Dear Doctor Dean, 

The email address askdrdean@healthcentral.com returns my email so

I am putting this into comments on Gastro Enterology site on Health Central.

I live in Lincoln  Nebraska but unfortunately do not get your program live .  

KLIN AM 1400 in Lincoln does replay some

of your programs in the night when I can catch it.  I learn a great deal 

from you which I share with family and friends.

You perform a great service - most of the time.

Last week a male caller related his problem with bowel elimination saying that it takes him large amounts of toilet tissue to clean himself.  Also he seemed to say he has residual "movement" at his anus which later requires a return to the toilet for addition cleansing. 

Your response to him was to go buy a bidet. 

I felt you really brushed this poor dude off.  I think it is safe to say 

he has fecal incontinence.  This is not to be taken lightly. 

He needs to go to gastro-enterologist and perhaps be prescribed an 

anti-spasmodic for his colon.  It could be diagnosed

as something other than  colon spasms but it needs to be checked out by 

specialist in this area.  Certainly it could be something

more serious.  

I suffered with similar problems for years, irregular bowel movements, 

multiple trips to bathroom during the day,

urgency, incontinence, seepage.  Beginning in  1976 I noticed an ache in 

my lower left abdominal quadrant.  Since then

I have made repeated visits to gastro-enterologists who used barium 

radiographs and sigmoidoscopy. Always the story

was the same, no pathology found.   I've been prescribed Donnatal and 

Bentyl at different times over the past three decades

but only for short periods of time and as a palliative.  Ten  and four 

years ago I had colonoscopic examinations. 

No definitive diagnosis except for diverticula and IBS. 

Then in 2009 I went to a new gastro-enterologist who performed a third 

colonsocopy.  He more accurately diagnosed

my problem as spasms of the colon.  He prescribed Pamine 

(methscopolamine) 2.5 mg BID.  This has helped me immensely,

life is much better now.  Doctor always asks me now if I'm having any 

soiling (formerly a big problem) whence I

happily say, 'None'. 

I think I am quoting/paraphrasing Dr. Peter Gott in his newspaper 

column.  "Fecal incontinence is one of the most vexing

problems to confront a patient or physician".

Let me assure you that statement is huge.  You cannot know the chagrin 

that caller faces when he has fecal incontinence episodes but I know.

Personally, socially and professionally it can be devastating not to 

mention humbling. See http://www.mayoclinic.org/fecal-incontinence/