To maintain continence, the puborectalis muscle chokes the anal canal. The sling of tissue is supposed to release during defecation. Mine has not been doing that.
Mid-March 2021, at a bowling alley, I watch balls thunder down lanes and wonder if I’ve had a bowel movement since Presidents’ Day. I try: Miralax, Restoralax, magnesium citrate (liquid and powder), senna (tea and pills), psyllium (powder and pills), Benefiber, Citrucel, digestive enzymes, Swedish bitters, probiotics, prebiotics, flax seeds (milled and whole), chia seeds, prunes, figs (soaked and dried), Squatty Potty, Dulcolax (pill and suppository), allicin, glycerin, berberine, neem, ginger, fleet enemas, artichoke extract, dandelion, cascara sagrada, pumpkin purée, licorice root, slippery elm, beans, colonic massage, sea moss, apple pectin, aloe vera (juice and gel), kiwi, acupuncture, perianal splinting, beta-glucans, alfalfa, red clover, going off Wellbutrin, going on Adderall, apple cider vinegar, prayer.
In May, I go to a gastroenterologist. He has a signet pinkie ring and gelled hair. I pull down my shorts to show the bulging in the iliac region of my lower left abdomen which, I conjecture, is from buildup in the sigmoid colon. I cry. The doctor stares.
Later, browsing the medical directory Zocdoc, I learn that he served in Afghanistan as the sole physician for 2,000 soldiers. I unfurl a tissue. I say I’m probably overemotional due to the gut-brain connection. People on podcasts say things like “gut bacteria is responsible for 95 percent of the body’s serotonin supply.” The doctor says to avoid cruciferous vegetables and download a low-FODMAP diet app (FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols). He prescribes Linzess — an oligopeptide agonist of guanylate cyclase-C — and refers me to Lenox Hill Radiology for an X-ray of my intestinal tract.
