How to get rid of ‘poo fear’ so you can finally do a number 2 in public and ditch the all-day bloat

DOES the mere thought of going to the loo in public leave you feeling anxious?

Or have you found it’s nigh on impossible to get your body to relax unless you’re in the comfort of your own home?

5

If you work in an office, or are on the move all day, this “poo fear” can cause you to feel uncomfortable all day long, until you make it home to relieve yourself.

“Holding onto your poo can cause excessive fermentation and a build-up of gas and unnecessary bloating,” says Lisa Macfarlane, co-founder of The Gut Stuff.

“Additionally, the stress and anxiety of not wanting to use the toilet can also lead to bloating.”

And the misery doesn’t end there. Holding in a number two can also lead to chronic constipation.

So why do we get ‘the fear’?

Toilet anxiety is a real thing, so much so that difficulty pooing in public bathrooms actually has its own name - parcopresis, or shy bowel.

“We tend to see two different types of toilet anxiety,” says Alana Macfarlane, also co-founder of The Gut Stuff.

“Firstly, if someone has a gut health problem, or they have experienced incontinence or an urgency to rush to the toilet, then their anxiety comes from the fear of something bad happening, such as not getting to the toilet in time.

“The other fear is the use of public toilets, something we saw a rise in the post-Covid world.

“We conducted a survey and found that more than half of office and front-line workers (54 per cent) feel uncomfortable going for a poo at work.”

You may also be slightly constipated and actually be unable to poo.

But wouldn’t it be great if you could just go for a number two comfortably, any time, any place?

If all-day bloating from holding in your poo is ruining your day, give these simple hacks a try…

IT’S not just when you poo but how, that can have a big impact on your bowel habits.

Dr Megan Rossi, founder of The Gut Health Doctor with a PhD in gut health, says: “A step can help if you're struggling with constipation and incomplete emptying, as elevating your legs helps straightenout your rectum, making it easier for things to move along.

“There’s a muscle around the rectum that naturally relaxeswhen we poop, helping to open up this angle.

“Using a step can enhance this process, making bowel movementssmoother and more effective.”

“When you sit on a western-style toilet your puborectalis muscle contracts - this essentially makes your rectum tight, which makes evacuating your poo difficult,” adds Lisa.

“You’ll end up straining and putting pressure on your pelvic floor, which is not what we want.”

By squatting with your feet on a 20 to 30cm-high step, you allow your puborectalis muscle to relax, allowing your rectum to properly open and overall making it easier to poo.

“At work, a little creativity may be required. You just need something that’s 20 to 30cm high, so, for example, a couple of books stacked is a great hack,” adds Lisa.

5

WHEN you find yourself consumed by thinking about needing a number two, it’s only natural to feel more anxious and stressed.

This in turn is likely to make it harder to go.

One study, published in the journal Microorganisms, suggests that music has a positive influence on gut bacteria, which can influence anxiety levels as well as gut-related symptoms.

Dr Rossi, founder of The Gut Health Clinic, Bio&Me and SMART STRAINS, says: “Music might help with a shy bowel as it can relax the gut-brain connection.

“Getting the fear in public is all down to the gut-brain axis, where the thoughts in our heads trigger bowel withholding.”

If you’re unsure what to listen to, then you’re in luck.

Type ‘poo music’ into YouTube and you’ll be met with hundreds of different music videos, all aimed at helping to avoid the poo struggle.

A study by Radox also found that listening to the song Weightless by Marconi Union lowered participants’ anxiety levels by a staggering 65 per cent!

GROSS BUT FASCINATING FACTS ABOUT POO

POO isn't exactly a topic for polite conversation. But the more you know about it, the better informed about your health you can be.

That's because your number twos can tell you a thing or two about your diet and digestion.

It can even let you know you're suffering from digestive problems, a stomach bug or something more serious that needs to be checked out, like early signs of cancer.

1. What's your poo made of?

This may seem like a silly question to ask. In your head you're probably saying: "The food I ate, surely!"

That is true to an extent - your stools do contain fibre that you ingest - but research conducted in 2015 shows that 75 per cent is made up of water, with the remainder a combination of fibre, dead and live bacteria, cells and mucus.

2. What does the colour of your poo mean?

Most poop is brown, but it does come in a variety of other shades, from red to green to black.

Red is one of the colours that you shouldn't ignore, unless you've recently eaten red food like beetroots, as blood in your poo can be a sign of bowel cancer, along with changes in your poo habits for over three weeks, tiredness and weight loss.

Yellow poo is also worth seeing a GP about, as it could mean you have coeliac disease, when your body can’t handle a protein called gluten, which is in wheat, barley, and rye.

3. All poop is smelly - does mine smell 'too bad'?

Foul-smelling number twos could have a number of causes, but they usually indicate something's not quite right.

Coeliac or Crohn's disease could be the cause, as well as malabsorption - when your body isn't fully able to absorb certain sugars, fats, proteins, or vitamins - and an infection.

4. How often should I be pooing?

There isn't really a right or wrong answer, but studies suggest 98 per cent of people go between three times a day and three times a week.

The key is finding what's normal for you, according to Dr Sarah Jarvis, GP and clinical director of patientaccess.com.

5. Should my poo sink or float?

According to research, whether your poop sinks or swims has to do with its gas content.

It's OK if your stool floats in the toilet bowl occasionally, as it'll most likely be caused by something you ate, but floaters that look greasy and smell foul could indicate poor absorption of foods.

Another reason can be high fat content in your poop, known as steatorrhea.

You can read the full article here.

THE gut-brain connection, a bidirectional communication system, can impact your bowel movements.

If you’re stressed about going to the toilet, this can make it even harder to ‘go’.

Research published in the Expert Review of Gastroenterology & Hepatology states that the corticotropin-releasing factor (CRF) hormone, which is produced by the brain in response to stress, impacts the gut, potentially disrupting bowel function.

Throw in work and life stresses and you’ve got yourself a recipe for disaster.

Breathing techniques can help to regulate the gut brain connection.

“Box breathing encourages your body to activate the parasympathetic nervous system (rest and digest) instead of the sympathetic nervous system (fight or flight),” says Lisa.

To box breathe, inhale for a count of four, hold for a count of four, exhale for a count of four and hold for a count of four.

Repeat as many times as you need.

5

WHEN your body is relaxed, you’re more likely to be able to go for a comfortable number two.

“Diaphragmatic breathing - more commonly known as deep breathing or belly breathing - is effective in managing stress and encouraging the body to relax,” says Alana.

“Some research suggests diaphragmatic breathing could be effective for patients with gastrointestinal issues to gently calm and massage the system.”

Research in the journal Frontiers in Neuroscience states that deep breathing increased "defecation frequency after six weeks for constipation patients".

If you suffer from IBS, bloating and or cramps, peppermint may be beneficial

Alana Macfarlane

Belly breathing is a little different to regular breathing and it can take a while to master, however it can be done as you’re sitting on the toilet.

“When you’re belly breathing, the stomach, rather than the chest, is moving with each breath, expanding on the inhale and contracting on the exhale,” says Alana.

Dr Rossi adds: “Incorporating a few minutes of diaphragmatic breathing into your day could help.

“Simply inhale through your nose for about four seconds, feeling your abdomen expand, not your chest.

“Hold your breath for two seconds. Then exhale slowly through your mouth for about six seconds and repeat for five to 15 minutes, or whatever you have time for.”

A DIY massage could make you feel more comfortable on the toilet.

A randomised control trial published in the International Journal of Nursing Studies looked at the effect of abdominal massage on constipation over eight weeks.

It found a good massage decreased the severity of gastrointestinal symptoms and increased bowel movements.

Lisa recommends starting your massage by placing the flat of your hand at the bottom of your stomach and gently stroking upwards towards your rib cage.

“Create circular stroking movements by starting on the lower right-hand side of your stomach, moving up and back down to the left and repeating several times, increasing the pressure to help stimulate the gut,” she says.

Lisa adds: “Next, start with your hand in a fist on the upper right abdomen, just below the rib cage, and create deep circular movements around the large intestine.

“Repeat several times before finishing by pushing down and shaking your hands over your tummy to help relieve gas.”

5

PEPPERMINT tea is a popular post-meal drink to help support digestion, but peppermint oil is the star of the show when it comes to this helpful herb.

Research published in the journal Alimentary Pharmacology & Therapeutics has shown that peppermint oil can have an antispasmodic effect.

This means it can help with bloating by releasing trapped gas and it may also help to relax the gut lining.

“If you suffer from IBS, bloating and or cramps this may be beneficial,” says Alana.

Dr Rossi adds: “Although peppermint is unlikely to have the same effect as caffeine on stimulating a bowel movement, it may increase the rate of food emptying from your stomach to reduce symptoms such as ingestion.”

YOU might think you can’t go in public because of anxiety around the toilet, however you may in fact be constipated.

Lisa says the following definition is widely accepted and included as part of the Rome IV Diagnostic Criteria for Constipation:

• If you poo less than three times a week
• If you strain or are in pain when you have a poo
• If your poo is often large and dry, hard or lumpy pellets
• And/or if you feel like you still need to go and not all poo has passed, then you may be suffering from constipation.

Sound like you? According to the NHS, around one in every seven adults and up to one in every three children in the UK has constipation at any one time.

Fibre can help relieve constipation.

“Adults should aim for 30g of fibre per day,” says Lisa.

“Just make sure you don’t go from zero to hero - gradually increase it by about 5g a week and stay hydrated to limit further (bloating) symptoms.”

Dr Rossi adds: “If you go from a little to a lot too quickly, when the bacteria eat they produce gas, so if you go from a little to a lot too quickly, it’s no bad thing but this extra gas can make you feel a little bloated and windy!

“The gut is incredibly adaptable, just give it a bit of time and increase slowly to adjust to the extra feast.”

Chia seeds pack in just under 10g of fibre per two tablespoons, two slices of wholemeal bread contains 7g of fibre, one medium apple contains just over 4g, one large potato contains around 6g and a banana contains 3g of fibre. That’s 30g in total.

“Hitting your 30g a day? It’s not necessarily the ‘golden’ number, so why not try getting 50g. The more the merrier,” Dr Rossi adds.

If you’re still struggling, speak to your pharmacist or GP who can recommend diet and lifestyle changes.

If these aren’t effective, your pharmacist may recommend an oral laxative medication that can help you empty your bowels.

5