Like a Sausage or Snake, Smooth and Soft

Medicine is an inexact science. So inexact, in fact, that doctors have sort of a complex about it. We look at those mathematicians and physicists, with their equations, and their real solutions to things, and we get jealous. So we have to assign numbers to every disease. It happens in every specialty, from gastrointestinology (5 types of bile duct cysts!) to rheumatology to pediatric cardiology. It’s probably the worst in orthopedics though. Seriously, they have to number every freaking type of fracture every which way. Sometimes it makes sense, most the time it’s some dude who wants his name on a research paper. Pretty much every disease, there either is a numerical scale/categorization system or someone is thinking one up, right now.

It should thus come as no surprise to you that there is a numbering system for poo.

I’m sure you can identify with the mindset required (and if not, why are you here?) to sit on a toilet and, pondering the diversity of your dooks, wonder about where they fall in the natural order of the universe. Isn’t there some cosmic scale that can quantify what has only hitherto been qualified?

Yes. Yes there is.

I'll give you a moment to fully take this in.

.It’s called the Bristol Stool Form Scale, and it was created at the Bristol Royal Infirmary in England. Jokes about oral/dental hygiene aside, the British certainly are ahead of us at the other end. According to some sources, types 3-4 are normal, though some sites claim 4-5 are the most desirable types. I guess it depends on how much you enjoy wiping. Yeah, 5 may get through you easier (indicating better colonic motility), but they do require some messy maintenance if you are pushing these out every day.

No one can argue with the awesomeness of type 4 though. There is no greater feeling than, answering the call of your distended rectum, you sit down and feel this sausage-snake slither out. Your anus barely bothers to yawn and you’re done. A single quick wipe with minimal residual and—what are you now going to do with all this extra time? Get work done, spend time with loved ones, play Angry Birds… all great options.

What was previously difficult to categorize and describe in your quest to attain mutual understanding with your friends and family is now as simple as assigning a number. Explaining your scat to doctors was the original purpose of the scale, as this guy tells us:

.Of course, Konstantin may just not realize that people don’t want to talk about their poo with him. But, I’m getting ahead of myself. It’s important that once you now understand the gift you have been given, you use it. Facebook status, Twitter updates, your own personal blog—the world is now open to you. If you think people care about the fact you found a sweet baguette on sale at your local market, they are going to love the fact that you averaged a 3.5 today. How could they not?

The beginning of another great thread.

.Now, if you’ll excuse me, I’ve got a magnificent 4 that’s been waiting patiently to come out while I’ve been writing this.

Do You Poo Blood? I Do!

No. I can’t boast about this last trip to the john. Whereas my last post began with a fluid masterpiece, I just now left the bathroom after spending 5 minutes trying to cleanse myself of paste-poo.  There’s nothing redeeming about paste-poo. It usually starts out fine, feels fluid, but then there’s that stop: that viscous slide to a hanging mass. Sure, the bulk of it may drop, but the ineffable stalactite remains. You wipe and scrape, but each time it feels like taking just a fraction, so that you divide to infinity, until you finally just stand up, exasperated, wondering if you will ever be clean again.

Nevertheless.

When you are growing up and learning about this amazing world, you always have a lot of questions. Some of these are fairly innocuous: “Why is the sky blue?” Others aren’t generally answered until you are older: “Why are Uncle Will and his roommate Ben holding hands?”  I always had plenty of these stored up for my exasperated mother. One of the questions I think may have been somewhat unique was: “Why is poo brown?”

Now come on. You are curious. My mom didn’t know. I asked her enough, but stopped after each answer was different and it became clear that I was gaining nothing by pestering her. Some examples:

“Because all the things you eat are different colors, and when you mix all the colors together, it turns brown.”

“It’s the easiest color for flies to see.”

“All the bacteria in there are brown.”

“GOD MADE IT THAT WAY!”

This last, though maybe true in a certain sense, means essentially nothing to the curious mind. So, I let it go. In college I never found out. Wikipedia and Google both were around, but were not to the omniscient level that they now present themselves. It wasn’t until med school that the answer came, just wafting by, a mere side point to a tangent—can you imagine?!—in a gastrointestinal physiology lecture.

The brownness comes from: blood.

To be more precise, stercobilin. Well, when blood cells die, they turn to biliverdin, to bilirubin, which gets sugar added to it and turns to bile, then excreted into the gut, then converted to urobilinogen, THEN stercobilin. But, please don’t remember any of that. It’s just in there for cred for my homies. Just accept my initial assertion that blood turns to poo.

A sleep aid.

Well, yes, sometimes you actually do poo blood directly (the red kind) and that’s usually bad. But when those red blood cells die of old age in your body, the other cells always say (to comfort themselves) “well, he’s in a better place now.”

Isn’t it the truth.

Dr. Colonic – Squeezing my way into your life

Ahhhhhhhhhhhhhhhhhh.

Sorry, I just came out of the on-call room after squeezing out a semisolid wonder. Not a thick rectum-stretcher, not one of those after-pulsators that deliver their pleasure in a fading echo, no—but highly satisfying nonetheless: a near-fluid duke, making the journey from intra-rectal to extra- in less than a half-second, delivering an almost supersonic emptiness high. Shudder: intense. The sequelae of my pepperoni and sausage with a lot of hot sauce.

But enough. I’m not trying to get you all up and jealous. This post isn’t even about you anyway.

I’m DrColonic, yes a for-reals doctor who managed to somehow make it through interviews for both medical school and residency despite my love for creating hilarious awkward social situations via my well-placed inappropriate comments. It’s not that I don’t understand social norms (I think), but shock-educating people out of their comfort zones via knowledge/references to their body is just too hilarious to pass up. Interestingly, I still have friends, and when one of them invited me to share my wisdom about the amazing world of our butts, it was difficult to pass up.

I have to read (or at least pretend to read) a steaming pile of scientific studies for this job, and since my brain is often in that mode, you will most likely be exposed to many liberally paraphrased chunks of academia from journals such as the Annals of Fecology (copyright on that name: mine), mixed with my own inappropriate insight. One of my goals is to teach you the Art of Awkward  Conversation Using the Gastrointestinal and Genitourinary System, since I can only write on this blog and can’t be there with your soon-to-be-smaller circle of friends via the Internet. Note: I plan to make this technology available as soon as possible (working title: Doctor Colonic’s Insta-Blog Virtual Presence). Until then, you have only my words to help you along the path.

Pictured: impolite conversation.

“Yeah my bathroom is just down that hall. Did you know the rectum is just a big vault for your poo?”

This is gold, people.

Or maybe I shouldn’t set up any goals, since that means you have to work to achieve them. Hmmm. We’ll see how it goes.

Anyway, I told you I was on call, and so should get back to work. There’s a patient here with a highly inflamed rectum on his CT scan. I can only imagine the generous volume he must create. Tip: do not make jokes about inflamed rectums when one so inflicted is in the room.