Why we have to break the poo stigma

I am no expert on poo. 

But everyone has a normal poo.

When there's a problem with the poo, you have to tell someone. 

EDIT: I wrote this piece about a month ago. The NHS has said we should start referring to our poo more often. I am so glad that the NHS has acknowledged the need to reduce the stigma around poo. People with a disability are likely to refer to their poo as poo- and may not understand what we mean by 'stool' 'bowel movements' or 'number 2'. The Metro article on the subject is here. As a result, this blog post will be referring to the word 'poo' directly and graphically. If this offends or upsets you, please consider changing the way you think about poo. 

This blog will also mention blood and mucous. Inflammatory Bowel Disease is not a glamorous condition, and unfortunately I tried to ignore my symptoms because they were too gross, and I didn't know these were serious. I hope that speaking openly about these things will raise awareness, especially in younger readers who are more likely to be ashamed of these things. 

I didn't tell anybody when I first noticed changes to my poo. I’ve subsequently spent eight months in agony due to an uncontrollable flare up of Crohn's Disease. Had I spoken to a doctor sooner, maybe we would have found treatment that worked for me quicker. We definitely would have had answers sooner.

My flareup began in October 2018, the beginning of October. I remember it well, unfortunately there was a traumatic event that kicked it off. I was over 500 miles away while a family emergency took place, and I couldn't travel home because I had three assignments due that week. My biggest fear at university suddenly became real: that something would happen to my family while I was away and there was nothing I could do, an unfortunate side effect of my attachment anxiety and homesickness. I spent the week in shock, I couldn't bring myself to work, eat or study. I was bursting into tears at any moment, and anything I did eat made me feel incredibly sick. the next week I became ill with what I now know to be the beginning of a flare of Crohn's. 

Crohn's disease is an autoimmune inflammatory condition where for some reason, your body believes your digestive system is foreign. Your immune system begins to attack your digestive system, most commonly your large intestine, and inflammation occurs as a result. Stress is often a factor in causing flare ups, as is minor infections, food poisoning or just luck. The symptoms of Crohn's are not limited to your digestive system; you can have inflammatory response across your body, from arthritic symptoms in your joints, to inflammation of the eyes, to symptoms on your skin. 

So I became ill in October. I didn't seek treatment until November. I left my symptoms for two or three weeks, noticing increasing amounts of blood with my poo. Some toilet trips were just blood. This was embarrassing. In healthy people, poo is usually formed, on the Bristol stool chart: a 3 or a 4. My poo was watery, loose, a 6 or a 7 on the chart. I was going to the toilet multiple times a day, having the sudden urge to go. For a healthy person, though toilet trips are very personalised, diarrhoea is classed as three or more trips to the toilet with loose stool. There were days I was going to the toilet 20 times a day with extremely loose stool.  


At times, I barely left my flat; having an en-suite university room was a lifesaver. I avoided going to my boyfriend's flat; he shares a bathroom with his flatmate and it just wouldn't be right for me to go and do a poo there. The poos were foul smelling, I would use all their toilet roll, they would hear the poo sounds. 

I stopped being able to make it to lectures- especially the ones in the buildings too far away from my bathroom, or I managed to attend lectures and then rushed back to my flat afterwards. some lectures I had to walk out of, the one I remember the most being a revision lecture for EU Law; a topic I really enjoyed, but missed quite a bit of content for. I was frustrated that I couldn't even make it a 55 minute lecture without rushing to the toilet.  

Another issue is the fear of public toilets I suffer from. I have enough tales to write a whole new post about this, but I have been scared of public toilets, toilets that were not 'safe', since being a little girl. When I was very young, I had a recurring dream of toilets swallowing me whole; and so since primary school have hated toilets. This anxiety changed when I developed social anxiety, into a fear of the other toilet users. I am terrified of being heard in toilets when I'm peeing. You can imagine how horrible it feels when I get the sudden urge to poo, and my only option is a public toilet.

One night that I want to talk about in particular is the night of my Mooting Society winter ball. Sometime in November, this took place while I was still trying to ignore my symptoms. It was one of the best nights at university this year, I thoroughly enjoyed myself. I went with my friends Katy and Liam, who are absolute stars. But I look back on the photos, and I just seem incredibly ill. My illness is invisible, but I can see how swollen I am, how pale. With the amount of blood I was losing, I wouldn't be surprised if I was anaemic at this point. If I had spoken to a GP as soon as my symptoms had started, maybe I would have been on medication by this time.

Katy, Liam and I while getting ready for the ball

Ceilidh dancing isn't my strongest skill, but it is an absolute blast

The night of the mooting ball was incredible, a three course meal and dancing the night away in a posh hotel on Dundee's waterfront. The night ended in the Union nightclub, and I walked home with a hot dog and a bottle of water at three in the morning. But I have to ruin this and mention my poo. I went to the toilet after I got home and passed the usual loose stool, with quite a lot of blood clots. I wasn't aware of this, but alcohol of course exacerbates the symptoms of Crohn's Disease. There was a lot of drinking this night, free prosecco and wine, shots of tequila, vodka cokes, a cocktail pitcher, the standard student night out. It was the next day I took my first A&E trip. 

This condition has really limited my social life; I will still join friends for soft drinks in the pub, but going to a nightclub and paying £2 for a small cup of likely-watered-down pepsi when there's alcopops, shots or shooters for £1 really doesn't seem economical. Especially when I keep having the urge to go to the toilet, and might have to do a poo in a nightclub. Our student drinking culture is seriously a separate issue for another blog post, but, with drinking making up a lot of social activities at university, I've spent a lot of time on my own over the past few months. 

I was turned away from A&E because I had previously been diagnosed with IBS. When I was eleven, I had a similar instance of chronic loose poo, with no real explanation. There was no blood in the stool, but for two weeks I was rushing to the toilet and unable to attend school. I was taken to hospital for an overnight stay and diagnosed with IBS when they couldn't determine what exactly was wrong. I remained ill for a while after this admission. This is now something I look at as a potential flare up of Crohn's; evidence that something hasn't been right with my digestive system for a while. 

Despite my protests, A&E said that the bloody stool was that IBS, Irritable Bowel Syndrome, a condition that is incredibly painful and results in diarrhoea, bloating, and  painful gas. These symptoms can pop up in Inflammatory Bowel Disease (IBD) too, but IBD is treated in a much different way, usually with steroids and immunosuppressants, while IBS can be treated with a muscle relaxer, and is a completely different condition. Crohn's is a form of IBD. You can die from untreated complications from Crohn's; whereas you cannot die from IBS.  

The problem with being turned away from A&E was that I had put off seeking medical attention for so long. I was at this point desperate for help. I cried, walking out of the hospital, calling my mam, because I knew that I wouldn't go to a GP. My GP was at home, hundreds of miles away, and I was going home at the beginning of December. If I had held out this long, why not wait a little longer? I think there were three weeks left at university at this point. 

A side point here; I cannot emphasise enough the importance of getting a new GP practice when you first arrive at university. I did not, and this is why the whole reluctance to see a GP came about in the first place. When I became ill in the second half of my first year with recurrent kidney infections, I was unable to join a GP practice as they had all 'closed their books'. At the start of second year, I was so busy telling the first years I look after as a Student Support Assistant to get a GP that I never got around to signing up myself. If I was registered with a GP, I probably would have sought help quicker.  

I would have another failed A&E trip that week. The GP surgery I had attempted to join in first year accepted me as a patient and I had an emergency appointment booked for the next day. This was November, and I would spend a lot of time going in and out of the GP practice having various examinations, fingers prodded into my belly and other areas, blood tests, et cetera. I was given an appointment with a gastroenterologist as soon as they could fit me in; mid January, but as you may already be aware, that would be too late for my condition, as I was admitted to hospital in the first week of December. 

The waiting times for a diagnosis of IBD are unfortunate. Your GP cannot diagnose you, it has to be a consultant gastroenterologist, and a consultant cannot diagnose you without a colonoscopy, sometimes without an endoscopy, or an MRI. you may need a Barium Enema, or a CT scan. Maybe you will need to take a PillCam. These are all procedures that have long wait times across the board. in some NHS trusts, these are booked up to a year in advance. I think in Tayside the average waitlist is three months. The consultants are very busy, and when you finally get there, with the consultant in front of your face,  you have a fifteen minute slot to express all the concerns about your poo. It is easy to forget important things that need to be said or asked, especially if you're an anxious-easily-flustered twenty-year old, used to attending appointments with a mother who knows exactly what to say and how to say it. 

"How are you doing, Leanne?"

"Yeah, uh, not bad, I guess... I'm not sure..."
"okay,  good, see you in a month."

After being admitted to hospital the first time around, I had a flexible sigmoidoscopy, but as my inflammation was not in my sigmoid or my rectum, it did not show the extent of my illness. Over the Christmas period, I was given an urgent colonoscopy, which showed my inflammation as much deeper into my system, and it wasn't until my second emergency colonoscopy after being admitted a second time that my diagnosis was officially changed to Crohn's. it took six months between noticing the beginning of symptoms to a correct diagnosis. Six months of hellish symptoms, and that was with rapid appointments since I was admitted to hospital twice. 

We have to break the stigma of poo. I do not mean that we have to open up and tell our best friends what our bowel movements are like each time we sit on that porcelain throne, but bowel health is incredibly fragile and our poo is incredibly telling. The first time I passed blood was a warning sign. I ignored it.  I convinced myself it must be haemorrhoids, despite never having haemorrhoids before in my life, and started using Anusol suppositories. When buying them, I gingerly walked to the counter in the chemist, avoiding eye contact with the cashier, as if it was a shameful purchase.

Sure, it is embarrassing when you're buying intimate products: think about how it feels purchasing condoms, or pregnancy tests. Somehow, a pregnancy test seems easier than suppositories. Haemorrhoids can be deeply unpleasant and painful. Any issue with bowels is horrible to deal with. The embarrassment shouldn't matter if it means that symptoms would go away; yet at the same time, this situation shouldn't have occurred, as according to NHS guidelines, if you believe you have haemorrhoids, you are advised to see a GP for diagnosis.

Now, how many people immediately go to a doctor when they think they have haemorrhoids, and how many people are embarrassed at the thought of a doctor sticking a finger up their bum, and do the same trip to the pharmacy in the hopes the issue will go away quietly?

 I was of course very wrong when I diagnosed myself, because I am not a medical professional, and the suppositories did not work. I was embarrassed and ignored the issues that presented themselves. At the time of my flare up, my mother worked as a surgical pre-assessment nurse. She even wrote the guideline sheet for Colonoscopy prep at our hospital. (Yes, I am so proud of her!) I didn't even tell her something was wrong, when she worked with doctors and surgeons whose bread and butter procedures are endoscopy, when she has been up close and personal with the symptoms of Crohn's time and time again. Nobody wants to tell their parents what their poo looks like; but my mother, as a medical professional who works with IBD, would be the best person to tell that something was wrong. She would be able to support me, she would be able to convince me to go to see a doctor long before I finally decided to go on my own, and she would be able to tell me what my symptoms likely were. But I was too embarrassed.

Poo is unpleasant. Nobody wants to talk about it. But if we did, taking concerns to doctors would be a lot easier. How many more people would complete their Bowel cancer screening kits rather than chucking them in the bin? Bodily functions are not shameful. when something goes wrong with our bodily functions, we should be comfortable enough to seek help. Doctors have seen so many arseholes that they really aren't phased when they'll be looking at yours. 

Speak up about poo. It really shouldn't be taboo. And for the love of God, if you're pooing blood, see a doctor as soon as possible.

Leanne x

https://digital.nhs.uk/blog/transformation-blog/2019/pee-and-poo-and-the-language-of-health
https://www.nhs.uk/conditions/piles-haemorrhoids/diagnosis/