My most painful moment is when I poop - Patient

In Usonga ward, Siaya county, just a stone's throw from Lake Kanyaboli,  lives a 29-year-old man with a rare life story.

From physical assessment he would pass as any other normal and energetic man, until he opens up on his life’s journey.

Isaac Otieno was born different. He has a problem that is not talked about because of the shame, fear of judgement and stigma it might attract.

For the first time he has decided to share his 'hell-on-earth' story with the Star.

Isaac Otieno, the only surviving son of his father, suffers from rectal prolapse, a condition known in Dholuo as 'thir'. This means he does not move his bowel in the normal way.

“My most painful moments on earth are when having a bowel movement,” Otieno told the Star last week on Tuesday.

His mother abandoned him, divorced his father and remarried due to Otieno's condition. He said his siblings, before him, died in infancy due to the same condition.

Otieno said his decision to share the story is to appreciate God for preserving his life, appreciate his life’s purpose, put the shame of his condition behind him and give a voice to others who could be in his shoes.

His wife of six years only got to know of her husband’s condition following the Star’s visit to their home.

At first, the wife, EA, was unhappy with Otieno for hiding his condition from her but she calmed down after he apologised to her. He said he feared telling her his problem would lead to rejection.

“No wonder I have always quarrelled with him for finishing toilet paper in the house very fast and staying longer in the toilet,” his wife said.

According to Otieno, on average, he spends one hour in the toilet.

The father of four said he has always been closer to death and wanted to live his life to the fullest.

It is the reason he married early.

He told the Star that he made the decision to drop out of school at Standard 7 because teachers, who knew nothing about his condition, caned him for overstaying in the toilet during mid-lesson breaks.

“Something (rectum) always bulges out of my anus whenever I am passing out stool. It then refuses to return inside after I am done,” Otieno said.

This is why he has to use more toilet paper to push it back inside.

Due to the rising cost of basic commodities in Kenya, toilet paper included, Otieno who is now jobless, uses old newspapers and leaves.

He said the process is always very painful, tedious and he fears it will kill him someday.

The pain becomes worse whenever there is a full moon as the rectum drops out more than usual and it is red and hot.

“Pushing it back makes me gasp for oxygen and threatens to tear the nerves on my neck and thighs and the power on my back. This thing will kill me,” Otieno narrates amid sobs.

As a boy his paternal grandmother would prick the bulged rectum with a thorn so that it rushes back inside following the abrupt pain.

He said pricking it with a thorn is the easiest way to return his rectum to position but it is extremely painful and he cannot do it himself.

The Star met Otieno’s grandmother but she is now too old and has suffered memory loss and could not add her voice to the plight of her grandson.

Otieno’s cousin EO is among the few family members who know about his problem. He said Otieno has learnt to survive with it.

“As children, I am the one who would accompany him to relieve himself in the backyard thicket. I did so to prevent ducks from feasting on his prolapsed rectum and to be there just in case he needed help,” his cousin recounted.

IO’s eldest aunt TN told the Star that six of his siblings died in infanthood due to the same health condition.

"We tried traditional medicine but the rectum kept on bulging out and we became tired," TN told the Star.

The Star could not reach Otieno’s mother on the phone. 

“In 2019, my mother apologised for abandoning me. She said she had feared I would die like my other siblings before me,” Otieno said.

Otieno is yet to find a toilet that fits his condition. He fears collecting germs from toilet bowls.

As such, he often rejects the idea of leaving home to work in towns where pit latrines have rapidly vanished.

But even pit latrines pose a challenge. “I do drop a stone in the hole to test whether a pool of water would splash on my bulging rectum if I squat. Dry pits are good for me.”

Dirty toilets with flies irritate him as they land on the protruding rectum.

With no proper education, Otieno relies on casual jobs to feed himself, wife, four children and grandmother.

He has since stopped riding a boda boda for, he says, the vibrations weaken his waistline and he undergoes unbearable pain after work.

Otieno is a mason but does not like the job due to the pain it subjects his abdomen, waistline and lower limbs.

“Every day, I have to sleep on my stomach for about an hour after a tough day’s job in order to suppress the pain in my abdomen.”

Lately, he stays at home for lighter duties and prays that a well-wisher would support him for surgical operations to correct the life-threatening condition.

A relative once linked Otieno up for treatment at Kenyatta National Hospital when he was a young boy. That stopped following the death of the relative.

Of utmost importance to Otieno though is to celebrate his life’s purpose and encourage others who might be in a bad and shame-laden situation not to succumb to their fears.

 Dr Dan Achar, a general medical practitioner, told the Star it is not a rare condition as it may result from strenuous activities.

He said it is common among older women.

“Causes of rectal prolapse are congenital, acquired or as a result of trichuriasis infection of the anal sphincter muscles,” Dr Achar said.

According to the Centre for Disease Control and Prevention, trichuriasis can be treated effectively in three days using drugs that get rid of parasitic worms.

While the condition can be managed conservatively, the ultimate solution to the problem is surgical intervention, Dr Achar said.

He said the surgery can be performed by a general surgeon or a specialist known as proctologist.

Edited by A.N