Today is going to be, entirely and unapolgetically, about poo. And the digestive tract in general. And haemorrhoids. Those of a sensitive disposition… Look away now.
Constipation is such a lifelong problem for a lot of zebras that we don’t realise there’s anything unusual going on until, after failing to flush the toilet at some point, someone else goes in after us and comes out, white as a sheet, asking; “Was that… Yours? They’re not meant to look like that.”
Basically, the slow gut transit, low appetite, stretchy bowels, and (by the time we’re symptomatic) stacks of opioid painkillers all join together into a perfect storm that results in basically every bowel movement being like giving birth whilst running a marathon. But, hey, at least it’s only once a week, right?
You’ll quickly become au fait with the Bristol stool chart, even if your doctor wishes you weren’t. You’ll have strong opinions on which laxatives you like, which you don’t, and which make matters worse.
And then there’s impaction. Impaction is basically when the mass of faeces in the rectum is so huge and so dry that it will not come out, and where applying a suppository or a micro-enema is, proverbially, going to make matters worse. (Imagine trying to pass a bowling ball. Now, add an enema which makes the bowling ball slippery, but still rock hard and weighing a tonne. This is not going to make it any easier to pass the bowling ball, it’s just going to make it more painful to hold it in.)
At this point you have a couple of choices – One is to start taking the polyethylene glycol (Laxido, Movicol – Basically an insoluble sugar that results in more water ending up in the end-stage of the gut, taken with plenty of water) that you were prescribed all along but absolutely despise because it makes you feel sick and bloated, and to take it in about eight times the dose that you would have for plain constipation, and the other is to stick on a nitrile glove and announce that anyone who needs the toilet for the next hour is going to have to use the one in the cafe. The most sensible option, really, is both – Let the Laxido increase the pressure behind the dam, then mechanically attack it from the other side. Resulting, hopefully, in walking or crawling away from the pan feeling about half a stone lighter and a bit dizzy.
For the record – Do NOT take irritant laxatives (Basically, anything that goes up your sphincter) for more than a few days at a time, or your bowel might end up unable to defecate without an outside stimulus, which is seriously not good for you. Likewise, don’t take senna if you think you might be impacted – You might just end up pushing so hard that you rip your rectum to pieces.
It’s horrible. It’s painful, and it comes with really unpleasant stomach cramps.
At some point in this bloody horrible cycle, the average zebra is going to either wipe, or look in the bowl, and notice blood. Not just a drop, but what looks like litres and litres of fresh, bright red blood, accompanied by a strong slaughterhouse-floor smell. This is alarming, but this isn’t all that dangerous – This is just haemorrhoids. The one to watch out for is black, digested blood, or blood really mixed in to the stool. Haemorrhoids, if you can get your GP or pharmacist to look you in the face, are easily treatable with over-the counter medications, and should go away on their own anyway. It ties in closely to the same fragile tissue that causes the easy bruising – Our blood vessels are fragile, so of course they’re going to burst.
When people who don’t have it think about EDS-HM, they seem to basically think of it as Victorian Novel Disease – It’s this syndrome that results in pale, big-eyed, doll-like waifs, with florid skin and delicate wrists and languid movements, who recoil from exertion and sigh dramatically and faint away. If you ever get caught up in that, think of the nitrile gloves, and think again.
(Notable runners-up to be “C is for…”; Comorbidities Chiari malformation, chronic pain, Zyndrom Chernogubovy, carsickness)