What Happens If You Hold Your Poop for Too Long?

Key takeaways:

• Functional constipation is a common problem, especially in children.
• It is diagnosed after ruling out organic and psychological diseases.
• Treatment focuses on treating the underlying constipation with behavior modification and laxatives.

Sometimes circumstances determine that you must wait before pooping. As long as this isn’t a frequent occurrence, “holding it” is okay now and then. But what happens if this becomes a habit? Sometimes patients will purposefully avoid pooping. This is a form of constipation known as functional constipation. Functional constipation is constipation that is not due to an anatomic abnormality or a disease process.

Approximately 3% of children suffer from constipation. 95% of these children have functional constipation. Adults too can develop constipation, but it is not usually the result of purposeful avoidance of bowel movements.

How long you can safely hold your poop in

There isn’t necessarily a hard and fast limit. Everybody is different. It will depend on how much you eat, your height and weight, and the size of your colon. The colon can hold a large amount of stool, however.

Risks of holding your poop in for too long

While holding in your poop is possible, it isn’t good for you. There are risks associated with the behavior.

Fecal impaction

Fecal impaction occurs because of hardened stool inside the rectum. The stool becomes so hard that we cannot push it out by normal bowel contractions (peristalsis). If a patient holds their poop in for a day or more, there is a risk of developing fecal impaction.

Fecal impaction is best treated by manual disimpaction and/or enema administration. Manual disimpaction involves the removal of stool using a gloved finger. This is usually performed by a parent or medical provider. Enemas promote stool passage by direct removal and chemical softening of the stool.

Stercoral ulcer

A stercoral ulcer is a complication of fecal impaction. When a patient has a longstanding fecal impaction, the stool exerts pressure on the colon lining. Over time this can erode through the colon lining. This is a stercoral ulcer.

Stercoral ulcers are serious. They can lead to colonic perforation, severe illness, and death.

Colonic perforation

A feared complication of chronic constipation is colonic perforation. This is when a hole forms in the wall of the colon. This can lead to severe illness, shock, and even death.

Colonic perforation as a result of chronic constipation is thankfully rare. When it does develop, it is usually a result of a stercoral ulcer. This carries a mortality rate of nearly 50%. The treatment is emergency surgery.

Causes of holding your poop in for too long

Depending on the age of the patient, the cause of constipation can differ. Here we focus mostly on the causes of constipation in children.

In adults, the causes are complex and often related to factors such as dementia, age, and medication side effects. Adults typically do not choose to hold their poop in too long, as children can.

Functional constipation

Functional constipation is constipation not caused by disease or anatomic abnormality. This is the cause of constipation in 95% of children. There can be psychological factors that contribute to functional constipation.

When children have an unpleasant experience involving pooping, they are understandably hesitant at the next bowel movement. There can be significant anxiety which leads to voluntary retention of poop. There are other possible psychological triggers as well. Changes in school schedule, separation anxiety from parents, toilet training, and abuse of any form can lead to this condition.

There is also a link between certain neuropsychological conditions and functional constipation. Children with ADHD and autism spectrum disorders are at increased risk of functional constipation.

Therapy for functional constipation centers around relieving any psychological stressors, behavior modification, and laxatives.

Hirschsprung disease

Hirschsprung disease is a rare disorder involving the neurons in the muscular layers of the rectum. These neurons fail to develop properly and as such the rectum is not sufficiently stimulated to contract. This results in constipation and can have the appearance of voluntary stool retention.

This condition is typically diagnosed during the newborn stage of life. It is rarely diagnosed in childhood, but it does happen on occasion. The treatment for Hirschsprung disease is surgery.

Ectopic anus

Anterior ectopic anus is a rare cause of constipation. This occurs almost only in female newborns. It is a cause of constipation. When the anus is not in its usual anatomic location, it is said to have an ectopic location. The treatment for this condition is surgical.

Read our guides on different types of stool, stool colors, and healthy vs. unhealthy stool for more.

How to get short-term relief from holding your poop in for too long

Short-term therapies for constipation are directed at alleviating the stool burden. It may be helpful to make use of these therapies under the guidance of a doctor.

Disimpaction

Fecal disimpaction is the process of removing stool from the rectum. This is typically accomplished with the index finger. Fecal disimpaction should be performed by a medical provider.

During fecal disimpaction, the performing provider may first want to administer an enema. This can help loosen up the stool that is present. Then, using a gloved hand with ample lubrication, the provider’s index finger is inserted through your anus. The provider will then remove the stool from the rectum manually.

It may be that some sedation is required to perform fecal disimpaction. Talk with your doctor if you or your child have anxiety around this procedure.

Medications

Certain medications can relieve constipation. Sometimes these are stool softeners and laxatives taken by mouth. At other times, your doctor may prefer to administer an enema for more immediate relief. A combination of both is also fine.

Some of these options are available over the counter. Please talk with your doctor before initiating therapy, as some are more suitable than others.

How to get long-term relief from constipation or anxiety around pooping

Long-term therapy for constipation focuses on laxative therapy, relieving any psychological stressors, and behavior modification.

Laxative therapy

For children with no fecal impaction or one that has been treated, the next step is beginning laxative therapy. This should be done under the guidance of a doctor.

Some of the most common laxatives for children are polyethylene glycol, milk of magnesia, and lactulose. These medications are increased or adjusted until the patient has regular soft bowel movements.

Behavioral modification

After beginning therapy with laxatives, the focus turns to behavior modification. This involves regularly sitting on the toilet several times a day for a set period of time. This typically takes place after meals. It should be followed every day. It is important to use positive reinforcement to improve adherence and cooperation.

If there are psychosocial triggers around pooping, these too should be addressed. Involving a trained psychologist may be helpful.

Dietary changes

Incorporating increased dietary fiber is important. Fiber bulks up the stool and draws in water, allowing for easier bowel movements.

Sources of dietary fiber include whole grains, fruits and vegetables, beans, nuts, and seeds. Be sure to drink more water as you increase fiber intake or constipation can worsen.

When you should see your doctor about infrequent bowel movements

If you or your child go more than two days without a bowel movement, you should be evaluated. On average, three bowel movements a week is a healthy amount.

You should see a doctor if:

• You or the patient have fewer than three bowel movements per week.
• The stools are pasty and hard rather than soft.
• You or the patient does not want to eat or is losing weight.
• You or the patient complain of pain during bowel movements.
• You have trouble toilet training your child or they refuse to sit on the toilet.

You should go to the emergency room if:

• You or the patient have a bloated abdomen.
• You or the patient is vomiting.
• There is severe abdominal pain associated with the constipation.

Questions to ask your doctor about infrequent bowel movements

• What is the cause of this?
• Are there therapies we can do at home?
• Are there any over-the-counter medications for this?
• What happens if this doesn’t improve?

Frequently asked questions: what happens if you hold your poop in

It is normal to have questions about such issues. Please ask questions until you understand what is happening.

What happens if you hold your poop in for a week or longer?

This can lead to fecal impaction. Fecal impaction often requires a trip to the doctor’s office or emergency room for manual stool removal.

Can you die from holding your poop in for too long?

While this is rare, it can happen.

Final thoughts

Holding in poop is a problem that primarily affects children. If you think your child may be doing this, please see your doctor.

General Medicine follows a strict editorial process, including using real experts to write our articles, vetted primary sources, fact-checking, a secondary medical review, and updates as necessary. This article was medically reviewed and fact checked by Dr. Lane Thaut, DO.

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