Sudden Stress and Bowel Incontinence
It is known that strong fear, unpleasant surprise, pain, gross scene or other strong stimuli or feelings may cause temporary bowel incontinence – an inability to prevent the passage of the stool.
Strong sensory stimuli may cause excitation of the vagus nerve and pelvic nerves (parasympathetic nerve) that stimulate large intestinal motility (peristalsis) and push the stool toward the anus. At the same time, depression of the sympathetic nerves may cause relaxation of the internal anal sphincter (the muscle that keeps the anus closed) resulting in the involuntary bowel movement. Described mechanism is a part of “fight or flight” or “combat or escape” response to stress, in which flight (parasympathetic) response has prevailed.
Bladder incontinence may appear at the same time, since the passage of the urine is controlled by the same nerves as the passage of the stool (Picture 1).
Picture 1. Autonomic nervous system (click picture to enlarge).
Both the large intestine and the bladder are controlled by
the sympathetic (red) and parasympathetic (blue) nerves.
Chronic Stress and Diarrhea
The same fight or flight mechanism as described above may take a role in a more prolonged stress. Nervousness before a school test, medical procedure or unpleasant meeting may cause diarrhea as long as the stress lasts.
Diarrhea alternating with constipation is characteristic in irritable bowel syndrome (IBS), where the colon is irritated by excited nerves and certain foods.
Why It Happens?
Some people, when experiencing something unpleasant, can not decide what to think about it: is it good or bad….and when they are facing a difficult task, they can not really decide what approach to take: to fully accept or avoid it…so their sympathetic nervous systems that control anal and bladder sphincters can not be activated properly, and parasympathetic system that stimulates defecation and bladder emptying takes advantage. Low blood pressure with dizziness and nausea are other typical symptoms in such situations.
How to Prevent Diarrhea in Stress?
When constantly experiencing incontinence or diarrhea in stressful situations, the following may help:
- Imagine several stressful situations in advance and think what would be appropriate reaction to it. It is not necessary to play a hero; just think which intended action leaves you in peace. Like you imagine that you are about to meet a big dog; now, will you turn back and walk away, will you go widely around it, will you ignore it and walk straight, will you look in its eyes…it is important that you make a decision that leaves you in piece in your heart before this meeting actually happens, and then act according to the decision you have made.
- Before the task that requires some period of preparation, like learning for an exam, again, first think if your heart is in peace, are you approaching to the task in a good consciousness. If not, don’t accept the task. If yes, make a reasonable daily plan and firmly insist with it, even when it seems that all things go wrong or appear difficult.
Commonly, it is a wrong decision or hesitating that brings troubles, and not the stress itself.