Constipation, surprisingly, can be a serious health problem. People can develop rectal prolapse from straining, hemorrhoids, anal fissures (let’s not even go there), and damage their bowels. The worse-case scenario is toxic megacolon, a condition so serious that it may require surgery to remove the affected bowel.
But sometimes, it is pretty damn funny.
My first encounter with a serious case of the poops (or lack thereof) was an 80 yr old woman who presented in my primary care clinic for a check up. As I palpated her abdomen, I felt a 5-cm lump that poked me back. Images of having to tell her and her granddaughter that she had colon cancer flashed through my head.
I reported my findings to my preceptor, who wordlessly went in, felt her abdomen, and asked, “When was the last time you pooped?”
Turned out it had been about 5 days.
On the inpatient oncology service, we had a 60-year old woman being treated for lymphoma. She developed severe, colicky abdominal pain with no findings on exam. We worried that it was typhilitis, a version of bowel necrosis in cancer patients. We ordered a CT scan which showed…a 7-cm stool ball.
Our attending commented to the patient after he told her the results, “Congratulations on your stool baby.”
Inappropriate? Maybe. Hilarious to us AND the patient? Yes.