“One of life’s underappreciated pleasures is the filling and emptying of one’s hollow viscus.” —attributed to Samuel Johnson, but maybe not.
Admit it, we all love filling our tummies, that much is obvious. But isn’t a good bowel movement also a pleasurable sensation? Yes, it’s inconvenient, and we’re taught from childhood that it’s somehow nasty and not to be talked about. If you’re honest with yourself, though, you’ll admit that the time you get to spend sitting by yourself in the bathroom getting rid of what your digestive system is casting off can be a pleasant experience.
Our fecal continence, being able to hold everything in until the time is right, is a complex system integrating both voluntary and involuntary muscles, sensory nerves, and some of the densest collections of touch receptors in the entire body. There are more pressure and temperature receptors in the anal skin than in the fingertips.
An old joke tells of a Hand Surgeon and a Colon Surgeon debating the relative importance of their areas of specialization. The Hand Surgeon waxes poetic about how hands can do everything from hard labor to playing a sonata to gently comforting a crying baby. The Colon Surgeon then has the Hand guy cup his hands. The Colon guy then fills them with his dinner—roast beef chunks, mashed potatoes and gravy. Then he tells him, “Now open your fingers and just let gas through.” That’s what our anal sphincters do every day.
Sometimes, surgeons like me are forced to pervert this natural process by the creation of a colostomy or ileostomy, pulling the intestine through the abdominal wall and draining it into a bag. Patients facing this procedure express worries about things like odor, inconvenience, and social concerns (everyone will know about it). In fact, with a well-constructed stoma and modern low profile appliances, none of these concerns are significant problems. For many, the stoma is a temporary problem. It can be closed in a few weeks to a few months. For others, it is a permanent fixture to which they must adapt.
One thing I hear frequently from patients who have lived for a while with a colostomy and then had it successfully closed, is how much they missed the sensation of having a good bowel movement. Truly one of life’s underappreciated pleasures.
Bruce Davis, MD, is a Mesa AZ based general and trauma surgeon. He finished medical school at the University of Illinois College of Medicine in Chicago way back in the 1970’s and did his surgical residency at Bethesda Naval Hospital. After 14 years on active duty that included overseas duty with the Seabees, time on large grey boats and a tour with the Marines during the First Gulf War, he went into private practice near Phoenix. He is part of that dying breed of dinosaurs, the solo general surgeon. He also is a writer of science fiction novels. His works include the YA novel Queen Mab Courtesy, published by CWG press (and recently reissued by AKW Books as the e-book Blanktown). Also published through AKW Books are his military science fiction novel That Which Is Human and the Profit Logbook series, including Glowgems For Profit and Thieves Profit.