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Bowel Disorders Message Board

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Hi Marc

I've read your comments carefully and am quite sure that you've got exactly the same symptoms I had. I'm 99% certain that, as I suspected, you have a blockage - a 'plug', if you like - of old, dry impacted faeces lodged inside your rectum, and that more recent waste matter is forcing its way past it. This will be the main thing that's making you feel lousy. In addition the diarrhoea will make you feel completely worn out, so you're probably sleeping a lot, as I did.

I'll try to respond to your points one-by-one.

Your diet seems to me to be fine for the time being. Even if you have the perfect diet, it's not going to make much difference, and there won't be much improvement, as long as you've got the 'plug' of older faeces lodged inside your rectum. If at present you feel hot and sore around the anus after defecating, or you're passing liquid, I would even try easing off a bit on the water or trying not to take too much after (say) 7 o'clock at night. This might give your stools a chance to harden a little and so push out more of the dry plug when you do eventually go. You need to keep the stool just soft enough so that it will actually force its way past the 'plug', but it also doesn't want to be too liquidy.

You mention the anus tightening. This also happened to me. Obviously any dry stool inside has little hope of getting out if the anal muscles (the anal sphincters) are tight, and any soft stool will only get out either in narrow stools, or else as liquid from higher up in the colon, together with the odd lump that's broken off from the plug - the 'impacted stool'. Anything that doesn't get out, will start to build up around and behind this plug and make matters (even) worse, which you want to avoid.

At the same time it's worth thinking about whether your stress/despondency/worries (on top of the constipation) are perhaps contributing to the problem not of your colon, but of the tightness in your anal muscles. This is why I mentioned in Message 1 how psychological factors can make constipation even worse. However, this may be something you won't start making improvements on unless/until after your guts have improved physically.

You mention feeling very self-conscious about your constipation. I had the same. Is your self-consciousness one of:

i) 'I feel embarrassed about being constipated/other people must laugh at me/they must look down on me/it's notsomething I can talk about easily' or more one of
ii) 'I'm embarrassed at the number of times I have to go to/the smell/the noise I must be making whilst on the toilet'?

Is it i), ii), or both?

In my case there were definite psychological factors which prevented the anus from relaxing quite apart from the physical problems, and so made the problem even worse: I'd become so self-conscious of defecating/making a noise/leaving a smell, that I became extremely tight 'down there' whenever I tried to defecate. For over a year, in desperation I was turning the bath taps on as loudly as possible to disguise any possible noise, taking a radio in with me - anything to disguise the noise. I can see looking back that I was going completely over the top - no-one, apart from me of course, was in the least bit interested. But then I was desperate.

So it's a matter of: a) getting the old stuff out; b) getting the colon into better shape; and c) getting the right stool consistency so that you become more regular, hopefully (eventually) without laxatives; and later on, perhaps working on the psychological problems.

Your first priority, I suggest, is to get rid of the old stuff. Remember that with a plug like this inside your body, you're effectively carrying a load of putrefied rubbish around inside you - toxins - that the body really wanted to be shot of days, possibly weeks ago. Freeloaders.

A colonic hydrotherapist [hydro=water, therefore, 'water therapist'] should help you achieve this as well as b) above. Note that I can't guarantee that it'll work - it may only work in 10% of cases. Or it might be 90%, I don't know. So tell yourself not to expect anything. But I would definitely start looking around for one rather than a gastroenterologist and certainly not a GP. It's not painful and is almost pleasant. Ring two or three (if they're available), describe what you suspect is going wrong - the drying out etc, - and ask what they can do and how much they'll charge, and go for one. Tell them that firstly you want the 'plug' removed but are also interested in colonic irrigation. And if they say that constipation isn't really a problem, or eat more fibre, go straight to someone else. As for c) above, my own hydrotherapist suggested a particular herbal preparation after about the colonic irrigation session. I can get you the details if required.

Here in Britain colonic hydrotherapy has only been going for 5-10 years, but I would try looking in Yellow Pages and searching on the web. Again, ask if you have problems.

Laxatives aren't really the answer - they're only a short-term remedy and tend to pulverise the digestive system and don't get at the root cause. There's a whole industry built up around telling people that if you've got constipation, the answer is to take a laxative. There's also evidence that in the long term they might make some forms of constipation worse. But for the time being, if they're the only way you can get things moving, I would keep with them. Ask your colonic hydrotherapist if/when you should stop using them.

Finally, a bit more on the mental health side: Constipation undoubtedly brings on depression after only a day or so, because you feel so completely different - worn out, despondent, thinking 'Why me?' The toxins (mentioned above) don't help either. The depression, in return, will affect your bowel. The rectum and anus, both of which seem to have died on you in your case, have their own nervous system (the enteric nervous system) which is separate from the body's main (central) nervous system, but is still affected by it. The ENS is very susceptible to psychological pressures. It means that if you're feeling sluggish and depressed, which is understandable, it will tend to make your colon feel sluggish also. It's not about having a 'lazy' colon as your mother suggested, but more that the colon is 'dying' on you. So there's a vicious circle that you'll need to break. For this reason, it might be worth seeking psychiatric help to help you with this - but if you feel that the other person simply doesn't understand how badly severe constipation can affect you, and starts (for example) to tell you not to worry, or that you're being obsessive, I would go to someone else.

Best of luck and do keep in touch.

John (UK)

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