Vaginal discharge: What's normal and what's not?

Doc, how do I differentiate between normal and abnormal vaginal discharge?
Molly

Dear Molly,
It is normal for all women after puberty to have a vaginal discharge. 
It is a mixture of fluid and cells that help to keep the vagina clean and moist and to prevent infection. The appearance changes depending on the menstrual cycle and can also be affected by exercise, stress, use of hormonal medication and sexual arousal.

The discharge may vary from white to clear, and from watery to thick, at different times of the cycle. It is also normal to have a brown or bloody discharge just before, during or after your periods, or sometimes in between your periods (spotting).

If there is abnormal colour (yellow, green, sometimes white), itching, a foul smell, or thick, chunky discharge, then most likely there is a vaginal infection. The infection may be caused by fungi, bacteria or other organisms.

To know the actual cause of the abnormal discharge, and sometimes to differentiate it from a normal discharge, a sample of the discharge may be taken and examined. If any infection is found, then it will be treated. Sometimes the doctor may also request for a urine test as well.

Dear Doc,
My husband has this lump on his left breast which until recently didn’t cause any pain. Apart from that, a few days ago some watery stuff started coming from this breast. He’s embarrassed to talk about it considering the part of the body involved. Could this be breast cancer?
Beatrice

Dear Beatrice,
A lump in the breast could be due to cancer or a non-cancerous growth. 
The only way to know for sure is to have a scan done and a sample of the lump taken for examination (biopsy). The earlier the diagnosis is made, the better so that the right treatment can be started. Men can also get breast cancer.

Dear Doc,
My wife gave birth two months ago but still the moodiness she experienced during the pregnancy is still on. Might she be having a mental problem?
Jimmy

Dear Jimmy,
During pregnancy, moodiness occurs because of the hormonal changes, fatigue, sleep disturbances, anxiety, physical discomfort,  nausea and vomiting. After delivery, the sudden hormone changes, the physical and psychological stress of pregnancy and delivery, the demands of caring for a new born, lack of adequate sleep, fatigue and the stress of establishing breastfeeding can cause post-partum blues. 

The mother may have mood swings – switching from feeling happy to feeling sad. She may also be irritable, restless, anxious, impatient, cry a lot or feel lonely. Many women experience this and it passes after several weeks with good food, adequate rest, appropriate exercise, interaction with and support from others.

However, for some women, the feelings of sadness and hopelessness continue and worsen, leading to post-partum depression. With post-partum depression, the mother feels sad, unworthy, guilty, and may have reduced concentration and loss of memory, and may have thoughts of harming herself or harming the baby, and these feelings affect her ability to carry out daily activities. This can start soon after the baby is born or months later. Treatment may be through psychotherapy, medication or both.

I keep having a lot of acid in my stomach, which makes me feel a burning sort of pain, and I burp a lot. I was told I have H.pylori infection, which was treated, and I got relieved for some time then the symptoms were back. How can I get rid of this once and for all?
Muli

Dear Muli,
Hyperacidity occurs because of irritation or inflammation of the lining of the stomach and the lower part of the oesophagus, caused by excessive stomach acid and digestive enzymes. The inflammation may be worsened by having an infection in the stomach, like H.pylori, but not everyone who has hyperacidity has H.pylori infection. If the irritation continues, it can lead to a break in the lining of the stomach, forming a wound or sore, which is called an ulcer. This can also occur in the lower part of the oesophagus (the food pipe) or in the first part of the small intestines (duodenum).

This causes abdominal pain, chest pain, loss of appetite, nausea and vomiting, poor digestion, bloating, and when severe, it can lead to weight loss, dark or bloody stools, severe pain and vomiting blood.

There are some tests that may be done for you when you have this problem, especially if it keeps coming back. These include stool tests, barium tests and endoscopy. For treatment, you will be given medication to reduce the amount of acid your stomach makes, medicine to neutralise the acid, medicines to protect the lining of the stomach, medicine to control reflux and pain medication. You may need to be on this medicine for a long time.

In some people, the disease may take long to treat or may keep coming back. This may be because your stomach continues to produce a lot of acid, either because of genetics or because it is triggered by stress or anxiety.

It may also be due to having other problems like inflammatory bowel disease, other infections, liver or kidney disease, or even stomach cancer.

To reduce or prevent the symptoms, avoid alcohol and smoking; some painkillers like ibuprofen, aspirin, diclofenac and also long term use of steroids. Do not skip any meals, avoid spicy foods, chilli, very fatty foods, sodas, black tea and coffee, or very concentrated tea and coffee, and other foods and drinks that are acidic.

Every person who has the disease has different foods that trigger the symptoms. You can keep a food diary and see if you can match which foods and drinks trigger the symptoms. In the long run, the purpose of treatment is to relieve the symptoms so that you can be able to eat what you would like.
 

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