Embarrassment Over Bowel Habits Linked to Serious Health Conditions

Teen magazine advice on “how to secretly have a poo without your boyfriend knowing” significantly influenced Jen Moore. She mentioned that one piece of advice even recommended using an over-the-counter drug to avoid needing to defecate during an overnight stay with a partner. The 35-year-old recently recognized she had incorporated some of these practices, but this self-consciousness had concealed a significant medical problem. Early in her relationship with her husband, she would postpone defecating until he had left the residence, or if he was on an upper floor, she “would run the taps.” She stated, “I have such a visceral memory of reading this article and I obviously internalised it and hadn’t even realised until fairly recently.” Last year, she was “forced to be open about something I had kept to myself for years” following an episode of rectal bleeding. This marked the initial instance she discussed the problem with her husband, Chris, despite their relationship spanning almost 15 years. Four months subsequent to undergoing excision surgery for endometriosis and a hysterectomy for adenomyosis, she feared the bleeding indicated delayed complications. However, a subsequent, unrelated MRI scan verified the presence of deep endometriosis affecting her bowel. The women’s health advocate, who hails from Swansea but now resides in Cambridge, commented, “I talk about my body parts and periods online all the time, I didn’t think I had taboos about my body. But there it was.” She chuckled as she remembered her medical records stating that she “is known for constipation.” She elaborated, “I have been constipated for as long as I can remember, there were occasions where I would go once a week.” She added, “In fact, I thought if people were in the bathroom really regularly there was something wrong with them – I was raised in the generation where girls are told they fart glitter and rainbows.” While embarrassment may have prevented Jen from disclosing her condition, Emma Williams-Tully did not experience the same hesitation. The 39-year-old from Wrexham also suffers from endometriosis. She reported feeling “fobbed off” by medical professionals when she described her constipation and rectal bleeding. She stated, “When I had constipation no matter what medication I took I couldn’t go to the toilet for 10 days at a time and would be in absolute agony.” She sought advice from various specialists across the border in England, and each colonoscopy yielded normal results. Upon receiving her endometriosis diagnosis at age 21, she recalls her consultant confessing, “We thought you’d been making it up all this time.” She commended the current medical team assisting her but characterized her years with endometriosis as “torturous.” She has undergone a total of 11 surgical procedures, including a hysterectomy and the removal of her colon, resulting in an ileostomy stoma. She emphasized, “I don’t want to scare people and think just because they have diarrhoea or constipation that this will happen to them. But it’s about advocating for yourself.” Julie Cornish, a colorectal surgeon affiliated with the Cardiff and Vale health board, noted that patients arriving at her practice had “typically been suffering for some time.” She added, “Things have escalated, because people are too embarrassed to speak up.” “Constipation is common, it affects about 20% of the population,” she stated, but also mentioned that in severe instances, patients may defecate as seldom as once a month. “It’s extreme, but we are seeing patients in their early 20s who have had problems opening their bowels since they were small and it’s never gone away. They’ve taken lots and lots of laxatives over time and have ended up having their colon removed.” She further indicated that straightforward measures could be beneficial. “The bowel is one of the vital organs of the body, if it doesn’t work well – you know about it. But we don’t talk about it, that’s the issue.” “We need a public health campaign around the bladder and bowel.” Regarding delaying defecation, Julie Cornish remarked, “You can get people who decide they are only going to go to the toilet in their own house.” She continued, “If they go on holiday for a week they take something to stop them going to the toilet because they don’t want to do it anywhere else. Or they feel it’s unpleasant or embarrassing to go at work, so they withhold.” On water intake, she advised, “Make sure you drink plenty of water. Caffeine is very good for the bowels in terms of making it work more, but if you’re getting diarrhoea that’s not very good.” For exercise, she suggested, “Just a simple walk of 15 to 20 minutes – your core abdominal muscles work a bit like a washing machine and will help the bowels move.” Regarding diet, she recommended, “You can increase the amount of fruit and fibre in your diet. You can look for things like psyllium husk, flaxseed and chia seeds to encourage it to move.” Julie Cornish stated, “A lot of people don’t actually look at their poo, but you should.” She posed the questions, “Is there any blood in there? What’s the consistency of the poo look like?” “Look at the Bristol Stool chart. If it’s type one or type two which is sort of rabbit pellets or Maltesers stuck together, that suggests you need a bit more water or fibre in your diet.” She continued, “If you’re struggling to empty, or have a lot of bloating, it may be that you’re constipated or have some pelvic floor dysfunction – you probably need to see a physiotherapist.” “Generally opening your bowel every one to three days, with a smooth stool is considered normal.” “If you get a significant change in your bowel habit – an increase or decrease in frequency, or if you start to get significant pain, bloating, weight loss or blood in the stool, please go and see your GP.” Copyright 2024 BBC. 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