up to menopause, or after surgical removal of the ovaries, after pelvic radiotherapy or chemotherapy for cancer, or as a side effect of breast cancer hormone treatment. There may also be a drop in oestrogen levels during breastfeeding.

Factors that may increase the risk of developing atrophic vaginitis include smoking, lack of sexual activity and no history of vaginal births.

Symptoms include vaginal dryness, burning, discharge, itching, discomfort and/or bleeding during intercourse, reduced lubrication, shortening and tightening of the vagina, discomfort and urgency of passing urine, frequent urinary tract infections, or urinary incontinence.

Tests may include a pelvic exam to check the pelvic organs, urine test, hormone test and a Pap smear test.

You can manage the symptoms by using a water-based personal lubricant like KY jelly during intercourse, using a vaginal moisturiser such as Replens, using a vaginal oestrogen cream, ring or tablet. You may also get hormone replacement therapy, that is, oestrogen tablets, usually prescribed by a gynaecologist.

Also wear cotton underwear and loose-fitting clothes.

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