Lynn Thompson has been married to her husband Jeff for 47 years.
‘Soulmates’ since they met in their early 20s at a friend’s wedding, the pair are still almost inseparable.
They enjoy holidays on the South Coast, and in the south of Spain, and share a passion for bridge and cycling.
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? She is too 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.’
It sounds like an irrational fear held by only the worst over-thinkers. But this situation appears to be far more common than you may expect.
Shy bowel syndrome sounds like an irrational fear held by only the worst over-thinkers. But this situation appears to be far more common than you may expect. [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.
Scores of readers, of all ages, wrote to us in response, revealing their own struggles with the little-talked-about problem.
Women – it was only women who got in touch – told of heartbreaking stories, with many ending up with lifelong bowel conditions. Most hid their bowel movements from husbands and romantic 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 mum, who is 78, has the same fear. She has been with her husband for 40 years and still waits for him to go out. 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.’
Another admitted, shockingly, to taking medication to stop her from going. ‘I take Imodium [tablets that limit the frequency of bowel movements] to try to delay until I am on my own,’ she wrote.
Do you suffer from shy bowel syndrome?
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Experts say such stories are not uncommon. It is a recognised medical phenomenon, known as parcopresis, or ‘shy bowel’.
While there are few studies looking at the prevalence of parcopresis, it is estimated that at least six per cent of the population suffer severe toilet-related anxiety.
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.’
The repercussions can be serious. 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 then fills, which signals to the brain that it is time to go.
‘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.’
The longer a stool is kept inside the rectum, the more water the body absorbs from it, making it harder to pass. Hard stools lead to straining, which, over time, can result in haemorrhoids, or small tears in the anal canal known as fissures, which can be extremely 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. Most hid their bowel movements from husbands and 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. The condition can be a result of ageing but it is also triggered by constipation, as large stools create excess pressure on the bowel tissue.
‘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 have passed out several times from the pain. I have now mostly got some sort of control, but holding it in most definitely leads to lifelong problems.’
In one case, a 71-year-old said she had been forced to undergo surgery as a result of extreme constipation related to 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.’
Shy bowel can sometimes be traced back to a difficult toilet experience earlier in life.
‘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? A host of medicines can treat constipation, including over-the-counter stool-softeners such as Fybogel and gentle laxatives.
But to combat underlying anxiety, specialist centres offer a type of psychological training to reprogramme the signals between the gut and brain, called biofeedback.
This involves working with specially trained nurses on a strict routine designed to reregulate 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. But the healthiest thing you can do for your bowels is listen to your body.
‘If your gut is telling you it’s time to go, it is time to go.’