Parcopresis (Shy bowel)
What is parcopresis?
Parcopresis (also known as shy bowel syndrome, psychogenic faecal retention) is a psychological condition involving the difficulty or inability to defecatein public restrooms, due to an overwhelming fear of perceived scrutiny.In severe cases, the difficulty or inability to defecate can occur in private restrooms, such as the family home’s restroom. Parcopresis often co-occurs with paruresis.
Individuals with parcopresis are likely to experience anxious thoughts about using the restroom, as well as difficulties with defecating. These symptoms are generally worse in public settings (e.g., shopping centres, restaurants), where the individual perceives that others can hear or see him/her using the restroom.
Individuals with parcopresis tend to experience an increase in symptoms when there are more people present and in closer proximity (e.g., a busy public bathroom with a queue of people waiting to use the facilities). For some individuals, anxiety relating to using the restroom while at home can occur when others such as family and/or friends are present.
Symptoms of parcopresis can include:
- A pronounced difficulty or inability to defecate in public restrooms. In severe cases, a difficulty or inability to defecate at home when family and/or friends are present.
- Physical symptoms consistent with anxiety such as a rapid or racing heartbeat, trembling, muscle tension, excessive sweating, nausea, and blushing.
- Avoidance behaviours such as avoiding using restrooms in public, limiting and/or avoiding public transport.
- Safety behaviours such as reducing food intake in order to avoid using a public restroom.
- Seeking public restrooms that offer greater privacy.
- Avoiding holidays and/or social activities such as parties, dating, sporting events, and other occasions where using a restroom may cause anxiety.
Parcopresisis associated with feelings of shame, embarrassment and problems across multiple domains of life, including relationships, social activities, and employment. Anxiety around restroom usage can influence the type of work environment that an individual is comfortable in, and may affect whether they are willing to travel for work, especially in the case of airplane travel. While parcopresis can have a significant adverse impact on psychosocial functioning and associated quality of life, the majority of individuals living with paruresis do not seek treatment.
Age of onset
The age of onset for parcopresis is currently unknown. However, given the similarities that parcopresis shares with paruresis, it is possible that they both occur in adolescence.
Prevalence of parcopresis
The prevalence of paruresis is currently unknown due to the lack of research on this condition.
Diagnosis of parcopresis
At this time there is no validated diagnostic criteria published for parcopresis. Diagnosis of parcopresis is based upon ruling out physical reasons for difficulties defecating and the presence of psychological symptoms associated with difficulties defecating in public restrooms. In some individuals, parcopresis may also be present along with physical reasons for difficulties defecating;however the psychological symptoms must be clear and significant contributors to the reported difficulties defecating in public restrooms.
Causes of parcopresis
There are a variety of factors that may contribute to parcopresis. The following is a summary of factors that have been associated with the development of parcopresis:
Past experience or trauma
Some individuals report that the onset of their paruresis was associated with a difficult or traumatic experience, such as being bullied or teased in a public restroom, being rushed by another personor being unable to produce a faecal sample for a medical test.
Parcopresis is associated with a number of other psychological conditions, including social anxiety disorder, obsessive compulsive disorder,and depression.Anxiety, regardless of its cause, can affect the ability to defecate. Through a series of physiological processes, feelings of anxiety and fear can impact upon the function of the bowel, making it more difficult to defecate. In addition, failure to urinate, and concerns about failing in the future, may further increase anxiety. Click HERE for further details.
Parcopresis may be learnt in childhood from the behaviour of close family members. For example, if a father experiences anxiety around using public restrooms, the child may interpret that restrooms are not a safe place and take on his father’s fears.