Lynn Thompson is married to Jeff Thompson for 47 years.
‘Soulmates’ since they met in their early 20s at a friend’s wedding, the pair are still almost inseparable.
They share a love of bridge and biking and enjoy holidaying on Spain’s South Coast.
Yet there’s one thing that rarely happens when they’re together – Lynn, 69, cannot go to the toilet while Jeff is in the house.
Indeed, when the couple go away together and stay in a hotel, she insists on two bathrooms – and will only go when he is fast asleep.
Why? It is because she is embarrassed.
‘I worry about what he might hear, or smell,’ admits Lynn, who asked us not to use her real name.
‘He knows about my problem and tries to reassure me, but nothing helps. It rules my life but I don’t know what to do.’
You could think it is an over-thinker’s irrational fear. This situation is far more frequent than you might think.
Shy bowel syndrome sounds like an irrational fear held by only the worst over-thinkers. However, this condition is more frequent than you would think. [File image]
Last week, The Mail on Sunday’s GP columnist, Dr Ellie Cannon, asked readers to get in touch if they suffered a so-called ‘shy bowel’ – having heard of the phenomenon via a teenage patient, who’d suffered digestive problems as a result of ‘holding on’ for too long, while living with a boyfriend and experiencing the same fears.
We received numerous responses from readers across the board, including many who shared their personal struggles with the problem.
Women – it was only women who got in touch – told of heartbreaking stories, with many ending up with lifelong bowel conditions. Many women kept their bowel movements secret from both husbands and partners.
One 57-year-old wrote: ‘I use the loo only when my partner of 11 years has gone out. Maybe it’s the thought of my partner going in behind me and knowing what I’ve done.
“My mother (now 78) has the exact same fear. For 40 years, she has waited for her husband to leave. We end up with stomach ache and excess wind, as well as grumbling bowels.’
Another wrote: ‘I have been with my partner for 23 years and if I need to go when he is in the bedroom, I will either run the shower or a tap so he can’t hear me, or avoid going altogether.’
One woman admitted that she took medication to prevent her from falling asleep. ‘I take Imodium [tablets that limit the frequency of bowel movements] to try to delay until I am on my own,’ she wrote.
According to experts, such stories are common. It is a recognised medical phenomenon, known as parcopresis, or ‘shy bowel’.
Although there is not much research on the incidence of parcopresis in the United States, studies have shown that approximately six percent of people suffer from severe anxiety about their bowels.
Professor Siwan Thomas-Gibson, consultant gastroenterologist at St Mark’s national bowel hospital in London, says most specialists are familiar with this problem.
‘We see patients who have spent years fighting their urges and are now battling terrible constipation.
‘Men suffer too but it is far more common in women. Patients say they feel it is “unladylike” to make a smell or a noise when opening their bowels.
‘For some it’s a mixture of being too busy at home and then feeling embarrassed to go in office toilets in a cubicle next to a colleague.’
These can have serious consequences. Studies show that keeping it in for a week – on purpose – can disrupt normal bowel function for up to six months.
‘The bowel is a long muscular tube. When we eat, something at the bottom has to come out to make space for the extra intake,’ explains Prof Thomas-Gibson.
‘The brain sends signals to the gut, which triggers contractions that move digested food through to the lower bowel.
The rectum will then expand, signaling to the brain to get up.
‘If it’s inconvenient, the brain can switch off these signals for an hour or so, with little harm.
‘But if you keep ignoring it, this signalling system begins to go awry, and you stop getting the urge, leading to constipation.’
To make it more difficult for the stool to move, it is better to keep it in the rectum. Stiff stools can cause straining which over time can lead to haemorrhoids or tiny tears in the anal channel known as fissures. These can become very painful.
‘I also see women where this has ended in prolapse – where straining causes the inner lining of the bowel to push outwards, into the rectum,’ says Prof Thomas-Gibson.
Women – it was only women who got in touch – told of heartbreaking stories, with many ending up with lifelong bowel conditions. The majority of women concealed their bowel movements to husbands or romantic partners. [File picture]
Two women wrote of recent diagnoses of diverticular disease – where small bulges or pockets develop in the lining of the large bowel. It can occur due to ageing or constipation.
‘I am paying for my “shy bowel” in later life, as I have been diagnosed with diverticulitis,’ wrote one 70-year-old woman. ‘In the past few weeks my bowel has given up completely as I cannot go without intervention from laxatives.’
One reader said she had faced a ‘lifelong war’ with her digestive system, as a result of ignoring natural urges.
‘I suffer severe constipation while attempting to pass very hard stools three or four times a day.
“I’ve fallen asleep several times due to the pain. I have now mostly got some sort of control, but holding it in most definitely leads to lifelong problems.’
A 71-year old woman claimed that she needed surgery due to severe constipation caused by shy bowel.
‘I have had this problem for as long as I can remember,’ she wrote.
‘My fear of using public toilets in case anyone heard me was so bad I would walk miles in crippling pain to find a toilet with privacy, sometimes not quite making it.
‘I’m awaiting surgery for a second pelvic repair because of constipation, caused by years of holding it in.’
Sometimes, a bad experience in the toilet can cause a swollen bowel.
‘Often you’ll hear of an extreme childhood story – patients say they were only allowed to use the toilet between eight and nine on a Monday morning and had to ignore the urge at all other times,’ says Prof Thomas-Gibson.
One woman blamed her nervous bowel on being ‘shushed’ by her father every time she went to the toilet as a young girl, while another recalled being forced to keep the toilet door open as a child
One woman blamed her nervous bowel on being ‘shushed’ by her father every time she went to the toilet as a young girl, while another recalled being forced to keep the toilet door open as a child.
‘So I avoided going when anyone was around and the habit has stuck,’ she added.
So what’s the solution? You can use a variety of medications to relieve constipation.
However, to address anxiety-related issues, specialists offer psychotherapy to reprogram the brain’s signals called biofeedback.
You will be working alongside specially-trained nurses to maintain a tight routine that regulates bowel movements.
‘It’s about planning when to go, and making sure you listen to the urges,’ says Prof Thomas-Gibson.
‘Perhaps get up 15 minutes earlier to give yourself enough time to go when you feel comfortable and use caffeine and high-fibre foods to get things moving.
‘This is most effective done alongside psychological therapy, to combat underlying fears and embarrassment. Listening to your body is the best thing for your gut health.
‘If your gut is telling you it’s time to go, it is time to go.’