3 Tips to Handle Bowel Urgency

Everybody Poops. We hope just not in our pants, right?

Here's 3 Tips to Handle Bowel Urgency

We've all been there. You're just enjoying your morning coffee, when...

BAM!

Oh crap. Literally. You get this HUGE urge to poop, and suddenly you're running to the bathroom...or at least waddling, with your cheeks pinched together (& not the ones that make you smile!)...it's not a nice feeling.  Ever wonder why that happens? And, more importantly, what you can do about it?

👋 Hi! It's me, Dr. Kelly, Double Board Certified Pelvic Physio and YOUR go-to expert for all of your pelvic questions and wonders 👋. Today, I am going to help you demystify bowel urgency (poop-mergencies, if you will). Let's get to it:

Poop Overview

Everybody poops. EVERYBODY. Most of us out of our rectum/anus (hole in our butt), and some of us out of a colostomy or ileostomy bag.  If you are a -stomate, then LUCKY YOU, you no longer have to worry about poop-mergencies (nice to have at least one silver lining, right?). For the rest of us, we need to understand WHY bowel urgency happens, in order to try to prevent it, or to use it in our advantage.  And to understand that, we need to understand how normal poop works. 

In our amazing bodies, in "normal" digestion, we break down the food in our mouths and in our stomach, via combination of crushing, mushing and digestive materials (think acid folks...like acid that could eat through metal!!).  The crushed/mushed food then enters the small intestine, where it (with the help of other organs, like the liver and pancreas), is responsible for absorbing most of the nutrients from the food we eat.  The crushed/mushed/partially processed food then moves through the cecum to your large intestine (the big tube), where it absorbs some remaining vitamins, then removes water and electrolytes, forming the crushed/mushed/used to be food into "your poop", via 3 main tube parts and one final "holding area", where, when the nerves on the "exit door" of the holding area get a certain signal, they tell us that we have to poop...we ought to walk calmly to the bathroom, sit down, relax our pelvic floor muscles, and viola!, our colon pushes our poop out.   The cycle resets, and we ought to poop easily and non-urgently, anywhere from once a day to three times a day. 

So that's "normal poops"...what about bowel urgency?

Why Does Bowel Urgency Happen?

In short, the pelvic floor, pelvic bowl, are 'sensitive' places, and the internal anal sphincter (the little ring of muscles on the inside of "exit door" of our rectum) is one of the most sensitive places, in our entire body.

I could actually geek out with you FOR DAYS about how awesome the internal anal sphincter is (like, have you ever thought about how you know if you have to fart, poop, or have diarrhea? Now you can't unthink it, can you? You're welcome, and yes, I'll do a blog post on it later and explain it all)...but where was I? Oh yes, WHY does bowel urgency happen?

So this highly sensitive internal anal sphincter, the "exit door" for the poop, is an entirely involuntary muscle that exists in a state of near maximal contraction (to hold poop in). When it senses enough pressure, it tells you that you have to poop...and when there's "too much" pressure, or the doorbell is "too sensitive"...the door is going to open, whether you are on a toilet or not!

And, sometimes, that signal is stronger than other times. This could happen because the food has moved "quickly" through the digestive tubes, arriving in the rectum as more fluid, or more volume. OR it can happen because the pelvic floor muscles are resting too tight, so they overreact to the presence poop material.  And this results in the POOP EMERGENCY!!!

I'll do a separate, in depth, post on more deets into the "why's" of bowel urgency, for my fellow geeks...but for now, let's dive into 3 Tips to Handle Bowel Urgency, when it occurs.  

3 Tips to Handle Bowel Urgency

1. STOP.

Whatever you're doing, stop. Take a deep breath and relax. Put the brain in control.

2. SQUEEZE!

Yep, but instead of the 5 "quick-flicks" that you are going to use to Control Bladder Urges, for bowel urgency, it is ONE, LONG, CONTRACTION of the pelvic floor muscles, focused around the rectum. 

The type of contraction is the traditional "Kegel", but instead of focusing on the vag or penile parts, really focus on the rectum instead. Literally think of squeezing and lifting and holding in a fart, but just with the actual butthole muscles, not the bigger gluteal parts (so the cheeks shouldn't move as you do this).

Another visual could be to think of pulling your tailbone towards your pubic bone, or lifting the anus up towards your belly button. 

HOLD this contraction 30-60 seconds (that's a long time), or until the poop urge passes. To get technical, this activates your Rectoanal Inhibitory Reflex (RAIR  and fun Dr. Kelly fact, I always visualize a lion when I say that, RAIR!!), which is a technical way of saying that when you hold the rectum up and in, in this way, for long enough, it activates muscles that actually move the 💩back and away from the internal anal sphincter (remember, super nervy and sensitive "exit door"), thereby reducing your urge, for the moment.

So by holding that prolonged contraction, your amazing rectum will move the poop tube in reverse a bit, to buy you a BIT of time, to get someplace where it’s convenient to poop.

But really, it's only a moment, like 10 minutes MAX. The muscles of the colon will push that stool back into that sensitive Internal Anal Sphincter shortly, hence the next step...

3. Calmly Walk To the Bathroom

Yep. Unlike bladder urges, after which we may sometimes wish to postpone, we always need to listen to bowel urges.

Let me say it again for those in the back:

Unlike Bladder Urges, after which we may sometimes want to postpone voiding, we always need to listen to bowel urges.

This. is. hugely. important. to. understand.

What goes in, MUST eventually come out, and the involuntary muscles of your digestive tract will contract rhythmically again in a few minutes, pushing that stool (or loose stuff) against the Internal Anal Sphincter, and while this long squeeze of the rectum will work to buy you some time (if you do it repeatedly with each urge, maybe up to 10 minutes), remember that the Internal Anal Sphincter is involuntary, so when the pressure inside builds up to a certain point, that sphincter will let go....and... well, crap. Literally.

Hopefully not in our pants.

So please don't try to postpone pooping, if you have a strong urge. Walk calmly to the bathroom. Stopping to squeeze again if another strong urge comes on, then proceeding calmly and collectedly, until you can poop in peace.

Why calmly? Because anxiety might change the status of 'things' in your rectum, and might worsen the urge, and-or trigger the Internal Anal Sphincter to relax and, POOF. Poop in our pants...and maybe the trousers too (shout out to my UK friends)!

Neat, huh???

I love talking about poop, and now you can understand your amazing body better, and be the life of the party, educating your friends and family about your amazing digestive tract!! 

A poop course is in the works!  Join the mailing list via the form below to receive first notice (& best prices) when it's released!!   And stay tuned for more fun poop topics, like more about the rectal anal inhibitory reflex, readiness of the internal anal sphincter, gastro colic reflex, as well as overall pelvic curiosities, like what happens in hysterectomy, best birthing positions AND more!

Thanks for Reading!

If you enjoyed what you read today, and are interested in more in-depth learning, please consider one of my online courses. Pelvic Floored is proud to offer world-class streamable Pelvic Wellness courses that you can complete from the comfort and privacy of your own home, at your own pace, for a fraction of the price of a one:one Pelvic Physiotherapy appointment.  And thanks to the FREE Kajabi App, once you purchase the course, you can stream it seamlessly between your computer, phone or tablet, so that world-class (FUN) pelvic health info & exercises, taught to YOU from ME, are never more than a click away.  My courses might just change your life, or the life of someone you love.

xoxo, Dr. Kelly 😊

Follow me on Instagram & Facebook!
Schedule an in-person or telehealth visit HERE!

www.pelvicfloored.com