Note: If you are squeamish, or think that talking about bowel movements shows incredibly poor taste, then read no further. Don't say I didn't warn you.

There's nothing quite like it. That weird sense of release, the strange squirming feeling as it escapes. It's new, different, odd, because you're so used to having solid bowel movements, so it can be a little unnerving. But if you have managed to make it to a toilet, and don't need to go anywhere for a while, it's a fascinating experience. I should point out though, that if you are not in the immediate vicinity of a toilet, diarrhoea is the worst thing in the world. When you feel that funny tingle in your stomach - the one that quietly whispers "Get to a toilet RIGHT NOW, man, I'm not even joking with you, or you will shit your pants and leave muddy footprints" - you probably have less than five minutes to get on that throne. And God have mercy on your soul if you don't.

You sit down. At first, you don't want to let go - it feels weird, like your intestines are about to explode out of your arse. When you eventually let it flow, there is a burst, an ugly noise, and you are shocked to feel that it is liquid, like you are pissing out of the wrong hole. It's not an unpleasant feeling, almost a relief that it is so easy - all you have to do is just relax, and it takes care of itself. It's quite entertaining, and makes some wonderful sounds.

It is around this time that one of the only two bad things about diarrhoea occurs to you (I'll get to the other one later): the smell. Oh sweet Jesus, the smell. Obviously, if you have got the runs, the squits, the thrupenny bits, the Jimmy Riddles, the scutters, the bowl pebbledasher, then there is something wrong with your insides. Food poisoning, dysentery, some sort of gastric problem, whatever - diarrhoea is not the normal run of things. Illnesses usually produce some sort of bad smell somewhere, but the shits take the gold medal for that. It's a sharp, acrid abomination, and it hits you like a slap in the face. Normally you can stand your own shit stink, appreciate it, even, but not this one. This one is rank. Eventually though, this passes. It's still there, but you've got used to it. Try coming back into the bathroom later on, after it's all over, and you can enjoy it all over again. Other people will be horrified by it, and will look at you in shock all day, staggered that someone they know, someone they like, could have produced such a foul stench.

After a while, you enter a zen-like state, calmly thinking about your life. Every now and then, there is another little explosion. It's not a constant stream, as you'd expect, so if you have the time to spare, you may as well stay where you are and get it out. Why do I enjoy it so much, am I some sort of pervert? No. I enjoy it because it is so much better than being constipated. When I'm constipated, I just want to fucking die. Diarrhoea, on the other hand, is easy, relaxing, and fun in a bizarre kind of way. Sue me.

When you think it is all over, you stand up to survey the damage. There are two kinds of diarrhoea: little blobs in a watery soup, and the pure, liquidy type. The first one flushes away quite easily, maybe you get the odd floater, but a second flush takes care of this. The second type is like a chocolate pudding, it floats on the top of the water, and takes approximately 9053 flushes before it even starts to consider shifting.

It is now that we come to the second bad thing about diarrhoea, arguably the worse of the two: the cleanup operation. Normally, arse-wiping is a fairly simple operation. Not this time. Your bumcheeks are caked with the filthy stuff, and you can easily go through half a roll of toilet paper before you start to feel remotely clean. If you happen to be of a hirsute nature, it's even worse: Liquid shit and arse hair do not mix well. Or rather, they do mix well, which is the problem. But let's not dwell on that.

Finally, it is all over. As illnesses go, it is by far the easiest to deal with. As long as you can stay at home, get to the bathroom quickly, and keep everyone out of the house, then you have a fairly easy time of it. How many illnesses simply involve sitting down for a while? You can even catch up on your reading. Of course, if it is merely a symptom of a bigger disease, like dysentery, then my simplistic analysis doesn't hold. If it lingers, or you feel any other ill effects, please see a doctor. But if you have merely got the shits one day for whatever reason, then that's okay. Sure, there are more pleasant ways of spending a day, but this one is free.

One word of warning, if this is your first time experiencing the runny-bottom madness: Be careful. Be absolutely sure that you have finished. If, later on in the day, you feel like farting - don't. Go and sit on the toilet, and then fart. Nine times out of ten it will just be a fart. But it is that tenth time out of ten that you will thank me for.

PI, you forgot a few:

When you're sliding into first,
And you feel a little burst,
Diarrhea! Diarrhea!

When you're sliding into home,
And you feel a little foam,
Diarrhea! Diarrhea!

When you're climbing up a ladder,
And you feel a little splatter,
Diarrhea! Diarrhea!

When you're sliding on a slide,
And you feel something glide,
Diarrhea! Diarrhea!

A template for easy creation of a Diarrhea! Diarrhea! ditty:

When you're (insert activity here)
And you feel a (insert sensation here)
Diarrhea! Diarrhea!

Note: There are many variations of both the template, and the way the rhyming goes, although in almost every version of this "song" the rhyme scheme is: AAB. Feel free to experiment with your own Diarrhea! Diarrhea! songs.

Everybody at some point in their life has suffered from diarrhoea. For most of us it is nothing more than an unpleasant and inconvenient short-lived affliction. However, diarrhoea is one of the top causes of mortality in under-5's in the world, infact, for the period 1995-2000 it was the top cause of infant mortality.

Diarrhoea is the result of fluid and electrolyte loss into the lumen of the gut leading to the production of unformed or liquid faeces. It is most frequently caused by infection of the intestine by a pathogen (bacterial, viral or protozoan) but it can also becaused by toxins (such as those secreted by some bacteria) or chemicals (phenolphthalein produces extremely violent and copious diarrhoea). Diarrhoea can be thought of as the mechanism by which the intestine purges itself of an irritant or pathogen.

Most cases of diarrhoeal disease go undiagnosed either because they are short-lived and self-limiting and the patient doesn't seek medical attention or because medical and laboratory facilities are not available.

In warmer climates diarrhoea becomes a more serious problem. Fluid and electrolyte loss can be severe and acute dehydration is a real possibility, children are particularly susceptible . Without adequate rehydration and electrolyte-replacement death can follow rapidly.

Infectious Causes of Diarrhoea

A) Food poisoning - toxins in food

B) Intestinal infections

Determination of the pathogen responsible for diarrhoea is almost impossible clinically. However, gathering information on the patient's food intake and recent travel history in addition to macroscopic and microscopic examination of the faeces can provide an indication of the likely cause. A precise diagnosis can only be obtained through laboratory investigation.


Medical Microbiology. Mims et al. Mosby 1994
Unicef (www.unicef.org)

Colorectal cancer. It is not a pretty word, and it could be coming to a bowel near you. Especially as it is the worlds fourth leading cause of death related to cancer. But wait, there is a avenue of prevention that you have yet to consider.

Cancer is one of those horrible diseases that seems to occur in the more developed aka industrialized countries. At least this variety of cancer that kills the constipated well medicated wealthy. In contrast it's much less common in developing countries, ones with frequent or chronic diarrhoea no less.

It appears that there is a link here, it's not that the backed up poop is poisoning you, though this perhaps is also true. It's because the toxin that causes soupy poop also has an inhibiting effect on the growth of cancer cells in the colon. It could be said in some cases diarrhoea protects against colon cancer.

Diarrhoea often results from E.coli contaminated food or water1. Certain strains of E.coli produce enterotoxins that are secreted into the intestine. These toxins not only cause cramps and violent backfires but also have the added bonus of allowing and excess of calcium to flow into the cells of the intestine, this slows down their growth and so inhibits the spread of tumors.

So next time you have the shits, traveling some unfamiliar country, cursing the food and the poor hygiene, think again, your life expectancy may have increased a fraction.

Journal reference: Proceedings of the National Academy of Sciences (DOI: 10.1073/pnas.0434905100)


1Death from dehydration is the leading cause of mortality for under five year olds in developing countries. Its also one reason why the average life expectancy is so much lower.

Di`ar*rhe"a, Di`ar*rhœ"a , (dI`ar*rE"a), n. [L. diarrhoea, Gr. dia`rroia, fr. dia`rrei^n to flow through; dia` + "rei^n to flow; akin to E. stream. See Stream.] (Med.)

A morbidly frequent and profuse discharge of loose or fluid evacuations from the intestines, without tenesmus; a purging or looseness of the bowels; a flux.

 

© Webster 1913

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