Never apologize for a messy house.  (Reader, move on if this isn’t your deal.)

English: Pedestal squat toilet (Photo credit: Wikipedia)

You’d think that being a not-so-old medical doctor, even now just eight years out of training, I would have known more about constipation than I did.  But I didn’t.  And the doctors I went to for help didn’t seem to know either.  I do remember one elderly OB/Gyn admitting that he didn’t know what to tell me to do, but to certainly do something; he had a friend who had severe constipation and had to have a colectomy (part of his colon cut out).  My OB/Gyn admitted, “I didn’t know constipation could get so bad.”  I appreciated his acknowledgement of the potential gravity of the situation.  However, nobody seemed to offer me anything helpful, and I just muddled through with various over the counter products with occasional, temporary success.  Luckily for most of my life, my slow transit was relatively asymptomatic (at least between bowel movements, which gave me quite a symptom-free interval—chuckle) and unaccompanied by too many other symptoms, until the last few years.

Since I got the awesome opportunity to homeschool my kids, I had just a couple of hours here or there to start reading for myself, so I could hopefully avoid that colectomy.  The first article that made me celebrate a couple of years ago was something about “fiber doesn’t help slow transit constipation (STC), in fact, it may make it worse.”  Validation of my own experience, counter to most suggestions from my own doctors and training!  However, mostly in my early searches, I came across depressing, belittling stuff like this (emphasis mine):

• “Chronic idiopathic constipation: a psychological enquiry.”  (click for abstract)
• “Functional constipation in children: does maternal personality matter?”  (click for abstract)

Now, I am beginning to read lines like this, helping me to see that, although research doesn’t know the answers, at least they’ve identified a REAL problem and there are researchers out there “fighting for me” (and my psychological profile):

• “… labels such as “idiopathic” or “functional”, that basically conceal the fact that too little is known of a specific pathologic entity, should be hopefully replaced when more knowledge is available… As such, the recent recognition of neurenteric abnormalities in many patients complaining of constipation should point to reconsidering at least some of these forms (especially STC) as true enteric neuropathies, and to drop the “idiopathic”/“functional” label.”    (full text available, from “Cellular and molecular basis of chronic constipation: Taking the functional/idiopathic label out”, World J Gastroenterol. 2013 July 14; 19(26): 4099–4105.)

Right.  So now I’ve got a nice review article to validate my personal knowledge that no matter what I try, nothing works great because I’ve got a real problem.  A problem that goes beyond trying  fiber, water, and yoga.  A problem beyond, “Well, you must have held your poop in too much when you were a kid so you wouldn’t have to poop in public places.”  Please.

So what is wrong down there?  A true problem with the nervous system and hormonal system of the gut, now in its early infancy of identification.  Science history in the making.

Thanks for reading.  I’m working up to my butyrate post.

Terri

Next up, Part Two:  Why Does My GI Tract Defy Physiology and Gravity?
(Alternate Titles To Amuse My Sense of Humor:  “Everybody Else Can Poop, Why Can’t I?”  or “Thank My ENS I Don’t Have To Touch The Toilet Bowl Brush!”)