This year, I have been dwelling on constipation. To be truthful, it hasn’t been all year. Just the last few months. Since August. Since my niece, Sarah, died of secondary breast cancer. Her mum – my sister, Jane – died of the same thing nearly 30 years ago. That was a rough year too, although I don’t remember being constipated.
It starts when Sarah is admitted to hospital because she can’t breathe. She’s having radiotherapy for tumours in her spine. The lack of breath comes on suddenly, and it’s what will kill her within the month. As I slug between the hospital and home, thinking this can’t end the same way, I am also aware that I haven’t pooed for five days. But it’s likely fine. I’m still breathing without an oxygen mask after all.
Constipation is a grim word, but what it describes is sordid, mucky. One day, you just don’t produce, or it slows to a couple of Maltesers. The next day comes, and still nothing happens. You start to feel heavy, like a wall is forming in your gut.
Constipation is a grim word, but what it describes is sordid, mucky. One day, you just don’t produce, or it slows to a couple of Maltesers. The next day comes, and still nothing happens. The day after: the same, on repeat. You start to feel heavy, like a wall is forming in your gut. Each time I go to the loo, I’m wondering how hard to push. Will that help or just cause haemorrhoids?
It’s trivial in comparison, but I wonder: where’s it all going, the faeces? Is it backing up into my small intestines, my stomach, into my heart and lungs? Will my major organs be overwhelmed by crap?
After Sarah dies, I wait a month before doing anything because maybe it will get better on its own. So I wait while I tell my parents that not only have they lost a daughter but now a granddaughter. I wait while we look for photographs and think of songs for the funeral, while my son buys a new suit, and my 92-year-old dad takes a train to London for the first time in forever. I wait while I send dozens of messages and people ask me if I’m ok.
I wonder: where’s it all going, the faeces? Is it backing up into my small intestines, my stomach, into my heart and lungs? Will my major organs be overwhelmed by crap?
I go to see my GP. She tells me constipation is a common side effect of stress and anxiety. That our gut reflects our emotions. She prescribes laxatives and says, “Given your history, you should contact the colorectal team.”
Ah, my history. Sarah died because she was a BRACA1 gene carrier – a gene that helps suppress tumors and repair DNA leaving her with an increased risk of certain cancers. Her mother was a carrier and I am too. I had breast cancer 14 years ago. Lumpectomy, chemotherapy and then – because with the faulty BRACA1 gene once isn’t usually enough – a double mastectomy. So, that was that. Except for two and a half years ago, just as Sarah was sitting in a small room, being told that what she had feared all her life had finally come to pass, I developed a pain in my side. Long story short, I had a wee bit of cancer in a polyp. One bowel surgery later, and all is good. Although the pain never went away, so what’s that all about?
But some time passes before I report my irregular bowel movements on the colorectal hotline. I say that they’re likely due to grief and disbelief. The team say, “Given your history…” and I am called in for a colonoscopy. The preparation is foul. Look it up. Starvation, then explosive, liquid poo, which smells like hell. It should be a relief to get a good clear-out but it isn’t. It’s humiliating.
I go to see my GP. She tells me constipation is a common side effect of stress and anxiety. She prescribes laxatives and says, “Given your history, you should contact the colorectal team.”
At the hospital, in paper pants with a gap in the rear, waiting in a small room, I think of Sarah, and my sister, all of us, in bleak hospital rooms, a couple of seats and a blood pressure machine, waiting for someone to deliver terrible news.
I ask the nurse to leave the door open.
Sarah would have been in a room like this when they told her the cancer was back.
A colonoscopy is a camera up the arse. It’s a skilled business. Your bowel is 1.5 meters long, and it twists, a lot. Mine is very loopy, so they have trouble. They are looking for polyps, tumours that grow out of the lining of the gastrointestinal tract. As they move the camera through, I get a tour of the inside of my own bowel, where all the crap lurks. Not just humorous, emoji crap which maybe won’t kill me, but the serious stuff, that might.
But this time it’s fine, so the problem must be stress. Death and stress. The medical team stand down. They haven’t found their thing, so I guess I am on my own. Drink water, eat fibre, deal with the sadness. I want to say this too will pass – both the grief and the constipation – but it’s early days for both.
So, what have we learned? Firstly, don’t take good bowel movements for granted. You’ll miss them when they’re gone. Secondly, if possible, avoid having people you care about dying at 33. That’s the main one. The poo will return. The people won’t.