Whether it’s an aversion to pooping in public bathrooms, masking any sort of bowel movements from a partner or going to extreme lengths to avoid having to go anywhere but your own loo, poo anxiety is a very real and common thing. In fact, in its severest form it’s even got a name: parcopresis AKA ‘shy bowel syndrome’.
“Shy bowel syndrome… is a condition that refers to an individual that experiences difficulty or an inability to empty their bowels in the presence of others or in public toilets,” explains Josie Porter, an expert dietitian with the London-based Gut Health Clinic.
And it’s far from an uncommon form of social anxiety to have.
Research conducted by professor and clinical psychologist Simon R. Knowles in Australia found that 14% of university students would avoid using public restrooms “for a bowel movement.” Instead they’d opt to go home, use a disabled toilet, or return when the bathroom was empty.
While the verdict is still out on whether there’s a gender aspect at play, some research suggests that women are more likely to have a faeces-related fear – Knowles’ research, found females were almost twice as likely to avoid doing a number two in a public restroom – and it’s likely perpetuated by the urban myth that “girls don’t poop.”
“Some researchers have proposed that women may be at greater risk due to the stigma surrounding women going to the toilet. This is rooted in societal and cultural beliefs that women are delicate and have to be private,” Porter adds.
“Consequently, some women may feel fear of being judged by others while using public toilets whereby others may be present.”
Unfortunately, women’s bathrooms are often a hive of activity rather than a quiet sanctuary in which to find relief.
“Women in toilets tend to congregate,” says Ann Allcoat, trustee of the UK Paruresis Trust, which supports people who struggle to urinate when others are in the vicinity. “And there are very often queues in [women’s] toilets so you can be heard and you’re also keeping people waiting, which is another thing we’re afraid of.”
Women are also more likely to experience gastrointestinal conditions, such as irritable bowel syndrome, and “individuals living with a gastrointestinal condition may be at a greater risk of experiencing shy bowel,” Knowles says.
But Dave Smithson, operations director of Anxiety UK, says that the charity had actually found evidence that the issue was more prevalent in men. “Both genders can experience problems around the bathroom,” he explains.
Ultimately, there’s not yet enough research on the topic but what is clear are the consequences that can come from denying nature’s call. Haemorrhoids, bowel perforation and constipation are just some of the potential repercussions of denying the doo-doo.
“Be mindful of the more permanent, long-term damage you could do physically to yourself if you don’t [seek help],” Smithson warns.
Then there’s the impact on day-to-day life. Having shy bowel syndrome can prevent people from wanting to go to work or school and affect holiday plans or social activities.
“For individuals experiencing extreme forms of shy bowel, they have to plan their everyday activities so they can get back to the toilet… It can be a significant burden,” explains Knowles, who works with individuals to overcome their fear.
How to make your bowel a confident one
Holding it in until it hurts, making excuses to return home, and avoiding eating certain foods are common ways individuals might try to get around the problem, but they’re not necessarily the healthiest.
“With any form of anxiety or fear of something, it’s about getting some help,” Smithson advises, citing anxiety medication or therapy to develop techniques to counteract the fear as typical treatments.
Porter suggests a series of practical tips that might make all the difference, such as laying down extra toilet paper to mask any sounds, carrying a room spray to mask potential smells, or using a set of headphones to play a relaxing playlist or podcast.
“If it’s the hygiene that puts you off, try packing a mini bag of wet wipes with you and some hand sanitiser,” she recommends, adding that relaxation techniques can also help manage symptoms linked to anxiety or stress. “Deep breathing exercises, mindfulness meditation and progressive muscle relaxation are just some strategies you can try before or during to help manage symptoms of shy bowel syndrome.”
For counsellor Tina MacDonald, it’s important to look at when and how the anxiety began, to potentially try “exposure therapy” where individuals initially try going to the toilet whilst a loved one is home before building up to going elsewhere, and to begin having conversations with friends.
Ultimately, it’s important to remember that this is not uncommon, adds Porter. “Many people in the public toilets are likely feeling the same way as you are.”
And following the death of journalist Deborah James from bowel cancer last year and the launch of her Bowel Babe fund, MacDonald believes “this is a time for us as a society to change the way we talk about some subjects that still feel a bit on the taboo side.”
While there’s historically been stigma around both bowels and mental health, it’s time to break that down and get the word out as to just how common shy bowel syndrome is, Knowles agreed. “This is a real thing.”