Can a person feel free to speak about the unspeakable - diarrhoea, constipation, flatus, faeces and the like ? The subject is so private and personal that many people wonder if their own rituals and behaviours are abnormal. People spend thousands of rupees on remedies for ailments ranging from diarrhoea to constipation, from bloating to flatulence. Disorders of the digestive tract are commonplace. Perhaps because of embarrassment or because of a fear that a serious disorder may be lurking, most people medicate themselves rather than seek medical help.
How It Works :
There is nothing mysterious about the function of the bowel. The large intestine - also known as the colon - is the final portion of the 30-foot-long gastrointestinal tract, the alimentary canal, which begins at the mouth and ends at the anus. After the small intestine absorbs everything nutritionally useful and digestible, the leftovers are propelled into the colon. This four-to-six-foot-long tubular structure terminates at the rectum, where it finally ends in a puckering structure known as the anus.
The colon is actually a very large drying tank. Liquid leftovers leave the small intestine, carrying waste particles, bacteria and electrolytes, and enter a pouch, the caecum, located at the beginning of the ascending colon. As the liquid passes forward slowly through the colon, taking approximately 24 hours, this organ along with its blood supply reabsorbs most of the electrolyte laden liquid, leaving behind solidifying waste material. While all this is happening, the colon secretes mucus that further binds this remaining debris into the mixture known by so many names, commonly known as the faeces.
Colon, this sophisticated organ, has still another function. It puts the billions of bacteria it contains to work. These bacteria break down undigested fibres and sugars that have managed to escape the digestive process of the stomach and small intestine. Over the course of the day, the colon which is also a muscular organ, contracts vigorously and, like a compactor, moves the stool towards the rectum, preparing it for its evacuation. When the rectum is sufficiently filled and its walls distended, a reflex is triggered to produce a bowel movement.
What is Normal ?
More or less it happens like a clockwork. But how often ? And when ? After breakfast, lunch, dinner, daily, every other day, once a week ... ? Advertising would have you believe that anything but once a day in the morning is abnormal. Overdoing laxatives can cause a variety of medical problems, including dehydration, electrolyte imbalance and cramps. Instead of laxatives, doctors recommend increasing fibre and fluid intake. Isabgol and liquid paraffin are also very good for constipation.
There is no universal definition of a normal frequency of bowel movement. Your pattern is unique to you, a reflection of your biology, your diet, your lifestyle and many other factors. It is important to be aware of and to let your physician know about any changes in the frequency and character of your bowel movements.
Now, let us take an arm's length look at faeces. Known by many names - excrement, night soil, crap, poop, stool, BM and yes, shit.... faeces is a window onto the dietary habits of its creator. For example, the colour may be red from too many beets, or black from internal bleeding or iron tablets.
Let us talk about Gas :
Flatulence is the means by which the body rids the colon of unwanted gases ( and, at times, rids the room of unwanted guests ). Approximately 99 percent of the gas found in the gastrointestinal tract is non-odorous. However, it is the other 1 percent from which there is no escape. These pungent and odoriferous gases include hydrogen sulfides, ammonia and sulfur compounds which have the smell similar to rotten eggs. Hydrogen accounts for as much as 80 percent of flatus. These gases come from fermentation. Each day, a small amount of ingested carbohydrate normally escapes digestion in the small intestine and reaches the colon. Here, anaerobic bacteria ferment these unabsorbed carbohydrates, producing hydrogen. Much of it is eliminated as flatus.
Foods and drinks which produce colonic gases are starches - from wheat, corn, oats, potatoes, cauliflower, broccoli, cabbage, onions, lentils and nuts, as well as red wine, beer and fruit juices containing fructose.
When you Swallow Air :
Swallowing of air while eating may give rise to a burp. It also contributes significantly to the volume of flatus. Swallowing a certain amount of air along with food or liquids is normal. But talking and chewing at the same time, gulping food, sucking on a hard candy or chewing gum, drinking carbonated drinks, using a straw or inhaling on a cigarette will contribute to excessive flatulence. This will produce a feeling of bloating.
Irritable Bowel Syndrome :
Of all the bowel problems you face, there is probably none more disturbing than the disorder known as Irritable Bowel Syndrome ( IBS ). This disorder of the colon, with bouts of diarrhea and constipation is associated with abdominal pain and affects millions of men and women. Associated symptoms of bloating, mucus in the stool, urgency or feelings of an incomplete evacuation keep on waxing and waning.
This disorder usually begins in adulthood and can last a lifetime. At times it would appear that the colon has a mind of its own. The colon reacts to anger and anxiety with increased motility and abnormal contractions.
Treatment Options :
When your physician diagnoses that you have an irritable bowel syndrome, there are many treatment options that are aimed at regularizing bowel habits and relieving abdominal discomfort. Diet should be well modified for these patients. Avoiding offending agents, whether lactose, caffeine, gas-producing foods or alcohol may be the answer. If dietary changes do not seem to help much, then stress reduction may go a long way in reducing the symptoms. Isabgol husk taken with warm water at bedtime will help relieve constipation. The same taken with cold water at bedtime will help stop loose motions.
The Bottom Line :
So now, at long last, you can learn to appreciate that thing you deposit in the toilet bowl daily. This bodily function, which sometimes necessitates us to make an urgent stop on the way home from a rich dinner out, demands to be considered with some respect. It is the bowel movement, and the total physiological system that produces it, that is perhaps one of the most under appreciated and hushed-up physiological events in the human body.
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