Ask the Doc

Your embarrassing questions answered!

By Harold Boutté Jr., MD

Q: I’m having some, um, issues with, uh, pooping. Is what I’m experiencing normal? How do I talk to my doctor about it?

A: Strong-smelling farts and accidents during the night while sleeping are the most common bowel issues people are embarrassed to talk about. Without question, not being able to trust your own farts is scary. 

Typically, noxious gas and urge incontinence — when you can’t stop your feces from exiting your rectum no matter how hard you try — are not symptoms of a fatal disease. Most gastrointestinal issues affect quality of life rather than longevity. There are caveats, of course, but more common culprits are lactose (dairy), gluten intolerance, or infectious or inflammatory colitis. 

An evaluation from your provider will help to figure things out. That evaluation is where the hard part comes in: To figure out what’s going on, you’re going to have to talk to your provider about what you’re experiencing and what’s worrying you the most about whatever embarrassing thing is happening to you. 

For many people, talking about bowel function is difficult. Farting, pooping, not being able to control when and/or how those things happen, and the sometimes pungent smells embarrass most people acutely.  

Add to that the negative social stigma associated with these natural body functions, and talking about them becomes even harder. But trying to ignore your bowel health can have some deleterious effects down the line, so it’s important to make the effort to talk to your provider about what’s going on down there.

One thing that might make talking about bowel function easier for you is understanding that gastroenterologists love talking about all that gastrointestinal stuff that grosses out and embarrasses most everyone else. We’re talking about a group of people who got into this profession because, as kids, we were inspired by reading [the 1977 children’s book] Everyone Poops. 

We understand that everybody poops, and everybody farts. When you’re talking to us about those things, we’re not revolted. We’re not making any judgments about you. We hear about these things every day.

So how do you talk to your doctor about body functions that you may not even be comfortable talking to your closest friends about?

Reframe. 

Think about your bowel function as normal and natural instead of as a personal failure because you can’t stop yourself from pooping in your underwear, or because your feces or gas is strong-smelling.

Make it a conversation.

Your appointment with your gastroenterologist isn’t an interrogation; it’s a conversation. Tell your gastroenterologist your story: what’s happening, how long has it been happening, when is it happening, You’ll find that once you start telling your story with all those details, everything — even those bits you might think are embarrassing — will come out naturally.

Use descriptive language, even if it’s crude. 

Your physician doesn’t expect you to have a medical degree or to know medical terminology, so don’t worry too much about what words you use when talking to us. We expect you to use the common vernacular to describe what you’re experiencing.

We know that for most people, talking about bowel function isn’t easy, but by being open and talking frankly withus about what you’re experiencing, you will help us figure out what might be driving your symptoms. We can also develop strategies to resolve those symptoms, or at least make them more manageable so that your quality of life improves.

Harold Boutté Jr., MD, is a gastroenterologist at Northwestern Medicine Digestive Health Center in Chicago.

Originally published in the Spring/Summer 2023 print issue.

Interview by Stephanie Bouchard

Stephanie Bouchard is a freelance journalist who writes about health and wellness, lifestyles, and pets.

www.stephaniebouchard.net