And It All Comes Back to the Poo!

***This is NOT dinnertime reading! Do NOT read if you are easily offended, nauseous, or just don’t like to talk about bowel movements***

Isn’t it funny, we all go to the toilet, but we don’t like to talk about it, particularly number twos.

Today, I had a ‘normal’ bowel movement – but what is considered to be a ‘normal’ bowel movement?

A bowel movement should be soft and easy to pass, though some people may have harder or softer stools than others. In general, stool should be brown or golden brown, be formed, have a texture similar to peanut butter, and have a size and shape similar to a sausage. In many cases, a stool that varies a bit from this description is no cause for alarm, especially if it is an isolated incident.

It seems that most of us, especially those with IBS issues, never have a ‘normal’ bowel movement. In fact, our ‘normal’ is more likely to be those ‘really difficult to push out rabbit droppings type,’ or the ‘rush to the closest toilet explosion,’ or even the ‘my ass is dribbling type.’

Most of us who live with FM also have IBS. FM and IBS are co-diagnosed in up to 70% of FM patients. IBS (also known as irritable colon, spastic colon, mucous colitis, or spastic colitis) is a disorder of the bowel, or large intestine. It is characterized by severe abdominal pain and cramping, changes in bowel movements, and a variety of other symptoms.

It has been estimated that as many as two-thirds of all IBS patients have FM, and as many as 70% of FM patients may also have IBS. These statistics differ greatly from the corresponding rates in the general population, where only 10%-15% of individuals are estimated to have IBS. It is unknown if the two conditions are related symptomatically or causally, or if their frequent co-occurrence is merely a coincidence.

Adding pain killers to the mix can be frustrating and painful.

Now, the ‘really difficult to push out rabbit droppings type’ tends to be a constipation. Constipation means different things to different people. For many people, it simply means infrequent stools. For others, however, constipation means hard stools, difficulty passing stools (straining), or a sense of incomplete emptying after a bowel movement. This is called fecal impaction, a condition in which stool hardens in the rectum and prevents the passage of any stool.  According to reports in the Journal of Psychosomatic Research, constipation or infrequent stools occur in 30% of FM sufferers.

Constipation also can alternate with diarrhoea. Diarrhoea is an increase in the frequency of bowel movements, an increase in the looseness of stool or both. It is caused by increased secretion of fluid into the intestine, reduced absorption of fluid from the intestine or rapid passage of stool through the intestine. This is the other two types of (what I refer to as) our ‘normal.’

My point to all this crap (Ha! Ha! Lol!) is that I get used to the IBS stuff: I have cramps, I take Buscopan; I have diarrhoea for too long, I take Immodium; and, if I’m constipated, greasy fish and chips seems to do the trick. But when I have a ‘normal’ poo, it feels like it is dragging all my insides out with it. It’s tiring and it’s physically draining. It leaves my body feeling empty (but not in a good way!).

So, is this what ‘normal’ feels like?

Further Reading: 

 

Let’s Talk About Poo!

Back in early April, I made a quick reference to poo. Now that I’m on stronger pain killers, it may be time to revisit the discussion…

poo-2Most of us who live with FM also have Irritable Bowel Syndrome (IBS). FM and IBS are co-diagnosed in up to 70% of FM patients. IBS (also known as irritable colon, spastic colon, mucous colitis, or spastic colitis) is a disorder of the bowel, or large intestine. It is characterized by severe abdominal pain and cramping, changes in bowel movements, and a variety of other symptoms.

It has been estimated that as many as two-thirds of all IBS patients have FM, and as many as 70% of FM patients may also have IBS. These statistics differ greatly from the corresponding rates in the general population, where only 10%-15% of individuals are estimated to have IBS. It is unknown if the two conditions are related symptomatically or causally, or if their frequent co-occurrence is merely a coincidence.

Adding pain killers to the mix can be frustrating and painful.

Pain killers are used to combat headache, body ache, muscle pain, etc. Prescription painkillers including Vicodin, Darvocet, Percocet, OxyContin, Fentanyl, Tramadol and Lortab are widely prescribed to treat moderate to severe pain. At times (all the time?) we are forced to take painkillers due to too much pain. The opiate analgesics block pain signals by attaching to opiate receptors located in various parts of the body and brain. Prescription painkillers are effective treatments for chronic or persistent pain and can be taken safely, but these pain killers have side effects associated with them. Along with reducing pain, these pain killers also give rise to some other disorders as well.

bird_pooConstipation is a commonly reported effect associated with the use of prescription painkillers. Whether taking opiates at therapeutic levels or abusing them, many users report sluggish bowel movements, a condition which can be both annoying and painful. The problem can be compounded when we are taking a combination of prescription medications. Opiates can interfere with normal elimination by relaxing the smooth muscle in intestines and preventing them from contracting and expelling waste. With regular use of opiates, stools can become rock hard, blocking the bowels. In severe cases, bowels can rupture, leading to sepsis or death. Symptoms of constipation include: abdominal bloating, swelling and cramping; straining to pass stool; pain, discomfort or blood with a bowel movement; nausea; weight loss; and decreased appetite.

The use of a laxative or other form of stool softener is often suggested. Further, to prevent constipation, users must consume plenty of liquids when taking painkillers. Regular bowel movements could also be kept intact by consuming a diet rich in fibre. Mommy swears by prunes (yuck!) and a greasy, cheese pizza tends to work for me!

And, for the sake of completeness:

Mild and More Serious Side Effects

Even with short-term use, patients can experience one or more side effects. They can include sedation, euphoria, dizziness, fatigue, depression, tremors, sleeplessness, anxiousness, flu-like symptoms, upset stomach, dry mouth, pupil constriction, itching, hallucination, delirium, sweating, muscle and bone pain, confusion, extreme irritability and muscle spasms. Taking too much of an opiate medication, or more frequently than prescribed can be dangerous, even fatal. Combining opiates with alcohol and some other drugs can also lead to severe reactions. More serious side effects can include severe respiratory depression, confusion or stupor, coma, clammy skin, circulatory collapse and cardiac arrest.