Endometriosis: 'I wouldn't poo if my husband was at home'

Teen magazine tips on "how to secretly have a poo without your boyfriend knowing" had a lasting impression on Jen Moore.

She said one tip even suggested taking an over-the-counter medication to prevent a woman needing a poo while staying overnight with a partner.

The 35-year-old only recently realised she had adopted some of these habits, but that embarrassment had masked a serious health condition.

When she and her husband first met, she would wait for him to leave the house before she "went for a poo", or if he was upstairs she "would run the taps".

"I have such a visceral memory of reading this article and I obviously internalised it and hadn't even realised until fairly recently."

Last year she was "forced to be open about something I had kept to myself for years" when she experienced rectal bleeding.

It was the first time she talked about the issue with her husband, Chris, despite being together nearly 15 years.

Four months after excision surgery for endometriosis, and a hysterectomy for adenomyosis, she was worried the bleeding was a sign of delayed complications.

But a later unrelated MRI confirmed it was deep endometriosis over her bowel.

The women's health campaigner - originally from Swansea, but now living in Cambridge - said: "I talk about my body parts and periods online all the time, I didn't think I had taboos about my body. But there it was."

She laughed recalling her medical notes detail that she "is known for constipation".

"I have been constipated for as long as I can remember, there were occasions where I would go once a week.

"In fact, I thought if people were in the bathroom really regularly there was something wrong with them - I was raised in the generation where girls are told they fart glitter and rainbows."

Embarrassment might have held Jen back from speaking up, but that was not the case for Emma Williams-Tully.

The 39-year-old from Wrexham also has endometriosis. She said she felt "fobbed off" when she told doctors about her constipation and rectal bleeding.

"When I had constipation no matter what medication I took I couldn't go to the toilet for 10 days at a time and would be in absolute agony.

"I went to different specialists over the border in England and every single colonoscopy came back normal."

When she was diagnosed with endometriosis at 21, she remembers her consultant admitting: "We thought you'd been making it up all this time."

She praised the team of doctors supporting her now, but described the years of endometriosis as "torturous".

She has had 11 surgeries in total, including a hysterectomy and the removal of her colon, leaving her with an ileostomy stoma.

"I don't want to scare people and think just because they have diarrhoea or constipation that this will happen to them. But it's about advocating for yourself."

Julie Cornish, a colorectal surgeon from Cardiff and Vale health board said by the time patients reached her they had "typically been suffering for some time".

"Things have escalated, because people are too embarrassed to speak up.

"Constipation is common, it affects about 20% of the population", she said, but added in the worst cases patients will have a poo as infrequently as once a month.

"It's extreme, but we are seeing patients in their early 20s who have had problems opening their bowels since they were small and it's never gone away. They've taken lots and lots of laxatives over time and have ended up having their colon removed."

She added there were simple steps that could help.

"The bowel is one of the vital organs of the body, if it doesn't work well - you know about it. But we don't talk about it, that's the issue.

"We need a public health campaign around the bladder and bowel."

Don't put it off: "You can get people who decide they are only going to go to the toilet in their own house," said Julie Cornish.

"If they go on holiday for a week they take something to stop them going to the toilet because they don't want to do it anywhere else. Or they feel it's unpleasant or embarrassing to go at work, so they withhold."

Water: "Make sure you drink plenty of water. Caffeine is very good for the bowels in terms of making it work more, but if you're getting diarrhoea that's not very good."

Exercise: "Just a simple walk of 15 to 20 minutes - your core abdominal muscles work a bit like a washing machine and will help the bowels move."

Diet: "You can increase the amount of fruit and fibre in your diet. You can look for things like psyllium husk, flaxseed and chia seeds to encourage it to move."

"A lot of people don't actually look at their poo, but you should," said Julie Cornish.

"Is there any blood in there? What's the consistency of the poo look like?

"Look at the Bristol Stool chart. If it's type one or type two which is sort of rabbit pellets or Maltesers stuck together, that suggests you need a bit more water or fibre in your diet.

"If you're struggling to empty, or have a lot of bloating, it may be that you're constipated or have some pelvic floor dysfunction - you probably need to see a physiotherapist.

"Generally opening your bowel every one to three days, with a smooth stool is considered normal.

"If you get a significant change in your bowel habit - an increase or decrease in frequency, or if you start to get significant pain, bloating, weight loss or blood in the stool, please go and see your GP."