Don’t Strain To Poop! It Can Be Dangerous

Straining to poop is not just uncomfortable, it can actually cause injury if you have to do it regularly.

Dangers of Straining

When you strain, you sharply increase intra-abdominal and rectal pressure. Straining is like putting your whole core system under pressure in the wrong way; it stresses blood vessels, muscles and connective tissue above and below the diaphragm. Over time, that pressure can cause:

• Hemorrhoids: The pressure from straining can cause the veins in the rectum and anus to swell and widen. It can weaken the vein walls and surrounding connective tissue, leading to hemorrhoids. Symptoms can include bleeding (blood on your stool or as you wipe), bulging or swelling through or around the anus, pain, or itching and irritation around the anus.
• Anal fissures: Straining forces the anal canal to stretch beyond its comfort zone. If the stool is hard or large, it can tear the thin lining of the anus, creating a fissure. Continued straining prevents proper healing, causing pain, bleeding with bowel movements and anal sphincter spasms.
• Rectal prolapse or rectocele: Chronic straining stretches the rectal walls and weakens the pelvic floor muscles and ligaments that hold the rectum in place. Over time, this can cause the rectum to slide out of the anal opening (rectal prolapse) or vaginal opening (rectocele). Symptoms can include pressure in the pelvic or vaginal region, feeling or seeing a “bulge” from your vaginal or anal openings, feeling that your rectum isn’t empty after a bowel movement, and loss of bowel control.
• Hiatal hernia: Straining also pushes upward. The sharp spikes in intra-abdominal pressure force the stomach against the diaphragm. This can weaken the opening in the diaphragm and allow part of the stomach to protrude upward into the chest cavity, causing a hiatal hernia. Symptoms can include reflux, heartburn, chest discomfort, feeling full soon after you eat and shortness of breath.
• Vasovagal syncope: Straining often involves you holding your breath and bearing down, which is called a Valsalva maneuver. This can cause blood pressure to drop suddenly. For some people, this triggers a vagus nerve reflex that slows the heart rate dramatically, causing dizziness or even fainting on the toilet. Vasovagal syncope usually is harmless but it's possible that you may injure yourself during a fainting episode.

Tips To Avoid Straining

• Optimize your posture: Keep your feet flat and use a stool to keep knees above your hips. This straightens the rectum and reduces the need to strain as it relaxes your abdominal and pelvic floor muscles. If you don't have a stool, leaning forward and resting your elbows on your knees can help.
• Breathe: Avoid holding your breath and bearing down. If you feel the need to push, instead of holding your breath, take a gentle inhale, then exhale slowly as you bear down lightly from the abdomen.
• Listen to your body: Avoid going to the bathroom until you feel the urge to have a bowel movement. Once in the bathroom, try to avoid distraction (using your phone or reading) so the mind-body connection can happen and allow your body to relax voluntarily.

Preventing Constipation

Constipation is the common cause of most straining. To keep your stools regular, make sure you are drinking enough water daily and eating foods higher in fiber like fruits, vegetables and whole grains or oat-based products to bulk and soften stool. Regular physical activity also stimulates bowel motility. Walking for just 15 minutes a day can help regulate your bowels and aid in emptying.

Talk to Your Doctor

If you notice any of the above symptoms, you should follow up with your primary care physician or a gastroenterologist or colorectal specialist. Frequent straining, bleeding, pain or a feeling of incomplete emptying are common, but not considered normal. A pelvic floor therapist can aid in working on proper body mechanics to decrease straining with bowel movements, promote a healthy bowel routine, and learn how you can poop smarter and protect your body.

Don't assume that rectal bleeding is due to hemorrhoids, especially if you have changes in bowel habits or if your stools change in color or consistency. Rectal bleeding can happen with other diseases, including colorectal cancer and anal cancer. Seek emergency care if you have large amounts of rectal bleeding, lightheadedness, dizziness or faintness.

This content is not AI generated.