A trip to the bowel doctor

Today I went to see the colorectal surgery team, so thats another part of the health system ticked off. As a reminder, this was suggested by the HSP specialist as I'd been experiencing bowel urgency problems, and this is not viewed as a common HSP symptom.

So, I wasnt sure what to expect on this visit, could it be about seeing if we could rule out other things, or would it be about management of the situation. It turned out to be a bit of both.

In the ruling out of other things front: I was examined, and things are not quite as expected, so I'll have a further appointment to have some nerve tests done, and then we'll hopefully know a bit more. The specialist I saw has not had any previous experience with HSP.

here's a description of things I've learnt about the bowel today:

Your bowel is controlled by two sphincter muscles, an inner one and an outer one. The inner one stays tight all of the time, and its main job is to prevent leakage. This muscle is not one which you have control over. The outer sphincter also stays closed all the time, but you control over this one, which allows you to choose when you want to go.

There are two types of incontinence - one where you know that you've got a problem - and the issue is getting to the toilet in time, and another when you dont know you've got a problem - and you end up with a mess to deal with.

On the management front:

Management strategy 1: It is possible to re-train the muscles for some people. But the general thought was that as the correct messages are likely as not failing to get through, this strategy may not work.

Management strategy 2: Use Loperamide / Imodium. Some people are on this all the time. This can help by making your stool/faeces/feces firmer, and therefore giving a bit more time to get to the toilet. However, as my urgency issue is not predictable this makes it difficult to use pro-actively. It could be taken when loose stools are noticed, or taken when it is known that you may have difficulty finding a toilet in time.

Management strategy 3: This was mentioned in passing, and not appropriate for me now. You can get a home colonic irrigation kit. Some people will use this 2-3 times a week, and others will use this after they have been once, which then makes you empty for a while, meaning that you cant have any incidents.

These are the management strategies which were mentioned, suggesting that there are some more. Perhaps I'll find out more at my next appointment. The one which springs to mind is checking that my diet helps the situation rather than hinders it.

So, in conclusion, it looks like I'll need to go to the chemist and get some imodium to add to my collection of tablets. I'll need to understand how quickly this works and how long it lasts.