The Good Gut Guide: Help for IBS, Ulcerative Colitis, Crohn's Disease, Diverticulitis, Food Allergies and Other Gut Problems. Stephanie Zinser
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that these muscles are toned. You can do pelvic floor exercises discreetly at any time. Just gently squeeze and tighten the muscles, as if you’re pulling up and in, hold and then relax. You can do it in stages, pulling up a little bit at a time, and holding in between. You can do them standing or sitting, and regular practice (several times daily) is essential.
The skin around our anus is sensitive – one only has to see what happens to a baby whose nappy has been left unchanged for even a little while to see how sensitive it is. When we get diarrhoea, the resulting faeces are generally more acidic than a normal stool, so it’s quite normal for our skin to get sore. And sore skin can get itchy.
Children are prone to getting an ‘itchy bum’ because they’re not always careful to wipe themselves properly after going to the loo. Itching isn’t always caused by lapses in hygiene, although if you have a bowel problem – perhaps IBS, haemorrhoids or an anal fissure – being scrupulously clean is even more important.
In children, the commonest cause of an itchy bottom is threadworm infection, while among adults it is most often due to haemorrhoids or pruritus ani. Eczema and excessive sweating can also cause an itchy bottom (it’s also common for people to get dry, itchy and sensitive skin as they get older). Proctitis and anal fissures may also cause this irritating symptom, as can anal cancer – though this is very rare.
Self-Help for an Itchy Bottom
How to Get the Best from your Doctor
Overcoming Shyness
There’s little argument that bowel problems represent the last taboo in today’s world. Forty years ago, women died in their thousands because they were too embarrassed to go to their doctor with a breast lump. Today, there are fashion shows promoting breast cancer research, with supermodels happily waving the flag. Thank goodness that they do – as a result there are thousands of women alive today playing with grandchildren they thought they would never see.
Unfortunately, sufferers of bowel disease stand almost in the same place as breast cancer victims did four decades ago. It may not be embarrassing to talk about your stomach ulcer, but what about telling friends that blood and diarrhoea are squirting out of your bottom, or that you have terrible wind and problems with incontinence? Not many people would.
It’s one thing not to want to make coffee morning conversation about your bowels, but many thousands of people are too shy even to tell their doctor and they quite literally end up dying … of embarrassment.
‘I couldn’t face telling anyone. I kept it to myself for over a year before I told my husband I had chronic diarrhoea. Eventually, I plucked up courage to go to the doctor, but I was a nervous wreck by the time I got there. I was, and still am, very embarrassed talking about bodily functions. I only recently discovered that bowel problems run in our family, and that my younger brother was also diagnosed with ulcerative colitis – like I now have been – some time ago. If only I knew, I would have seen the doctor much earlier.’
Ellie, age 29
Picking the Right Words
It’s possibly the hardest place to start – what words do you use? Most people find medical terminology (like ‘stools’, ‘flatus’, ‘anus’) ugly and uncomfortable to use, while the other words we know about are either too babyish (‘poo’, ‘number twos’) or too crude (‘fart’, ‘shit’, ‘arse’). However, if you use vague descriptions like ‘down there’ or ‘down below’ in order to avoid mentioning these embarrassing words your doctor can become confused about what you’re really trying to say.
There’s no easy answer, but it helps if you realize that doctors hear ‘embarrassing’ words all the time and aren’t generally fazed by any of them. If they sense your embarrassment, they will often step in to help – one gastroenterologist I know often uses words like ‘shit’, knowing that he can break the ice this way. If knowing your doctor isn’t going to be offended doesn’t help, then tell him you are embarrassed about having to discuss the subject with him and usually he or she will help you along in an effort to spare your blushes.
The following useful phrases are both descriptive yet not too awkward for anyone who feels uncomfortable discussing intimate body parts and functions with their doctor:
‘BELCHING’ (BURPING) AND ‘SOUTHERLY WIND’ (FARTING)
Most people normally say ‘burping’ or ‘belching’ and neither of these words is likely to offend. When it comes to ‘farting’, however, there may be sensitivities – even though the word is so commonly used that it may soon carry no social stigma at all. Some people like to refer to farting as ‘southerly wind’, but if you think this is too twee, another option is simply to call it ‘breaking wind’. If you’re asked to be even more specific you can always add ‘from the back end’.
‘NAUSEA’ AND ‘VOMITING’
Bear in mind there is a difference between these two words – nausea normally means feelings of