How Bad Is It to Hold in Your Poop?

Ah, friends. They're like family but cooler. Fully customizable. Fall and one of them will be right there to pick you back up. But as great as friends can be, they also do a lot of really stupid stuff. Stuff that blows your mind. Like, sometimes it seems crazy that you even hang out with people who make such crappy decisions. Stuff that, were it to get out, would be mortifying for anyone with even a shred of self-respect. Lucky for your friends, they've got you to ask their deepest, darkest questions for them. And lucky for you, we started this column to answer those most embarrassing of queries.

The Scenario
Your friend is scared shitless of going #2 at her small office. Slinking past coworkers toward the bathroom is a gauntlet of sorts, and she worries she’ll make eye contact with the developer who sits near the door and he’ll know exactly who had to flush twice.

As she downs the dregs of super dark roast K-Cup coffee—the beverage equivalent of drain cleaner—she feels a familiar wave that makes her cheeks clench. Your friend weighs her options: “Run an errand” and find solace in a McDonald’s single stall or wait to poop until she’s in the comfort of her studio apartment where only her dog can judge her. For a moment, she considers holing up in the office restroom, in the stall furthest from the door. But what if her frenemy from accounting comes in to powder her nose, takes a whiff, and hears a drop? She envisions the office-wide Slack message: “Karen just took a shit so nasty I can taste it.” It’s settled: She’ll stick it out until she’s home.

The Reality
If your friend waits to poop until she’s in a more comfortable location, she might not even have to go anymore, and even passively holding it in could lead to damage over time. That’s because once or twice a day, contractions pass through the colon to let your body know a bowel movement is on its way, says William D. Chey, professor of gastroenterology and internal medicine at the University of Michigan. When stool hits the last section of your large intestine, aka the rectum, it stretches and nerves send a signal to the brain that it’s time to empty ‘er out.

This Earth-to-colon signal is rooted in the brain-gut connection, according to Sarah Kinsinger, a Loyola Medicine health psychologist specializing in GI disorders. Our enteric nervous system in the gastrointestinal tract communicates with the brain to control digestion. “Because they work together so closely, our gut feels the effects of any significant emotional shift we experience,” Kinsinger says. So your morning coffee or breakfast can trigger these contractions, but a freakout over a pitch meeting can give you the urge, too. It’s even worse for those with GI disorders, who don’t have much control over their bowels and often get caught in a cycle of stress and heightened digestive symptoms.

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When your friend is too shy to dump, she could miss the opportunity to go and have to wait about 12 hours, or until the next day, for the feeling to come back. It’s easy to get caught in a waiting cycle. To hold it all in, she squeezes her outer sphincters and pelvic floor in a gravity-defying stunt. That may work in the moment, but then comes the great big build-up. “It’s not like you’re not eating and it’s not like your body’s not making stool,” Chey says. As your friend tosses back office-supplied Cheez-Its and fruit snacks, her colon is quickly turning into a literal wasteland.

The Worst That Could Happen
Holding it in has become your friend’s new habit, and her avoidance of dropping a load is a futile mission in unhealthy restraint. “If you hold it in over and over, there may be unintended consequences that could make you a lot more miserable than the embarrassment you feel when you have to use a public restroom,” Chey says.

First up: chronic constipation. “Over time, you get very large amounts of stool backed up in the bowels. And you may or may not completely empty that out,” Chey says. This onslaught of stool can stretch the colon and your friend might be stuck with inescapable cramping and bloating worse than the aftermath of eating a burrito the size of her face. As stool hangs out in the colon, it absorbs water and hardens. When she finally gets around to it, your friend will have a tough time doing the deed—think straining, bleeding, or impacted stool that might need extra help getting out, like with laxatives or other meds.

“The other thing is that if you progressively stretch out your colon over and over again, there’s the possibility it won’t return to normal,” Chey says. He compares it to heart failure, when the muscle stretches and becomes nonfunctional over time. If you’re always constipated, you can damage the signaling nerves in the rectum, lose strength in those muscles, and be prone to, ahem, leaks. In other words, by adopting this abnormal habit, your body might forget how to poop correctly.

What Will Probably Happen
If your friend simply cannot muster up the courage to drop a deuce around others and waits to be in private, she’ll pay for it in abdominal cramping and discomfort. She can get away with it—but just this once. “It’s not a good thing to do, ever,” Chey says. “Is it really dangerous? No. But is it a good idea? No.”

What To Tell Your Friend
“Respect the urge to defecate,” Chey says. If she holds it in once, she won’t ruin her digestive system, but she should listen to her body’s natural urges instead of her anxiety that someone will hear. Tell your friend to get in the public restroom and do the dirty work—nothing catastrophic will happen. Pooping will never be sexy, but just remember literally everyone does it and it shouldn’t be made into a big deal.

Kinsinger says people who are too shy to go in public should figure out what they’re most afraid of—whether it’s creating a gruesome stench or making eye contact with someone and them making that "I-know-what-you-did" face—and then think about the likelihood of those outcomes. “Don’t try to mindread, or assume people are going to have negative judgments about us because we had a bowel movement in the bathroom in the middle of the party,” she says.

A couple things might help your friend: She can ask her office to stock the bathroom with air freshener (or bring in one for the group’s benefit) or she can make a habit of flushing mid-movement. Polite poopers call this the courtesy flush. Armed with these tools, she can take a few cleansing breaths and take care of business.

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