It’s just poop: encounters with severe constipation

If only our patients were this cute, I might forgive them

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.

Pooooooop.

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.”

Have you thought of a name yet?

Inappropriate? Maybe. Hilarious to us AND the patient? Yes.

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About the friendly intern

Ask a question: The Friendly Intern My personal blog: Pathos and Pathology
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