Effects Of Suppression Of Urge To Defecate, Treatment

Article by Dr Raghuram Y.S MD (Ay)
It is a fact that we all would have controlled or postponed or suppressed this urge to defecate at one or the other point of our life. Some of us would have done in unavoidable situations, which is quiet natural. Some of us would do it frequently and many of us are addicted to doing it or habituated to hold these urges every time. This only happens when we give priority to something else!!

Why should we not suppress this urge?
If these things are held back in our system, they might damage the whole mechanics of life and cause wide array of psycho-somatic disorders.

When the body wants to expel something which is harmful to our body, we just need to obey the commands or signals and facilitate the mechanism to go on in a smooth way. We do not have any business to meddle with the ‘smooth functioning of our body’. By doing so, we become the culprits and hostile to our own system.
urge to defecate

When body gives a call for natural urges, they need to be obeyed with respect; nothing comes as priority against it. This is the key of getting naturally cleansed and detoxified. This is the key to enjoy ‘health at its best’.
Forcibly suppressing the ‘urge to defecate’ is called ‘pureesha vega dharana’ in Ayurveda. This has a bad impact on the body-mind health.
Read related: Why Did I Skip My Lunch Today, Though I Am Not On Fast?

Vega Dharana
There are some things which need to be put out of the body in right time, in right quantities. The body sends signals when these things are impending are ready to be put out. These signals or reflexes or urges are called as Vega in Ayurveda. Vega is body’s expression to ‘discharge something or put some undesired thing out of the body’

These impending reflexes are called ‘Adharaneeya Vegas’ or the urges of the body (natural calls) which should not be avoided or held back forcibly. (Adharaneeya – not to be controlled, Vegas – reflexes or urges)

Vegas are signals of auto-detoxification –
The body needs to keep itself in pure, sterile and healthy condition to keep things going in a smooth way. For this to happen, the body needs to throw some unwanted things regularly out of the system, as and when they are produced.

If these unwanted things are held back, they might produce damage to the system in due course of time by contaminating the body elements.
Thus vegas or signals to throw these harmful things out are ‘signals of auto-detoxification process of the body’
By doing this, the body conducts a self servicing and self maintenance of itself, monitored by the basic inbuilt intelligence of the ‘body-mind-system’.

What to do when the vegas are manifested?
When these vegas are manifested, we just need to help them out. We should not be holding the urges, instead help the body by allowing it to throw them out. As and when an urge arises we need to attend it.
On the other hand, these reflexes should not be artificially created!!
Read related: Vega Dharana: Suppression of urges, types, symptoms, and management

Pureesha Vega Dharana
In this article I will explain about pureesha vega dharana (forcible suppression of defecation urge) and its consequences on health. I will also deal with its management in brief.

Impact of Pureesha Vega Dharana on body-mind health –
Pureesha or stools or faeces is the metabolic waste which is formed as an end product of digestion, in the Colon (Large intestine) after the left out nutrients, water and electrolytes have been absorbed by the membranes of the colon. When the faeces collect in the rectum, there is a pressure on the muscles to push the contents downwards. This is called ‘defecation urge’ or ‘pureesha vega’.

The formation and expulsion of pureesha is contributory to the functions of Apana Vayu or the subtype of Vata which is located below belly (in the colon). Apana Vata controls all the activities occurring in the region below the navel region, i.e. defecation, urination, menstruation, semen ejaculation etc and also controls the movements of the low back, hip and joints of the lower limb. When apana vata is balanced and normal, these activities take place uninterruptedly and in a regular way. When apana vata gets vitiated all these activities are disturbed and take place either in an exaggerated way or diminished way.

When we forcibly suppress the natural urge to defecate, we would be disturbing the normal functioning of Apana Vayu. The Vayu gradually learns to hold the faeces and gases instead of expelling them. The muscles and layers of the colon also are trained to hold the stools over a period of time. This may lead to constipation and other serious disorders of pakwashaya or colon.

Pakwashaya or colon is not only the chief site of vata, but also is the controlling station of all the activities of the body. It is also a control station and coordinating point of all the subtypes of vata.

When we practice holding on to the ‘defecation reflex’ it not only will disturb the functioning of apana vata but will also impact on the smooth functioning of the other subtypes of vayu, pitta and kapha. This will also lead to the damage of large intestine.

Udavarta – The apana vayu disturbed and vitiated as a consequence of repeated and habituated ‘apana vega dharana’ will tend to move haphazardly in abnormal directions, mainly in the upward direction. This abnormal movement of Vayu will impart pressure on the abdominal and thoracic viscera and will impair their functions.

This abnormal movement of Vayu will also put pressure on urinary bladder, uterus, and genital system leading to various disorders related to these systems.

As a consequence of Udavarta, the layers of the intestine further absorb whatever water in present in the stools making it dry (owing to the dry and rough nature of Vata). It becomes very difficult for the dried stools to get evacuated. Due to the obstruction of the large gut with stools, many toxic gases are produced causing pain in the abdomen (colic) along with gurgling sounds. Due to the total obstruction in the lower passages, the vitiated vayu moves upwards in the form of eructation and gaseous burps. The udinary bladder is located in the front of the large intestine. The vitiated apana vayu in the large intestines imparts pressure on the bladder. Pain in the bladder, urethra and penis may be manifested. The pressure transmitted upwards can cause vomiting and nausea. Since the vomitus is mixed with gases moving upwards i.e. apana vayu, it may exhibit the smell of stools (pureesham asyad sravati – stools moving towards mouth, according to sushruta)
Read related: Effects Of Forcible Stopping Of Fart, Remedies

Pureesha vega – urge to pass stools or faeces, urge for defecation, effects of suppression
Shakrutaha pindika udweshtana pratishyaaya shiro rujaha\
Oordhwa vaayuhu pareekarto hrudayasya uparodhanam
Mukhena vit pravruttihi cha poorva uktaaha cha aamayaaha smrutaaha (Ref – Ashtanga Hridaya Sutra 4/3,4)

Pakwaashaya shiraha shoolam vaata varcho apravartanam
Pindikodweshtanam aadhmaanam pureeshasya syaat vidhaarite (Ref – Charaka Sutra 7/8)

Aatopa shoolau parikartanam cha sangaha tathaa oordhwa vaataha
Pureesham aasyaat nireti pureesha vege abhihate narasya (Ref – Sushruta Uttara 55)

The symptoms of forcible suppression of ‘urge to defecate’ are as below mentioned –

  • Pindikodweshtana – calf muscles cramp (twitching pain in the muscles of the calf region)
  • Pratishyaya – running nose, cold congestion
  • Shiroruja – headache
  • Urdhwavayu – upward movement of vayu
  • Parikarta – cutting or splitting pain in the anal region
  • Hrudayasya uparodhana – feeling of tightness or compression in the chest
  • Mukhen vit pravritti – vomiting of faeces or feeling as if the faeces is regurgitating into the throat and mouth, foul and faecal breath
  • Pakwashaya shulam – Colic, pain in colon
  • Vata apravartanam – Obstruction to the passage of flatus or fart
  • Varcho apravarthanam – obstruction to the passage of stools, constipation
  • Adhmana – flatulence, distension of abdomen
  • Aatopa – gurgling sounds in the abdomen
  • Parikartika – cutting pain in the anus
  • Sanga (pureesha sanga) – constipation
  • Pureesham aasyaat sravati – movement of faeces towards the mouth (faecal elimination through the mouth)

Common principles of management of disorders arising due to forcible suppression of vata (flatus), pureesha (stools or faeces) and mutra (urine) vegas –
Sweda abhyanga avagaahaaha cha vartayo vasti karma cha
Hitam pratihate varchasya anna paanam pramaathi cha (Ref – Charaka Sutra 7/9)

The above said conditions should be managed by administration of –

  • Swedana – sweating therapy, fomentation, sudation
  • Abhyanga – herbal oil massage (general body massage and local massage around the pubic area, abdomen, pelvic region and around the genitals can also be done)
  • Avagaha – tub bath or sitz bath in herbal liquids like decoctions, oil, milk etc
  • Varti (rectal and or urethral suppositories)
  • Vasti karma – therapeutic enemas with medicated (herbal) decoctions, oils, ghee and or milk
  • Pramathee anna pana (Vid bhedi annapana) – foods which help in easy passage of stools

External treatments:
Abhyanga (massage) and Swedana (sudation) – This combo is always antagonistic to vata. They not only combat Udavarta and set right the movements of vata, but also help in combating constipation and other symptoms caused due to vata vitiation.

The unctuous nature of medicated oils and ghee are antagonistic to the dry nature of Vata. Similarly the ushna (hot quality) guna of swedana is antagonistic to the sheeta guna (cold quality) of Vata.

Thus Snehana in the form of Abhyanga and Swedana combats vata and help in alleviating the symptoms caused by pureesha vega dharana.

The pressure and strokes given during Abhyanga, especially over the tummy will normalize the movements of Apana Vayu.

The dual treatment opens up the blocks in the channels, relaxes the nerves, enhances the blood circulation, relax the muscles, open up the channels and release the pressure on the viscera caused by upward movement of vata.

Avagaha (Tub bath) – The tub broad and long enough to immerse one’s body completely is used for Avagaha. We call it Avagaha droni or avagaha tub. It is similar to the bath tub. In this tub is filled the medicated decoctions or milk which is processed with vata alleviating herbs. The patient is subjected to abhyanga and made to sit in the tub filled with medicaments for 30-45 minutes. Avagaha is a type of swedana because the medicinal liquids are usually hot (tolerable). This combination of abhyanga and avagaha also acts in a similar way as abhyanga and swedana. The combination bestows the same benefits and destroys the bad effects and symptoms caused by pureesha vega dharana.

Internal treatments –
Varti (Rectal suppositories) – Varti or medical suppositories are wicks made up of medicinal herbs (paste of the herbs), usually of vata alleviating or vata expelling or laxative herbs. Their length and breadth permit their entry into the rectum. They are smeared with medicated ghee or oil and inserted into the anal opening, after smearing the anal orifice with ghee or oil (this facilitates the easy entry of varti into the rectum). The varti is left in place for a couple of hours.

The suppositories stimulate the bowel movements and ease the excretion of stools and flatus (fart). They facilitate free movement of apana vayu in its normal course (downward). With regression of udavarta, the pressure on the organs are released, mainly the pressure and obstruction caused in the colon, urinary bladder and uterus. This helps in reestablishment of physiology in the entire body since the vata morbidity is taken care of in its prime centre i.e. colon. Urethral suppositories can also be used since the urinary bladder too will be afflicted due to udavarta caused by pureesha vega dharana.

Vasti Karma – Medicated enemas are unparalleled treatments for combating vitiated vata. These are the treatment in which the medicated decoctions (kashaya vasti), oil and or ghee (sneha vasti) or milk (ksheera vasti) are introduced into the bowel (colon) through the anal route.

The enemas can be skilfully combined to combat and expel vata at its prime centre i.e. colon and thus normalise the movements and activities of vata, reverse udavarta, release the pressure over the visceral organs and colon, helps in excretion of fart, stools and urine and establish health.

Vasti helps in effective cure of symptoms and complications arising from pureesha vega dharana. Vasti can be given through the anal route and also through the urethral or uterine routes (uttara vasti). Uttara vasti also takes care of severe complications and obstructions occurring in urinary bladder and genital organs due to udavarta caused by pureesha vega dharana.

Diet:
Pramathi annapana or vid bhedi annapana (foods which help in breaking the composition of obstructed faeces and in easy expulsion of stools)

Nija veeryena yad dravyam srotobhyo dosha sanchayam
Nirasyati pramaathee tat (Ref – Shaarangadhara Purva Khanda 4)

The food which by the virtue of its natural potency removes the accumulated morbid doshas and wastes (excreta including faeces) from the channels and also expels them is called pramathi aushadha. Thus, pramathee dravya can be of 2 types, foods which act as pramathee or foods processed with medicinal herbs which have pramathi quality.

The pramathi dravyas expel the stagnated morbidity from the body and cleanses the channels. On the other side, they also help in regularizing the movements of vata following the removal of morbidity. This reverses the udavarta process and alleviates the symptoms caused by the pureesha vega dharana.

What does modern science say about ‘holding in poop?
Stool is a combination of waste material and bacteria, resulting from your body’s digestive process. It is made up of 75% water along with a mixture of bacteria, protein, and undigested food, waste material from food, cellular linings, fats, salts and mucus.

The large portion of water is there to easily slide the stool through the body and out of the rectum. But if you deny the urge to defecate, the stool remains in your body and your body absorbs the water from the stool. This causes the stool to dry out and thus harder to pass. This results in constipation. Once constipated for a long time, the stools can pile up in your system and worsen the condition over a period of time when the condition becomes stubborn.

When the digested food reaches your large intestine, the rectal walls are stretched and that sends a complex signal to the brain that it is time to push it out.

Everyone’s schedule and frequency differ; some go a few times a day or once every couple of days. But you are more or less on a regular schedule which is fixed or natural to you, or by practice is erratic to you.

But when you have got to go, it is best that you ‘listen to your body’.

‘Holding in your poo on the rare occasion is fine, but (shouldn’t be) done all the time’ (Alison Chen, N.D., author of ‘What your poo says about you’). Keeping in your bowel movement can lead to unnecessary constipation. The longer you hold the stool in your colon, the more water is absorbed and the harder it becomes says Chen. This can potentially damage your colon due to effort and strain of expelling it later on.

‘Holding poop can result can result in distended bowels and problems with normal stooling in the near future’ (Spencer Nadolsky, D.O., a family physician)

He adds and tells ‘When you hold, the muscles of your rectum stretch and send the signal to stop responding to the urge to go, which can sometimes result in slower emptying of the colon when it’s time’.

Related reading – http://greatist.com/live/hold-in-poop-fart

‘Holding in your poo, even once is dangerous, because it allows stools to build up. As they dry out, they block your system and can lead to an impacted bowel’ (Konstantin Monastyrsky, author of ‘Gut Sense’)

‘We’ve found people who hold their poop longer because of their profession – nurses, teachers, or truck drivers, for example, or people who are afraid to go to work – can get into bad habits that causes constipation of dysfunction in the muscles used for pooping’ (Kyle Staller, M.D., a gastroenterologist at Massachusetts General Hospital)

Related reading – http://www.attn.com/stories/5851/what-happens-when-you-hold-your-poop

Related video – https://www.youtube.com/watch?v=bd_IfbaEEBk

The curious and tragic case of Emily Titterington
Emily Titterington, a 16 year old girl from Cornwall, England, having mild autism and had dealt with bowel issues for most of her life, died on February 8, 2013, after not pooping for eight weeks. She also had fear of toilets which made her withhold stool until it became life-threatening. According to medical reports, she suffered from a heart attack as a result of enlarged bowel, which shifted around and compressed some of her organs. This resembles udavarta caused by ‘forcible poop suppression’ or pureesha vega dharana.

Though, this was not a case of forcible suppression of fecal urge, the case depicts the extent of damage the faecal retention can cause over a period of time and the need of evacuating it as and when the urge arises.

Related reading –
http://www.womenshealthmag.com/health/holding-your-poop-too-long

How often should you poop?
It varies from person to person

If you do not have a bowel movement every day, you need not worry. The important thing is to have a bowel movement and remember, it takes 24-72 hours for food to process and exit the body through the colon. At the end of the day, anything less than 3 times a week is abnormal. But the pattern can be healthy as long as your frequency doesn’t impact your quality of life.

Other effects of forcible suppression are –

  • Abdominal discomfort
  • Constipation, cramps in abdomen
  • Bloating and distension of abdomen
  • Dyspnoea, feeling weak
  • Dysfunction of muscles related to evacuation of bowel
  • Building up of stools and stool impaction and bowel impaction, needing surgery for intervention many times
  • Haemorrhoids and anal fissures
  • Vomiting
  • Holding of toxins and poisons in the body
  • Disruption of healthy bacteria in your digestive system and raise your beta glucaronidase levels, an enzyme that prevents your body from cleaning out the natural hormones and chemicals it absorbs from the environment

Just before finish –
Holding on to any natural body urge or urges is dangerous to the health and might damage our system on long run. They are also the chief causes for the manifestation of wide array of psycho-somatic disorders. The ancient and modern wisdom tell the same.

The urges are not just the body signals, but are in fact dangerous to health when held back forcibly. They are responsible for causation of many psycho-somatic illnesses when their normal expulsion is forcibly suppressed.

We just need to allow the body to perform its functions normally, without meddling into any of the proceedings. The vegas will help us maintain our health and prevent many diseases when we let them go.

‘Just listen to your body language and respond accordingly, don’t meddle with its functions and enjoy good health’.
Click to Consult Dr Raghuram Y.S. MD (Ayu) – email/skype


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Comments

  1. Nirmal Kayaz says:

    Great guide. Thanks for sharing.

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