The need to delay a bowel movement is common, often arising when a suitable restroom is unavailable, such as during travel. While the body is built for elimination on demand, humans can temporarily override this natural reflex. This temporary control is safe, but regularly suppressing the urge can lead to complications. This article explores the physiological mechanisms that allow for temporary delay and outlines safe, immediate strategies, as well as long-term adjustments for predictable bowel stability.
The Physiology of Delay
The urge to defecate begins when stool moves from the colon into the rectum, causing the rectal walls to stretch. This distention activates stretch receptors, sending signals to the brain that initiate the defecation reflex. The reflex involves the involuntary relaxation of the internal anal sphincter.
Continence is maintained by the external anal sphincter, which is composed of skeletal muscle and is under conscious, voluntary control. When a delay is desired, the voluntary tightening of the external sphincter is the primary mechanism used to override the reflex. If successful, the stool is pushed back slightly into the sigmoid colon, causing the initial strong urge to subside until the next mass movement occurs.
Immediate Strategies for Temporary Control
When the urge arises, the immediate strategy involves physical and mental control to reinforce the external sphincter. The primary physical action is to contract the external anal sphincter and the surrounding buttock muscles firmly. This conscious clenching helps maintain the closed state of the anal canal, counteracting the involuntary relaxation of the internal sphincter.
Adjusting your posture can also provide a temporary reprieve by reducing pressure on the rectum. Instead of sitting or squatting, try standing or lying down, as these positions are less conducive to a bowel movement. It is also helpful to remain still and avoid sudden movements, as jarring the body can increase the sense of urgency. Distraction techniques, such as focusing intently on a mental task, can help override the visceral signals being sent to the brain.
Long-Term Adjustments for Bowel Stability
Establishing predictable bowel habits is the best way to reduce the need for emergency delay. Several factors contribute to stable bowel function:
Dietary Fiber
Dietary fiber plays a major role in regulating transit time and stool consistency, with a recommended intake of 25 to 31 grams per day for adults. Both soluble and insoluble fiber contribute to healthy, bulky stool that is easier to pass on a routine schedule.
Hydration and Triggers
Adequate hydration is also important, as sufficient water intake keeps the stool soft and prevents the colon from absorbing too much moisture. Drinking about eight to ten 8-ounce glasses of caffeine-free and alcohol-free fluids daily supports this process. Identifying and avoiding personal dietary triggers, such as excessive caffeine or high-fat foods, can prevent unexpected urgency.
Physical Activity
Engaging in regular physical activity can promote colon motility and help maintain a consistent routine.
When to Stop Trying to Hold It
While temporary delay is safe, habitually suppressing the urge to defecate carries significant health risks. When stool is held back, the colon continues to absorb water, causing the feces to become harder and drier, which quickly leads to constipation. Chronic withholding can also stretch the rectum, leading to reduced sensitivity and potentially contributing to fecal incontinence.
Severe complications from chronic delay include the development of hemorrhoids or anal fissures, which are tears in the anal lining caused by straining to pass hard stool. In rare cases, fecal impaction can occur, where a mass of hard stool becomes lodged in the rectum and requires medical intervention. You should seek medical attention if you experience chronic constipation lasting longer than seven days, severe abdominal pain, sudden changes in bowel habits, or notice blood in your stool.