This is not something I track or even
talk about...to anyone. But, here I am going to tell you what
researchers like to call anecdotal evidence. A story. My story. But a
story I dare say many of you out there also could tell.
For many years -- most years -- I had
very infrequent and difficult to pass stools. I tried every remedy
short of drugs for decades, including 8-10 glasses of water daily, large
doses of vitamin C and magnesium, prunes, psyllium powder and/or husks,
probiotics, and a minimum 30g of fibre daily. Nothing was a total fix: I
needed to employ ALL of these strategies to reduce the huge gap between
bowel movements from 9 days (my record) to 3-6 days. In 2005 I began to
take dicyclomine (an anti-spasmodic), which stopped my painful bowel
spasms, but didn't do much to speed things up.
I was trapped in bathrooms probably hundreds of times for hours at a time. I couldn't pass the hardened
stool, but nor could I leave the immediate vicinity of a toilet. It
didn't matter if I was at home or at a restaurant: I was being held as a
hostage by my bowel. I wish to thank the many friends and family who
helped me navigate these times with dignity and humour.
Stool that stalls through the colon gets
drier. Toxins on their way out of the body get resorbed. Thus,
when I finally would go,
the stool itself was hard, which then became my next nightmare (as if
chronic constipation by itself isn't bad enough).
A sad consequence of passing very hard
stool is a clogged toilet. As I said, I never tracked this unfortunate
side effect, but I'm sure the percentage of times I needed to "take the
plunge(r)" was around 60% or more. Even toilets found hard stools
impossible to pass!
My multiple sclerosis started affecting
my legs in around 2001. I found standing at a toilet plunging
exhausting. I remember how very tired my legs would feel as I used up
the last of my energy just so I could flush the toilet.
I want to add that my life between bowel
movements was pretty good. I typically would go a few times over a few
days (sometimes diarrhea after the first stool passed), then a lengthy
gap (constipation), then the cycle would repeat. Thus, I had security to know I would
go days without another hostage/plunger episode while I was constipated. I strategically used
glycerin suppositories to induce a bowel movement when I had a busy day
ahead and my 3-6 days were up. On my bathroom days, I sat for hours on
the toilet or lay on the bathroom floor, waiting. I even took a portable
table and my laptop into the bathroom. If I was going to be trapped that long I was going to stay busy!
A physiatrist I met in 2010 told me my
bowel management was my biggest health issue. Imagine his surprise and
my delight that angioplasty to fix narrowed and stenosed jugular veins
(CCSVI) in July 2010 also mostly normalized my bowel function. My bowel spasms disappeared immediately (good-bye dicyclomine!) and frequency was every 1-2 days without any long gaps within 6 months.
Let me introduce you to the Bristol stool chart.
We were asked to track our bowel
movements during preparation for our fecal microbiota transplant, during the 10 day procedure, and afterwards. I did not track stool type before my 2-month FMT preparation, but I did
occasionally track frequency. Unfortunately, my calendars from pre-2011
are long gone. Thus, you have to take my word for it that
pre-angioplasty my bowel movements were infrequent and generally hard to
pass. I do have data from 2011 on frequency, though, which is one year post CCSVI angioplasty. Here's a 17 day
period:
Average (over 17 days) = 17/9 = 1.88 days apart
This may not look normal to many people, but it was normal for ME after decades of chronic constipation. However, I still recall having to take the plunge
on many occasions despite the greatly improved frequency, especially
after a multi day gap.
In August/September 2014, I started a
modified paleo diet developed by Dr. Terry Wahls. Despite seeing
benefits elsewhere in my health, my bowel function was thrown almost all
the way back to my Dark Ages after just a short while on the diet. This
is what prompted me to seek treatment to restore my microbiome.
Here's some frequency data of bowel movements over 13 days after I started my new diet:
Average (over 13 days) = 13/5 = 2.6 days apart
Many of these post-diet change bowel
movements were hard and needed plunging. My journal also details several
instances of bad diarrhea -- all signs of a messed up gut.
Now, to bring you up to date post FMT treatment. I track my bowel function religiously, so here's a recent period:
Average (over 25 days) = 25/18 = 1.38 days apart
You'll notice a few key differences. The
frequency is definitely improved. One large gap (17-18) was when we did a
road trip, which may be the reason. The other gap (5-6) is unexplained.
Most stools were Type 4 = normal! Also, I haven't had to use a plunger
once since my FMT. My consistency, according to the Bristol Stool Chart, is always three or four (normal!) post FMT. Clearly, my microbiome is still trying to sort out my
new normal. Gaps aren't necessarily a bad thing if stool quality is
still normal.
I have a theory with regard to what may be happening
as my new microbes settle into their new home. Because stool quality is
now normal, I wonder if the few issues I still have outstanding are
related to neurological control. People with MS can have problems with bowel motility independent of problems with stool consistency (source). Several times over the past few months
post-FMT I had difficulty initiating a bowel movement despite having a feeling like I had to go. I initially worried this could be a return to a constipated
state; however, the consistency of the stool remains soft without being
considered diarrhea. Basically, I think my microbes are doing their job, i.e., keeping the stool a normal consistency, but the state of my nerves that trigger elimination is not 100%.
~ Sandra
