The sudden, intense need to find a restroom when none is available can be stressful. This situation triggers an involuntary physiological response that must be counteracted by conscious muscular effort to maintain continence. Understanding the physical mechanisms involved provides the framework for controlling the urge in the short term. The ability to delay a bowel movement relies on your capacity to override reflexes until a suitable facility can be reached. This temporary control is achieved through specific muscular contractions and positional adjustments that reduce pressure on the lower digestive tract.
How Your Body Manages Defecation
The process begins when stool moves from the colon into the rectum, the temporary storage unit. This distension of the rectal wall activates stretch receptors, which send signals to the nervous system and create the conscious urge to defecate. The involuntary response to this stretching is called the rectoanal inhibitory reflex (RAIR).
As part of the RAIR, the smooth muscle of the internal anal sphincter automatically relaxes. Since this internal sphincter is continuously contracted, its relaxation allows a small sample of the rectal contents to reach the anal canal to differentiate between gas, liquid, or solid stool. At this point, the entire burden of continence shifts to a voluntarily controlled muscle.
The external anal sphincter, composed of skeletal muscle, is the muscle you must consciously contract to delay the bowel movement. This voluntary muscle acts as a strong, final barrier, closing off the anal canal. The puborectalis muscle, which is part of the pelvic floor, also plays a significant role by creating a sharp bend or “kink” at the junction of the rectum and the anal canal.
Continence is maintained when the puborectalis muscle remains contracted, preserving this anorectal angle. By keeping the external anal sphincter and the puborectalis muscle engaged, you can push the stool back up temporarily into the rectum, where the stretching sensation may subside as the rectal wall relaxes around the mass. This provides a brief window of relief before the urge returns.
Immediate Physical Techniques
Maintaining continence requires the sustained contraction of the external anal sphincter and the surrounding pelvic floor muscles. This action is similar to performing a Kegel exercise, where you tighten the muscles used to stop the flow of urine or hold back gas. The contraction must be firm and consistent, not a series of short, intermittent squeezes, to effectively counteract the internal pressure.
You can enhance muscular control by contracting the gluteal muscles, or “clench your butt cheeks,” which provides additional mechanical support and keeps the external sphincter tightly closed. This combined muscular effort keeps the anal canal shut while contributing to the upward pressure that pushes the stool away from the anal area.
Positional changes are effective because they manipulate the puborectalis muscle. Sitting down and leaning forward naturally encourages the puborectalis muscle to relax, straightening the anorectal angle and preparing the body for defecation. Therefore, the goal is to adopt a posture that keeps this muscle taut, maintaining the kink in the rectum.
Standing up straight is generally better than sitting, but crossing your legs while standing or sitting can be particularly helpful. This maneuver puts tension on the pelvic floor muscles, which tightens the puborectalis sling and increases the anorectal angle, making it harder for stool to descend. Remaining as still as possible and avoiding movements that put pressure on the abdomen, such as bending over or lifting heavy objects, is advised.
Controlling your breathing helps reduce the intra-abdominal pressure that can exacerbate the urge. Deep, forceful breathing and the Valsalva maneuver (bearing down or straining) are techniques used to aid defecation. When attempting to hold it in, focus on light, shallow chest breathing to keep the diaphragm from pressing down on the intestines. This minimizes downward pressure on the rectum, making it easier for the external sphincter to do its job.
Managing the Urge and Knowing When to Stop
The psychological component of the urge is significant; stress and anxiety can increase intestinal motility and make the situation worse. Mental distraction can help prevent the panic response from intensifying the physical sensation. Focusing on a complex task, counting backward, or concentrating on neutral environmental details can temporarily draw the brain’s focus away from the distress signals in the rectum.
Finding a quiet, private spot helps reduce external stimuli and lower your stress level. The goal is to create a calm mental state where involuntary reflexes are less likely to be triggered. If possible, lean against a wall to take pressure off the lower body while maintaining a stable, upright posture.
While occasional short-term retention is typically harmless, holding in a bowel movement for an extended period carries risks. The longer the stool remains in the rectum, the more water the colon absorbs, causing the feces to become harder and drier. This can lead to temporary constipation and make the eventual bowel movement difficult or painful.
A prolonged habit of ignoring the urge can desensitize the rectal stretch receptors over time, potentially leading to a weakened sense of the need to go. If you begin to experience severe, sharp abdominal cramping, nausea, intense dizziness, or persistent, overwhelming pain, you must stop trying to maintain continence. Continuing to strain against a strong urge can cause excessive pressure that may be harmful to the anal canal and surrounding tissues.