For most people, the daily or near-daily ritual of having a bowel motion is not something we give a great deal of thought to. But for some people, the need to do a “number two” in a public toilet or at work can be beset with significant stress and anxiety.

In recognition of the discomfort people may feel around passing a bowel motion at work, the Queensland Department of Health recently launched a social media campaign with the message “It’s okay to poo at work”.

The campaign has gained significant traction on Instagram and Facebook. It has been praised by health and marketing experts for its humorous handling of a taboo topic.

A colourful Instagram post is accompanied by a caption warning of the health risks of “holding it in”, including haemorrhoids and other gastrointestinal problems. The caption also notes:

If you find it extremely difficult to poo around other people, you might have parcopresis.

What is parcopresis?

Parcopresis, sometimes called “shy bowel”, occurs when people experience a difficulty or inability to poo in public toilets due to fear of perceived scrutiny by others.

People with parcopresis may find it difficult to go to the toilet in public places such as shopping centres, restaurants, at work or at school, or even at home when friends or family are around.

They may fear being judged by others about unpleasant smells or sounds when they have a bowel motion, or how long they take to go, for example.

Living with a gastrointestinal condition (at least four in ten Australians do) may contribute to parcopresis due to anxiety about the need to use a toilet frequently, and perceived judgment from others when doing so. Other factors, such as past negative experiences or accessibility challenges, may also play a role.

For sufferers, anxiety can present in the form of a faster heart rate, rapid breathing, sweating, muscle tension, blushing, nausea, trembling, or a combination of these symptoms. They may experience ongoing worry about situations where they may need to use a public toilet.

Living with parcopresis can affect multiple domains of life and quality of life overall. For example, sufferers may have difficulties relating to employment, relationships and social life. They might avoid travelling or attending certain events because of their symptoms.

How common is parcopresis?

We don’t really know how common parcopresis is, partly due to the difficulty of evaluating this behaviour. It’s not necessarily easy or appropriate to follow people around to track whether they use or avoid public toilets (and their reasons if they do). Also, observing individual bathroom activities may alter the person’s behaviour.

I conducted a study to try to better understand how common parcopresis is. The study involved 714 university students. I asked participants to respond to a series of vignettes, or scenarios.

In each vignette participants were advised they were at a local shopping centre and they needed to have a bowel motion. In the vignettes, the bathrooms (which had been recently cleaned) had configurations of either two or three toilet stalls. Each vignette differed by the configuration of stalls available.

The rate of avoidance was just over 14% overall. But participants were more likely to avoid using the toilet when the other stalls were occupied.

Around 10% avoided going when all toilets were available. This rose to around 25% when only the middle of three toilets was available. Men were significantly less likely to avoid going than women across all vignettes.

For those who avoided the toilet, many either said they would go home to poo, use an available disabled toilet, or come back when the bathroom was empty.

Parcopresis at work

In occupational settings, the rates of anxiety about using shared bathrooms may well be higher for a few reasons.

For example, people may feel more self-conscious about their bodily functions being heard or noticed by colleagues, compared to strangers in a public toilet.

People may also experience guilt, shame and fear about being judged by colleagues or supervisors if they need to make extended or frequent visits to the bathroom. This may particularly apply to people with a gastrointestinal condition.

Reducing restroom anxiety

Using a public toilet can understandably cause some anxiety or be unpleasant. But for a small minority of people it can be a real problem, causing severe distress and affecting their ability to engage in activities of daily living.

If doing a poo in a toilet at work or another public setting causes you anxiety, be kind to yourself. A number of strategies might help:

• identify and challenge negative thoughts about using public toilets and remind yourself that using the bathroom is normal, and that most people are not paying attention to others in the toilets
• try to manage stress through relaxation techniques such as deep breathing and progressive muscle relaxation, which involves tensing and relaxing different muscles around the body
• engaging in gradual exposure can be helpful, which means visiting public toilets at different times and locations, so you can develop greater confidence in using them
• use grounding or distraction techniques while going to the toilet. These might include listening to music, watching something on your phone, or focusing on your breathing.

If you feel parcopresis is having a significant impact on your life, talk to your GP or a psychologist who can help identify appropriate approaches to treatment. This might include cognitive behavioural therapy.

Simon Robert Knowles, Associate Professor and Clinical Psychologist, Swinburne University of Technology

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Intermittent fasting has become a popular dietary approach to help people lose or manage their weight. It has also been promoted as a way to reset metabolism, control chronic disease, slow ageing and improve overall health.

Meanwhile, some research suggests intermittent fasting may offer a different way for the brain to access energy and provide protection against neurodegenerative diseases like Alzheimer’s disease.

This is not a new idea – the ancient Greeks believed fasting enhanced thinking. But what does the modern-day evidence say?

First, what is intermittent fasting?

Our diets – including calories consumed, macronutrient composition (the ratios of fats, protein and carbohydrates we eat) and when meals are consumed – are factors in our lifestyle we can change. People do this for cultural reasons, desired weight loss or potential health gains.

Intermittent fasting consists of short periods of calorie (energy) restriction where food intake is limited for 12 to 48 hours (usually 12 to 16 hours per day), followed by periods of normal food intake. The intermittent component means a re-occurrence of the pattern rather than a “one off” fast.

Food deprivation beyond 24 hours typically constitutes starvation. This is distinct from fasting due to its specific and potentially harmful biochemical alterations and nutrient deficiencies if continued for long periods.

4 ways fasting works and how it might affect the brain

The brain accounts for about 20% of the body’s energy consumption.

Here are four ways intermittent fasting can act on the body which could help explain its potential effects on the brain.

1. Ketosis

The goal of many intermittent fasting routines is to flip a “metabolic switch” to go from burning predominately carbohydrates to burning fat. This is called ketosis and typically occurs after 12–16 hours of fasting, when liver and glycogen stores are depleted. Ketones – chemicals produced by this metabolic process – become the preferred energy source for the brain.

Due to this being a slower metabolic process to produce energy and potential for lowering blood sugar levels, ketosis can cause symptoms of hunger, fatigue, nausea, low mood, irritability, constipation, headaches, and brain “fog”.

At the same time, as glucose metabolism in the brain declines with ageing, studies have shown ketones could provide an alternative energy source to preserve brain function and prevent age-related neurodegeneration disorders and cognitive decline.

Consistent with this, increasing ketones through supplementation or diet has been shown to improve cognition in adults with mild cognitive decline and those at risk of Alzheimer’s disease respectively.

2. Circadian syncing

Eating at times that don’t match our body’s natural daily rhythms can disrupt how our organs work. Studies in shift workers have suggested this might also make us more prone to chronic disease.

Time-restricted eating is when you eat your meals within a six to ten-hour window during the day when you’re most active. Time-restricted eating causes changes in expression of genes in tissue and helps the body during rest and activity.

A 2021 study of 883 adults in Italy indicated those who restricted their food intake to ten hours a day were less likely to have cognitive impairment compared to those eating without time restrictions.

3. Mitochondria

Intermittent fasting may provide brain protection through improving mitochondrial function, metabolism and reducing oxidants.

Mitochondria’s main role is to produce energy and they are crucial to brain health. Many age-related diseases are closely related to an energy supply and demand imbalance, likely attributed to mitochondrial dysfunction during ageing.

Rodent studies suggest alternate day fasting or reducing calories by up to 40% might protect or improve brain mitochondrial function. But not all studies support this theory.

4. The gut-brain axis

The gut and the brain communicate with each other via the body’s nervous systems. The brain can influence how the gut feels (think about how you get “butterflies” in your tummy when nervous) and the gut can affect mood, cognition and mental health.

In mice, intermittent fasting has shown promise for improving brain health by increasing survival and formation of neurons (nerve cells) in the hippocampus brain region, which is involved in memory, learning and emotion.

There’s no clear evidence on the effects of intermittent fasting on cognition in healthy adults. However one 2022 study interviewed 411 older adults and found lower meal frequency (less than three meals a day) was associated with reduced evidence of Alzheimer’s disease on brain imaging.

Some research has suggested calorie restriction may have a protective effect against Alzheimer’s disease by reducing oxidative stress and inflammation and promoting vascular health.

When we look at the effects of overall energy restriction (rather than intermittent fasting specifically) the evidence is mixed. Among people with mild cognitive impairment, one study showed cognitive improvement when participants followed a calorie restricted diet for 12 months.

Another study found a 25% calorie restriction was associated with slightly improved working memory in healthy adults. But a recent study, which looked at the impact of calorie restriction on spatial working memory, found no significant effect.

Bottom line

Studies in mice support a role for intermittent fasting in improving brain health and ageing, but few studies in humans exist, and the evidence we have is mixed.

Rapid weight loss associated with calorie restriction and intermittent fasting can lead to nutrient deficiencies, muscle loss, and decreased immune function, particularly in older adults whose nutritional needs may be higher.

Further, prolonged fasting or severe calorie restriction may pose risks such as fatigue, dizziness, and electrolyte imbalances, which could exacerbate existing health conditions.

If you’re considering intermittent fasting, it’s best to seek advice from a health professional such as a dietitian who can provide guidance on structuring fasting periods, meal timing, and nutrient intake. This ensures intermittent fasting is approached in a safe, sustainable way, tailored to individual needs and goals.

Hayley O’Neill, Assistant Professor, Faculty of Health Sciences and Medicine, Bond University

This article is republished from The Conversation under a Creative Commons license. Read the original article.