Health & Lifestyle

What’s making me so windy and constipated? DR MARTIN SCURR on the symptoms many find difficult to discuss

Q: I am very flatulent and sometimes pass mucus. I also get constipated, for which I take a laxative. But even after going to the bathroom I still feel like I need to go again. Are these problems connected — and is there a cure?

Name and address supplied.

Dr Martin Scurr: Many people find these kinds of symptoms difficult to discuss, so I commend you for raising this important topic.

The sensation of not being able to completely empty the rectum is called tenesmus. It is a constant feeling, a sense that you failed to get everything out and need to try again. Sometimes it also causes abdominal pain.

You have not mentioned bleeding, which is reassuring, but the passage of mucus isn’t normal.

Tenesmus is a symptom of an underlying condition and you must talk to your doctor about this and request referral for further investigation.

Tenesmus is a symptom of an underlying condition and you must talk to your doctor about this

 Tenesmus is a symptom of an underlying condition and you must talk to your doctor about this

The most common potential cause is inflammation in the lower bowel, for instance due to inflammatory bowel disease such as Crohn’s disease.

The initial investigation, called sigmoidoscopy, involves passing a thin viewer into the rectum and large intestine. The specialist might also suggest a colonoscopy in order to examine the full length of the large bowel.

The mucus and the tenesmus may be linked, though not necessarily, to the flatulence. The important thing is to seek an exact diagnosis.

Q: My 65-year-old brother suffered a blood clot in his leg six months ago and has been on daily anticoagulant drugs since. But during a recent hospital check doctors said the clot is still there and always will be. Is this correct?

Jo Whyley, by email.

A: I understand your confusion. Your brother was diagnosed with a deep vein thrombosis (DVT), presumably via a scan after he’d developed symptoms — the most common for DVT is unexplained swelling in the leg. It can also cause pain and an unexplained increase in visible veins in the lower part of the affected leg.

The veins below the knee are more superficial, so if a deep vein is obstructed by clot, these superficial veins have to carry most, if not all, of the blood flow, and become very prominent (the veins higher up tend to be deeper and obscured by fat).

The danger of a DVT is that the clot, or part of it, can break off and travel through the bloodstream back to the heart.

As clots are soft and gel-like, it would be pumped through the chambers of the heart and into the lungs — leading to a potentially fatal blockage in a blood vessel there, known as a pulmonary embolism.

In your longer letter you mention your brother was prescribed rivaroxaban, a blood thinner designed to reduce the risk of a pulmonary embolism.

But this drug doesn’t completely dissolve the clot. Instead, it ‘stabilises’ it; meaning within days, and over the forthcoming weeks, the clot shrinks and becomes what is, in effect, scar material that won’t break off. When your brother was examined again months later, it was this residual healed clot material that the doctor identified.

It’s no longer a blood clot, in the same sense, and it’s no longer accurate to describe it as a DVT.

Although it might shrivel further, it will always be there.

An important question in anyone with a DVT is identifying the cause. When there is no obvious source — such as the immobility imposed by a long journey — the patient should undergo tests for thrombophilia, a condition that increases the risk of clots.

This can be caused by many factors, ranging from genetic diseases such as protein C deficiency to liver disorders.

  • Write to Dr Scurr at Good Health, Daily Mail, 9 Derry Street, London, W8 5HY or email: [email protected]
  • Dr Scurr cannot enter into personal correspondence. Replies should be taken in a ­general context. Consult your own GP with any health concerns. 

In my view… Weedkiller chemical link to men’s fertility  

As chairman of the ethics committee at a fertility clinic, I have an interest in male infertility — and have long been worried about the decline in sperm counts. Between 1951 and the 1970s these fell 50 per cent, from an average of 107 million sperm per millilitre to 48 million.

Then in 2017, a review of 185 studies from between 1973 and 2011 revealed a further 50 per cent drop.

Among potential causes of this worrying decline are pollutants called endocrine-disrupting chemicals — and in particular, glyphosate, a weedkiller. 

A study in 2022, published in the journal Environmental Science and Pollution Research, suggested that more than 99 per cent of people in France had residues of glyphosate in their urine — not surprising considering that the chemical is sprayed on to wheat fields prior to harvest. 

Environmental pollution is more than just global warming — some estimates show counts of healthy sperm are dropping by 1 to 2 per cent a year, so it could be that within 20 years we will lose the ability to reproduce — which will knock all other environmental worries into a cocked hat. 


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