The Scoop on Poop

What are your bowel movements telling you?

Whether you love or hate the Quilted Northern TP ads on TV,now’s the  time to get real about what happens in the bathroom. Before March morphs into April we need to spread the scoop about poop in recognition of colorectal cancer awareness month.

Bottom line, (excuse the pun), we all poop. So now it’s time to stand up, or sit down, and take notice of what our bowel movements are telling us.

Signs of everything from disease to stress may show up in your bathroom bowl. The key is knowing what to look for — and what the signs may mean.

First off, there is no normal. People are different. So are bowel movements. The size, shape and consistency of feces will change greatly from person to person.

So instead of looking for “normal,” look for change. Are you going less, or more often? Has the consistency altered? Have you gone from runny to solid? If you experience a noticeable change that lasts, it’s time to see your doctor.

Are you seeing red?

If there is blood in your feces on a recurring basis, you need to see a doctor, stat. Blood can be a sign of polyps or colorectal cancer. It also can be caused by benign conditions such as hemorrhoids and anal fissures. In any case, it’s worth getting checked out.

Also, keep an eye out for other symptoms: weight loss, fever, chills. When they come together, those are “high-alert” symptoms of bowel disorders.

Size does matter!

If you used to have sizeable stools but now they are always pencil thin and hard to pass, consult your doctor. In certain types of colorectal cancer, the bowel gets narrow, and so can your bowel movements. And while thin stools do not automatically mean cancer you should still see your doctor and have a  colonoscopy just to be on the safe side.

Consistency, consistency, consistency

We all have bouts of diarrhea from time to time, usually as a result of food poisoning or an infection. But if you have frequent diarrhea it could be a sign of an inflammatory bowel condition such as Crohn’s disease or ulcerative colitis.

The scoop on stress

Your body as well as your brain reacts to things that go on around us. The impact of stress and unresolved issues may show up in your bathroom.

So next time you go to the bathroom instead of simply wiping and flushing take a moment or two to look and learn what your bowel movements are telling you.

No s**t!

 

Patients Don’t Pooh-Pooh Fecal Transplants

Let’s start this blog with the disclaimer that what you’re about to read has a high “yuck” factor…unless it seems you’re a patient or a parent of a patient with ulcerative colitis.

A new study just published in the journal Inflammatory Bowel Disease examined the social and ethical issues associated “fecal microbiota transplantation” (FMT).

Yes, FMT is just what you’re thinking it is!  Also known as fecal bacteriotherapy, it is a provocative treatment performed in an attempt to calm a troubled bowel by reintroducing the vast diversity of collaborative bowel inhabitants after the usual mix has been disturbed. More than 1,000 different strains of bacteria co-exist peacefully in the typical healthy bowel. But when the delicate balance is altered, by antibiotics or other causes, a few strains can become dominant, leading to severe diarrhea, inflammation and tissue damage.

Although transplants of fecal matter have been used sporadically to treat gastrointestinal disease for more than 50 years, more recently, the approach has produced lasting remissions for a small number of patients with ulcerative colitis.

The first fecal transplants date back to 1958, when they were used to treat life-threatening bowel infections. They did this by collecting fecal matter from a healthy donor and injecting it into the patient’s colon.

Then in 2003, an Australian team published a report on successful treatment of six patients with longstanding ulcerative colitis with this approach.

And although you may be feeling a little squeamish by now, it seems that patients with severe inflammatory bowel disease develop a high tolerance for therapies that others might consider unorthodox. According to study author David Rubin, MD, Associate Professor of Medicine at the University of Chicago, “Once patients get past the yuck factor they find the concept appealing.”

Like an organ transplant, fecal microbiota transplantation begins with finding a donor, often a family member. The treatment team collects a fresh stool sample of at least 200 – 300 grams (7-10 ounces). The sample is mixed with salt water in a blender and filtered to remove particulate matter. It can be administered to the recipient through a colonoscope, as an enema, or, when the inflamed region is higher in the colon, through a nasogastric tube.

The researchers organized six focus groups with patients or parents of children with ulcerative colitis to explore the attitudes and concerns raised by this approach.

They found that:

• 21:22 patients or parents of patients were interested in trying FMT for themselves or their child
• Most wished it were already available
• They viewed the treatment as more ‘natural’ than using drugs to control the disease, and easier and safer than currently available therapies
• Many compared it to probiotics, a popular alternative therapy among patients with colitis.

The major concerns were focused on how donors would be selected and screened. Patients wanted healthy donors, usually family members, and asked that even their diet and medications be considered. A donor who had eaten peanuts recently, for example could be hazardous for a recipient with peanut allergies.

The “yuck” factor came up in the focus group discussions of bacterial delivery. Patients and parent were comfortable with the idea of a “spray” colonoscopy or delivery via enemas, but were disturbed by the idea of using a nasogastric tube for the transfer of fecal bacteria.

“What our study ultimately tells us is that patients are not only tolerant of this therapy but are eager for it to become available,” Rubin said. “A few have already tried this strategy at home, using ‘protocols’ they found on the internet and tools available at any drug store.”

The team plans to begin offering FMT this fall.

Would you sign up for a poop transplant or consider being a donor?