In today’s fast-paced environment, many office workers are falling prey to an increasingly common phenomenon known as ‘voluntary withholding’ where the natural urge to go to the toilet is ignored.
Sydney gastroenterologist Professor Peter Katelaris said it’s most common among office workers, especially young women, who may not want to use the office toilets.
“People may try and override the urge to pass a bowel motion,” Prof Katelaris told news.com.au.
“Some people do this as they may consider it inconvenient or embarrassing to go to the toilet during a busy day at work. Others don’t like to use a shared public toilet, and much prefer to use their own toilet, so suppress the urge which then passes.”
Then, when it is convenient for them, they might sit on the toilet and try and push even though they don’t have the urge to empty their bowels anymore.
This often ends in disappointment as the moment has passed.
Not only that, but studies have shown that people who do this often develop a host of uncomfortable symptoms due to their bowel habits being disrupted.
“It can cause bloating, fullness, and discomfort as they become constipated,” he explained.
Prof Katelaris suggests people go to the toilet when there is “a call to stool”, rather than when they feel like they’d like to go.
“Some people expect their bowels to open when they want them to, typically after breakfast and before work,” he explained. “They sit in hope and expectation, sometimes for a long time, waiting for something to happen.”
This can lead to forced straining which can cause fissures around the anus (a painful split in the skin) and hemorrhoids.
In older people, it can even be dangerous as excess straining may raise blood pressure, leading to a heart attack or a stroke.
The overarching message, according to Prof Katelaris, is that we must not lose sight of the fact that “our bodies are not machines.”
We have to respond to our bodies’ messages and go to the toilet when we get nature’s call.
Just as we eat when we are hungry, drink when we are thirsty, and sleep when we are tired, so too we should respond to the urge to open our bowels when we get the message to go.
In terms of what constitutes a “healthy” bowl routine, there is a widely held belief that you have to open your bowels every day.
While Prof Katelaris acknowledges that it is a common bowel habit, he said it can still be perfectly normal with a different frequency.
“What is normal for one person may not be normal for another. In general, the majority of adults open their bowels between three times a day and three times a week,” he noted.
To promote overall bowel health, he recommends a return to basics – a healthy diet, adequate fluid intake and exercise.
“Remember, humans have evolved in nature as omnivorous beings. Our bowel functions best when we eat the diet we have evolved to eat. This isn’t complicated,” he explained.
He advocates for a balanced wholefood diet that is portion-controlled and contains minimal ultra-processed foods.
Foods like vegetables, fruits, healthy oils, whole grains, nuts and seeds are all excellent fibre-rich foods.
“If a diet contains mostly low fibre, processed and ultra-processed foods, it is much more likely that bowel function will be affected – as well as lots of other potential downsides to our health,” he added.
Fluid intake also needs to be adequate.
“There is not a precise amount for each day,” he said. “For most healthy people, if you have a dry mouth or always feel thirsty, or your urine is dark, you are not drinking enough fluid. If you are not thirsty and your urine is pale or clear, you are. It’s that simple.”
Physical exertion of any type also helps bowel function.
Of course, there are medical conditions that disturb bowel function.
If there is any concern, a discussion with your GP is the first port of call. As people get older, and in some younger people who just have a very slow bowel habit despite a good diet, there may be a need to take something that helps the bowels to open.
These might be simple fibre supplements or stool softeners, but also sometimes laxatives that stimulate the bowels to work.
