Let’s Talk About Poo

Let’s talk about poo (baby). Why is it such a taboo subject? We all poo, some more successfully than others. But it is such an integral part of our lives, yet we are still too embarrassed to talk about it openly. I want to change this. 

Embarrassment over talking about pooing often leads people waiting months or even years before seeking medical advice when they experience changes in their bowel movements, or new symptoms like blood in their stool or pain. This is a dangerous situation as serious illnesses like bowel cancer and IBD are left undiagnosed for years. 

First up, I want to talk about constipation.

My husband often jokes that I’m obsessed with poo, because it’s a common topic of conversation with my friends. Yes, I talk about it a lot, but why shouldn’t I? – We talk openly about other aspects of our health. My goal is to take the embarrassment out of pooing. So this is the first in a series of posts designed to break the stigma around perfectly natural bodily functions.

My poo story

I have suffered from IBS most of my adult life. I experience prolonged periods IBS-C, followed by periods of IBS-D, but in recent years constipation has dominated my life. You may think I’m being over dramatic here, but when you live with chronic constipation it can really take over your life – you think about pooing multiple times a day. You envy people who can poo normally, and you obsessively try anything and everything to shift the mounting mass that is building in your bowels. I have been in tears many times over the pain and discomfort of chronic constipation, and desperation often creeps in. 

Not only is it uncomfortable, but constipation also causes nasty symptoms. Your body expels poo because it is a waste product. A build up of this waste causes toxins to travel around your body. For me, it feels like I have been poisoned. My skin crawls, my whole body itches and I have horrible headaches. I also get terrible back pain too. And even on the days I do manage to poo, I never fully evacuate my bowels. So I live with the constant feeling of needing to poo – it’s uncomfortable and leaves me feeling agitated, which triggers my anxiety. Over the years, I also developed hemorrhoids and an anal fissure (a tear) due to the amount I was straining. 

My constipation became particularly bad when my physical health severely deteriorated 6-7 years ago and I became pretty much bedbound. When my body crashes (ME/CFS) so do my bowels – they just stop functioning how they should. Added to this, my very limited activity and physical weakness makes the perfect environment for constipation. 

Having constipation and IBS is particularly frustrating. Most people associate IBS with diarrhoea, but constipation is just as common. But here’s the problem when you suffer from IBS and constipation; anything designed to stimulate my bowels to treat constipation, causes excruciating pain. 

What is IBS?

I would like to briefly discuss IBS for those of you that are not familiar with it.

Irritable bowel syndrome (IBS) is a common condition that affects the digestive system.

It causes symptoms like stomach cramps, bloating, diarrhoea and constipation. IBS is usually a lifelong problem. It can be very frustrating to live with and can have a big impact on your everyday life. There’s no cure, but diet changes and medicines can often help control the symptoms.

What is constipation and what causes it? 

Back to the subject of constipation – what is constipation and what causes it? Simply put, constipation is defined as irregular and infrequent or difficult bowel movements. But although the definition of constipation is simple, the causes, treatments, and the devastating effects chronic constipation can have on someone’s life, are far from straightforward.

Here are a few of the common causes of constipation:

• Changes to what you eat or your activities
• Not enough water or fibre in your diet
• Not being active
• Stress
• Overuse of laxatives
• Some medications
• Antacid medicines that have calcium or aluminum
• Eating disorders
• Irritable bowel syndrome
• Pregnancy

Less common causes;

• Problems with the nerves and muscles in your digestive system
• Colon cancer
• Neurological conditions such as Parkinson’s disease or multiple sclerosis
• Underactive thyroid (called hypothyroidism)

Medication was a big cause for me to begin with. When I first developed fibromyalgia my pain was completely out of control. I spent months trying different pain killers, and although I didn’t know this at the time, constipation is a common side effect for most of them. Also inactivity is a major contributing factor. I went from being relatively active, to virtually bedbound. And let’s not forget IBS – this is another major cause. 

Treatment

The successful treatment of constipation can vary considerably from person to person. What works for one person will not necessarily work for you.

Common treatment advice includes:

• Take regular exercise
• Eat more fibre
• Drink plenty of water 
• Avoid alcohol
• Reduce medication that causes constipation
• Take Laxatives 

As laxatives are probably the most common way of treating chronic constipation, I wanted to take a moment to discuss the options. 

The term laxative refers to a wide range of substances, including stool softeners. A laxative is any medicine or supplement that helps the body have a bowel movement. Each laxative works differently. I use stool softeners which draw water into the bowel softening the poo, making bowel movements easier. 

Types of laxatives:

• Osmotic laxatives. These laxatives draw water into the intestines from the surrounding tissues.
• Bulk-forming laxatives. Often derived from plants, these laxatives help form a watery gel in the intestines that adds both body and lubrication to the stool.
• Stimulant laxatives. Fast acting laxatives that can stimulate the intestines into having a bowel movement.
• Saline laxatives. Magnesium-based laxatives that pull water into the intestines.
• Lubricant laxatives. Oily laxatives that coat the intestines to help move stool through quicker.
• Guanylate cyclase-C agonist laxatives. Certain drugs both increase water in the gastrointestinal tract and make the stool move through the colon faster.

Of course, treatments like exercise are not possible for everyone, especially for those of us living with chronic illnesses like ME/CFS. And fibre, along with many types of laxatives, often aggravate IBS and Inflammatory bowel disease symptoms (IBD) . Also, if you have lived with constipation for a number of years like me, you have probably tried all, or most of these anyway.

What has helped me

For me personally, the usual advice to increase fibre intake did absolutely nothing, and stimulants like laxatives cause excruciating pain. So I had to experiment to find other options.

1. Eliminating food and drink that aggravate my IBS

Here are the steps I took which have helped me live more comfortably with my chronic constipation. I am far from cured but life is definitely easier now.

Firstly, I needed to take some control over my IBS. This meant eliminating food and drink that aggravated my bowel, including caffeine. Unfortunately the short term effect of this was a worsening of my constipation.  

2. Taking stool softeners daily 

Ultimately I discovered stool softeners were my best option. They draw water into your bowel, softening your poo and making it easier to shift the build up. Stool softeners can take a few days to work, but as long as I take them every day, my bowel movements are more regular, and less painful than without them. Apparently stool softeners are not supposed to cause spasms as they do not stimulate the bowel, but no one told my body this. But at least the negative side effects are less severe than other remedies. I tried a few stool softeners and the most effective, and least problematic for me is Lactulose. 

3. Increasing my water intake

Drinking plenty of water does help a bit, and I also reintroduced caffeine first thing in the morning to stimulate my bowel. It does cause some pain, but if I limit it to mornings only, the pain is manageable. 

4. Using glycerin suppositories when needed

With this routine, I still have times when my bowels do not want to cooperate, especially when my physical health is bad, and I’m weak and exhausted. For these times I use glycerin suppositories. These suppositories stimulate the bowel and help get things moving. 

5. Petroleum Jelly (Vaseline)

Now I’m sure people who don’t suffer from constipation will find this one gross, but I promised to be open about everything and I refuse to be embarrassed about it.

Each morning I place vaseline on my forefinger, and massage this inside my anus. This isn’t enough to stimulate a bowel movement but it does make it easier for me to poo when my bowels decide to cooperate. The vaseline acts as a lubricant, meaning I don’t have to strain as hard when I do poo.

6. The Squatty Potty

The introduction of the Squatty Potty was a bit of a game changer for me. For those of you that don’t know, a Squatty Potty is basically a raised platform that sits around the base of the toilet. When you want to poo you place your feet on the Squatty Potty. This puts your body in a squat position making it easier to poo. The squat position is a more natural placement of the body for pooing, and it means your poo doesn’t have to fight with gravity as it’s expelled.

7. Learning not to panic about my constipation 

Another big turning point for me was mentally accepting constipation as part of my life. Constipation often caused panic attacks. I would imagine the toxins circulating around my body and the damage they were doing, and panicked that I would never be able to get rid of them. Rather than obsessing over not being able to poo, and spending ages each day straining, I let my body do its thing with the help of the stool softener. I believe my anxiety around my inability to poo added extra tension which only made my constipation worse. 

Please don’t be embarrassed to talk about poo

I still suffer from chronic constipation but I have accepted it’s part of my life. I have good times when I poo more regularly but there are still times, even with the steps I have taken, when I don’t poo for a couple of weeks. These times are horrible, and my health suffers but thankfully, unlike before, they are not as common. 

I often tweet about constipation and these tweets are always popular. People are relieved to find someone who is happy to talk openly about this subject, and once the conversation has started, everyone joins in. I tweeted the following recently:

“When you live with chronic constipation something as simple as a bowel movement can turn a shit day (no pun intended) into a bearable one. Yep, I just pooed 💩 Today is a good day 😁” 

As expected, I received the usual advice to eat more fibre and drink more water, and apparently kale smoothies and yoga cure constipation. But along with the unsolicited advice I received many comments thanking me for being so open about my constipation.

If you suffer from constipation too I hope this post, and some of the treatments discussed help you. Please don’t be discouraged from trying remedies that didn’t work for me. We all respond differently, so treatment can vary greatly from person-to-person.

Some experimentation is normally needed to find the right product, or combination of remedies needed for your specific circumstances. This can be frustrating, but hopefully this time spent trying all the options will result in a more comfortable life.

But most importantly, please don’t be embarrassed to talk about poo, whether with your friends or your doctor. If you notice changes in your bowel movements, increased pain or blood in your stool, please speak to your GP to rule out other health conditions.

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