Matthew Perry has given several interviews recently to promote his new book, the central feature of which appears to be a recounting of his astonishingly severe opioid addiction. He said at one point his health was so bad that his colon “exploded” and he nearly died.
Can someone explain what that means? I’m aware that a side effect of opioid use/abuse is constipation. Can constipation be so bad that one’s colon ruptures? Can the upstream part of the colon really cram fecal matter downstream with such force that it exceeds the mechanical strength of the downstream portion of the colon? Or was there something else about his physiology or general opioid-addled state of health that might have rendered his colon prone to rupture?
I’ve never had an explosive gut, but I did have to have surgery for twisted gut about a year and a half ago. Healthy gut is very stretchy, but any time something restricts circulation, the tissue can become necrotic very fast, and necrotic gut can rupture easily. I got a lecture on this, and why I should go straight to the ER with repeat symptoms.
I didn’t have constipation, and why I got a twisted gut is just “luck”-- it usually happens to dogs and horses, not so much to people. Anyway, while IANAD, I would guess that fecal impaction can compromise blood flow to the colon. Tissue is no longer healthy and stretchy, and BANG!
I don’t know the particulars of Perry’s situation, but you don’t have to be literally packed with shit to get a colon perforation if you’re already ill for other reasons - I’ve seen Ogilvie syndrome develop in patients who were hospitalized for non-GI reasons, like for orthopedic surgery or respiratory illness. It’s basically a paralysis of the colon in the setting of continued gas introduction by gut bacteria and swallowed air. Untreated, the massive distention leads rapidly to ischemia of the bowel wall and perforation, with dire consequences. You treat it in the short term by decompressing the colon by positioning the patient or placing a rectal tube to let the gas out. I did once see neostigmine used, which resulted in a horrifying sequence of farts.
Horrifying just because of the large amount of gas that had been trapped by the patient’s condition, or because the neostigmine somehow made the farts worse?
I, too, don’t know about Perry, but my father’s gut exploded. He had a very fragile gut for other reasons, and was in the hospital recovering from major gut issues. He finally was upgraded from intensive care to rehab. And while in rehab, he became severely constipated. They tried enemas, but the blockage was too far up. And he ate a meal that generated a lot of gas. And his intestines literally burst, like a balloon.
Which put him back in intensive care, of course.
Ever since then, I’ve felt grateful I can fart. That first-thing-in-the-morning-fart? Everything is working the way it’s supposed to.
The duke was a lung cancer survivor. He died of colon cancer. He was also full of shit. To the best of my meager knowledge, it was more of the intellectual variety of feces than the product of digestion.
A fairly common way for anyone with cancer in their viscera to die is via intestinal blockage. That’s what actually killed my first wife.
Depending on how far up- or down-stream the blockage occurs, and what sort of medical treatment is available or applied and how soon, you can get a bit of a backlog of compacted stuff in there. IANA medic by any stretch, but the “26 lbs” thing sure sounds like urban legend amplified through repeated telling.
Ostomy, so no sphincter to hold in farts, so they sneak out freely whenever they generate ) Silent and sometimes very deadly [especially after seafood, wow!]
Unfortunately I can get blockages from something as annoying as an unchewed whole baby spinach leaf or apple peel turned flat and plastered against the opening.
Last person who told me that I should have avoided chemo and radiation and ate some damned herbs or whatever I lovingly described what was happening to me …
The end 15 cm of my large intestine had full depth [all the layers of the intestinal tube] and full circumference [all the way around the intestinal tube] had tumor buildup that was gradually closing down the ability to push out the poop - it was down to about a finger in diameter, call it just over a cm and a squidge of opening left. So … ignoring tumor cells spreading to my liver and lungs or wherever, my intestines were closing so when poop would no longer pass through, it would give me megacolon and eventually it would burst giving me peritonitis and I would die.
They turned green, sort of hurked lightly and left me alone =)
My dad’s friend kept trying to eat the same foods after he got his ostomy, even though his doctor specifically told him to eat a low-fiber diet. Too many beans and he managed to burst his bag on his way to his his chemo treatment for prostrate cancer. My dad’s friend wanted to try to clean himself up (in the car, before going in) instead of asking for help. My dad just rolled his eyes and told him that the medical team probably could do it a lot better, and had probably done it before. They did and had.
Daily mail explains the approx 50 times ( in the 9 months of having it) that he exploded his colostomy bag… but also there is no doubt that he needed the colostomy due to having exploded the colon initially.
