Stool Holding

Stool holding, also known as fecal retention or withholding, is a behavior where an individual intentionally delays or resists the urge to defecate.

Causes

• Painful bowel movements: Individuals may associate defecation with pain due to conditions like anal fissures, hemorrhoids, or proctitis.
• Fear of using public restrooms: Some people may feel anxious about using public toilets, leading them to hold their stool.
• Constipation: Hard stools can be painful to pass, causing individuals to delay bowel movements.
• Neurological disorders: Certain conditions like spinal cord injuries, multiple sclerosis, or Parkinson's disease can affect bowel function and lead to stool holding.
• Pelvic floor dysfunction: Weakness or poor coordination of the pelvic floor muscles can make it difficult to initiate a bowel movement.

Consequences

• Constipation: Chronic stool holding can lead to constipation, which can cause discomfort, bloating, and abdominal pain.
• Fecal impaction: Prolonged retention of stool can result in a mass of feces becoming stuck in the rectum, requiring medical intervention.
• Bowel obstruction: In rare cases, stool holding can lead to a bowel obstruction, which is a blockage of the intestine that can cause severe abdominal pain, vomiting, and constipation.

Diagnosis

Diagnosing the underlying cause of stool holding typically involves a physical examination, medical history, and possibly diagnostic tests such as:

• Colonoscopy: A procedure to visually examine the colon for any abnormalities.
• Anorectal manometry: A test to assess the function of the anal sphincter muscles.
• Defecography: An imaging study to evaluate the movement and function of the rectum during defecation.

Treatment

Treatment for stool holding depends on the underlying cause, but may include:

• Bowel training: Establishing a regular bowel routine to help retrain the bowels.
• Laxatives or stool softeners: Medications to help soften stool and make it easier to pass.
• Pelvic floor physical therapy: Exercises to strengthen and coordinate the pelvic floor muscles.
• Cognitive behavioral therapy: Counseling to address any underlying psychological issues contributing to stool holding.