Are you full of shit?  When I was young, FOS meant something completely different than it is now.  Now, FOS is a literal term and means you are constipated.  The older I get, the more my conversation revolves around the morning “dump.”

Today, you get your joke early.  Three old guys are sitting at the breakfast table in the nursing home.  The first guy says makes those “grandpa sounds,” oye, oye, oye, I can’t shit.  I sit on the toilet for an hour, straining to get out a few little pellets.  It’s horrible.  The second guy says he can poop just fine.  He just can’t piss.  He says he stands over the toilet and pushes and strains for an hour and finally he pees a little all over the toilet.  The third guy laughs and says he pees and poops fine.  He just does it an hour before he gets up.

As a young doctor, I knew this joke was true but found it hilarious nonetheless. I no longer think it is hilarious and am living proof that it’s real.  There are lots of reasons for constipation.  There are dietary, disease state, medication and mechanical reasons. Sometimes, the cause is multifactorial.  My constipation is a direct result of the Parkinson’s and the medications for Parkinson’s.  I’ll cover urinary problems in a future article.

So, what do you do about constipation?  The first thing is to make a joke out of it.  Believe it or not, relaxing can help and laughing at constipation is better than crying.  Afterall, potty jokes are some of the first we learn.  The older we get, the more child-like we get.  If we live long enough, we will all be back in diapers.  Luckily, my generation has sexy diapers as seen in TV commercials.

Dietary changes are tricky.  What constipates one person gives another person diarrhea.  My advice is to play with your diet, observing what your response to various foods.  Greasy foods, as well as foods high in fiber, often help.

Next on the list is pharmaceutical.  There is an entire row of products for constipation in every pharmacy in the US.  I usually recommend a bulk fiber substance like Metamucil as a starting point.  If that fails, I’ll recommend a product named polyethylene glycol (Miralax) to be taken daily.  I’m not a big fan of oral laxatives as they often cause diarrhea.

Probably the best tool in the medicine cabinet is a glycerin suppository.  Inserted anally, it almost always produces a stool you can be proud of in under an hour.  Convincing a patient to use a suppository is not easy.  It seems that touching your anus ranks right up there with first degree murder. GET OVER IT!  If you can muster the intestinal fortitude to insert one, you’ll realize how easy it is.

I would be remiss in my “dooties” if I didn’t remind you to see your doc before starting any medications for diarrhea.  If you haven’t had a colonoscopy recently, you may need one.  Assuming that your exam is all normal and everything discussed above has failed, you may need an oral laxative.  Your doc can discuss the use of oral laxatives with you.

Here’s your song of the day.  I had no idea there were so many songs on poop.  Here are a couple of extra songs to make you smile.

What did one fly say to the other?  “Is this stool taken?”

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