Pooping etiquette: what I learnt at toilet training
I thought long and hard about how I want to start this article. Even though we’re talking about the most natural thing in the world – let’s not beat about the bush, I mean pooping – writing about it still makes me uncomfortable. When I raise the subject with colleagues, it becomes clear I’m not the only one who feels like this. But that’s exactly why we have to talk openly about it. After all, it affects everyone. And Jutta Wunderlin agrees. Jutta is a breathing and pelvic floor therapist who offers something called «toilet training». People get referred to her from their doctor to learn the right way to go to the loo. It sounds a bit weird but there seems to be a desperate need for it. While talking to Jutta, I find out that people usually don’t know the right way to use the porcelain throne. Goodness, apparently even I missed the memo on the right way to poop. You might be wondering why any of this is relevant or how there can even be right and wrong ways to go to the loo. I’ll let Jutta explain.
«Not emptying the bowel correctly can cause a number of health problems in the long term.» These include things like fissures, which are small tears in the inner wall of the intestines. This can cause pain and blood in the stool. Even haemorroids can become a problem. The veins around your bum are called the rectal venous plexus and they play a vital role in the functioning of the bowel. They make sure that we stay continent – i.e. that we keep control of the bowel. They usually fill up with blood before we need to go and help the sphincter muscles afterwards. But this alone wouldn’t be enough to hold back stool. If you don’t use the right technique when going to the loo, the blood in this area might not drain away. That in turn can cause bleeding and pain or even make the haemorroids slide down so they’re visible externally.
As women have a weaker pelvic floor than men, there’s a risk that the bowel could drop towards the vagina. It then creates a kind of bag there, which fills up with stool and can’t be excreted. In women who have had their uterus removed, it’s especially common for their small bowel to get pressed into the large bowel and as a result everything starts to clog up. The bowel can also turn in on itself. Jutta Wunderlin even gets clients who have their bowel coming out. And those are just the most common complaints she sees.
«The most important thing is making sure we stay continent,» Jutta stresses. «Problems with bowel incontinence can happen when the inner sphincter muscle gets weak. Unlike the outer muscle, the inner sphincter can’t be strengthened with pelvic floor exercises.» She goes on to explain that incontinence isn’t just an issue for the older generation. Increasing numbers of young people are affected. It’s just that no one talks about it. Jutta uses targeted exercises to help relieve the various complaints her clients have. «The right treatment ensures my clients feel better in their own skin and lets them go about their lives without bowel problems.»
But I’m guessing most people don’t want it to get to that stage. That’s why I asked Jutta for some pooping hacks so you know what to be aware of when taking a trip to the loo.
Don’t force it
When you push or bear down, you’re increasing the chance of getting the kind of problems listed above. You might assume that this technique will be better at clearing what’s in your bowel. But rather than relaxing the sphincter muscle, it actually closes it and makes it tense up.
Jutta Wunderlin shows me how this works by asking me to sit on a seat that’s fitted with a blue sensor – don’t worry! I was fully clothed. The sensor registers how much my pelvic floor strains when I press down. The seat then sends these results to software on Jutta’s laptop. You can see a change of direction on the graph each time she asks me to bear down. That means that when you push, your pelvic floor tenses. But given that you’re physically releasing something from the body when you poop, the pelvic floor needs to be completely relaxed. If you push too hard, you also increase the pressure on your head. But pressure won’t be of any use up there. When your bowel is ready, when the consistency of your stool is right and when you’re relaxed, everything should just happen naturally. And that leads us onto the next point.
Wait for the signal and avoid spending a long time on the loo
Only go to the toilet when your body gives you the signal that it needs to poop. Bear in mind the body doesn’t work like clockwork and it keeps its own schedule. And that’s something you should respect. Just because you have time to go to the loo at home doesn’t mean your body can poop on demand. So for that reason, it’s best to avoid just sitting on the throne and waiting – it won’t do you any good. Let me explain why. Imagine your pelvis is a hammock that is hanging freely when you sit on the loo. The more time you spend on the toilet, the more you’re straining this «hammock». Your organs no longer have the relaxed pelvic floor to rest on and that’s when pressure builds up on them.
You should think of the toilet as a place of complete relaxation. That’s not to say you need to spend a lot of time there. But it does mean that distractions, such as magazines and mobile phones have no place in the bathroom as they just keep you sitting on the loo longer. They also make you sit at the wrong angle by encouraging you to lean forward and this makes it difficult to empty the bowel.
Don’t hold it in
Waiting for your body’s signal to go to the loo also means you shouldn’t ignore it and hold everything in. If you wait until you get home just because you don’t want to go at work, your poop will get too hard. That’s when you run the risk of pushing down too much and damaging your sphincter muscle. And as Jutta has told us, that can in turn lead to bowel incontinence.
Adopt the correct position
If nature had its way, you’d be pooping while squatting somewhere in the wild. That would certainly be the ideal position for your body. Unfortunately, our toilets are built so we’re not sitting correctly or safely for our bowels. What you want to avoid is putting your feet on their tiptoes – this is something shorter people tend to do. Having a straight back also makes it more difficult to let things out. That’s because your pelvic floor automatically supports your organs in a straight position. But when you’re sat on the loo, your pelvic floor needs to be fairly relaxed. In other words, it shouldn’t tense because it’s trying to «push something out».
Ideally, you want to sit hunched with your feet flat on a height. You can grab something as simple and DIY as a couple of stacks of newspapers or get something specially designed for the bathroom, such as a toilet stool. Let your knees go slightly apart. Generally speaking, it should look like your body is deflating. You can also use a breathing exercise to help this process. Start with your lips gently apart and breathe out slowly into your pelvic floor, while imagining everything «flowing out from top to bottom».
Spending time with Jutta made me realise just how wrong we’re getting a seemingly simple, everyday activity like going to the toilet. And it got me thinking that we ought to pay more attention to how our body works and not just brush it off as irrelevant or minor. «It’s not easy in the world we live in today. Noisy distractions, such as our smartphones have made us lose touch with what’s essential,» Jutta explains. And sadly, she’s right.
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