Pains of pooping

General surgery taught me one poignant message -- trouble-free pooping is never something be taken lightly. The tortuous gooey journey food takes from the mouth to the anus is fraught with peril. The human alimentary canal (also known as the poop factory) can be up to 30 feet long in a normal human. Within that 30 feet anything goes. It can bunch up, pinch off, knot up, swell, shrivel, burst, bleed, telescope in on itself, detach, reattach, and erode.

A lot of these problems warrant surgery. If someone starts pissing air (pneumaturia) it means a hole has worn through their colon and bladder. Same goes for someone pissing poo (fecaluria -- you get the idea). Some of these problems happen because of a reckless lifestyle, but often people's bowels just turn against them. In a squishy revolt a colon will start wearing holes in itself and bleeding. The answer can be to remove it, connect the small intestine to the butt, bunching it up at the end with staples to make a new rectum. This new answer works OK, but it can get infected, and even if everything goes according to plan it leaves the patient with 6 - 8 poops per day that are the consistency of oatmeal on a good day.

So this is why we pester our patients about poop from post-op day one. Every morning I wake my patients and asked if they've pooped yet, or farted. Farting is a harbinger of poo, and is a good sign.

"Gas is music to our ears," we tell our patients.

When one of my patients had his first poop with his newly revamped colon post-op day 4, I stopped by and said,

"I've heard the good news sir -- two poops, amazing."

Poop means we can start a patient on solid food, it means that they are one step closer to getting out of the hospital. I've always thought pooping is hilarious and awesome, and now it is my professional duty (heh) to hassle patients about their movements. Surgery is the best.