Nausea, tenderness and "the sh*ts" etc are all common symptoms that could be masking something more sinister which they reckon could result you needing to use a colostomy bag full-time and not just at Hard On.
So, what's the reality?
Cynical: Well, you've two docotors making name for themselves (you got to get those papers published!) and they admit it's very rare and more associated with crack users. There could however be a ticking time bomb of bottoms waiting to blow. It'll no doubt happen when we all come down with Mad Cow disease.
Sober: Most users do know that using the stuff can and does cause dicky tummys (some report an immediate need to 'evacuate') so watch out if it gets serious. If you are having problems tho, seek help and TELL your medical person the truth. You know who you are.
A timely reminder that drugs are actually not vitamins and they do have effects outwith the club environment, back in reality.