Pooping in Public: How to Manage the Anxiety – Healthline

If you have difficulty forcing yourself to poop in a public bathroom, you may be experiencing a little-studied psychiatric disorder, known as shy bowel (parcopresis).

Parcopresis refers to a difficulty or inability to defecate while around other people.

Parcopresis differs from constipation, which is the inability to poop anywhere, not just in public places.

It also differs from obsessive compulsive disorder, which is sometimes earmarked by cleaning compulsions and fear of bodily waste.

Due to its sensitive nature, there is no reliable data about the number of people who have parcopresis.

Someone living with shy bowel may have more challenging life experiences compared to someone who doesn’t have shy bowel, or who typically dislikes the use of public restrooms.

People with shy bowel often force themselves to “hold it in,” rather than use a public toilet.

You may be unable to use the bathroom at work or in someone else’s home, even if uncomfortable gastrointestinal symptoms result.

But there are treatments for shy bowel. In this article we’ll go over your options, and provide tips for overcoming your fears.

Shy bowel can present as an overwhelming fear of public scrutiny and judgement about the following experiences caused by defecation:

  • sights
  • sounds
  • smells

This fear can affect your health in many ways and interfere with your daily routines. For example, it may limit your ability to:

  • have a job
  • go to a gym
  • interact socially with friends

It may also cause you to drastically reduce your nutritional intake, so that you need to poop less often. When faced with the need to poop in public, people with shy bowel may experience symptoms such as:

  • increased heart rate
  • sweating
  • breathing quickly
  • muscle tension
  • trembling
  • nausea

People with shy bowel may not always be comfortable seeking treatment for it. For this reason, data about this condition and its underlying roots are lacking.

The symptoms of parcopresis are caused by a variety of social anxiety disorders. They are also caused by phobias. Shy bowel is not classified as an anxiety disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

But a 2016 study showed that parcopresis is recognized as a form of social phobia by the National Phobics Society. More research is needed before it can definitively be determined what type of disorder parcopresis is.

According to one 2011 case report, parcopresis has some of the same underlying causes as an anxiety disorder known as shy bladder (paruesis). Paruesis presents as a fear of public urination.

Paruesis is better studied than parcopresis. It is thought to affect between 2.8 and 16.4 percent of the population, according to a 2019 research review. Some people may have both conditions, while others only have one.

Everyone wants to avoid using public restrooms occasionally. They’re not always sanitary or sufficiently private. Concerns about being overheard or leaving a foul smell is natural.

To determine working criteria that would help professionals make a diagnosis of shy bowel, several researchers developed a Shy Bladder and Bowel Scale, according to a 2016 study.

If you’re unsure whether you have this condition, the questionnaire included in their study may help:

  • I can’t have a bowel movement when around others in a bathroom or restroom.
  • I avoid going to the toilet, even if I need to have a bowel movement.
  • I delay going to the toilet, even if I need to have a bowel movement.
  • I worry I cannot empty my bowel when close to others.
  • My bowel habits are the most significant contributor to my anxiety levels in life.

Experiencing parcopresis impacts more than your emotional health. Ignoring the need to poop consistently can also have an impact upon your gastrointestinal health. Holding it in for too long can cause complications, such as:

  • Remember that everyone poops. Try visualizing someone you respect, such as a political figure or actor, pooping.
  • Carry a small bottle of air purifier or sanitizing spray with you to use when you need a public bathroom.
  • Line the inside of the toilet bowl with toilet paper. This will help absorb some of the sound.
  • Flush several times while pooping. This will disguise the sound and reduce the smell.
  • Breathe deeply or do a short mindfulness meditation exercise if you feel the onset of anxiety symptoms.

Talking with a therapist for parcopresis can be highly effective. Your therapist may help you to understand the root of your fear, as well as provide strategies for managing it.

There are several types of therapeutic treatments that may be beneficial. Your therapist my employ one or several. They include:

You may also be prescribed medications for anxiety or depression. Medications used for this condition include gabapentin and SSRIs (selective serotonin reuptake inhibitors).

However, medications have not been used in clinical trials due to the low frequency of this condition.

Due to the unavailable data, medications alone may not appear to be effective for treating parcopresis. But medications may help when they’re combined with other treatments.

If you’re unable to use a restroom when other people are around, or concerns about bowel movements are interfering with your daily life, you may want to consider talking with your doctor or therapist.

When the thought of public defecation causes you to have anxiety disorder symptoms such as sweating or an increased heart rate, therapeutic support may help you overcome your fear.

If you currently consult a doctor of any type whom you trust, talk with them about your concerns. They may be able to help or refer you to a specialist.

You can also find a therapist through these organizations:

Fear of pooping in public is referred to as shy bowel or parcopresis. People with this condition have an overwhelming fear of being judged by others because of the sounds or smells associated with defecation.

This condition has not been studied extensively, but it is thought to be a social anxiety disorder or phobia. Its prevalence in the general population is unknown.

Shy bowel can be effectively treated by therapeutic interventions, such as cognitive behavioral therapy or graduated exposure therapy.

If shy bowel is interfering with your daily life, talking with a therapist can help.