I Have IBS and Anxiety. It's Not a Great Mix.

I was warming up for the 100-meter dash at a high school track meet in my skin-tight spandex shorts when a very sudden, strong urge hit me: I had to poop. I was already feeling nervous at the thought of my peers and boyfriend watching me race and potentially cross the finish line last. I had a decision to make: Would I hold in my bowel movement while sprinting in discomfort, or would I swallow my pride and excrete my feces? I chose the latter. 

I hurried into the bathroom. To my avail, there was no one else in there. I took care of business swiftly but was mortified to hear “Ew! It stinks in here” as I pulled up my shorts. Two girls walked in promptly after I flushed all my dignity down the toilet. I stood in the stall ashamed and weighed my next decision: Would I confidently march out and proclaim it wasn’t me, or would I hide until they left? I feared they could identify my feet. My mind conjured up a scene of two girls watching me race and saying to a third person: “That’s the girl who reeked up the bathroom!”

I chose a third option. I left the stall and acted as if I wasn’t the culprit. I couldn’t muster up a word, but the beet-red color of my cheeks probably spoke volumes. 

That was eight years ago. I can literally count on one hand how many times I’ve had a bowel movement in a public bathroom since then. 

I live with two chronic conditions: irritable bowel syndrome (IBS) and generalized anxiety disorder. The two don’t mix well. I have a phobia of using public bathrooms, yet I have a type of IBS characterized by frequent bathroom usage and loose stools. I use the word “phobia” because my fear of using public bathrooms is irrational, persistent, and impairs my daily life. 

I panic at the thought of clogging a toilet, stinking up a room, or having someone wonder how I could produce such a vile smell. 

Although I’ve experienced gas, bloating, diarrhea, and abdominal discomfort since my childhood, it took years to receive a diagnosis of IBS. The disorder is commonly categorized into three types: constipation (IBS-C), diarrhea (IBS-D), or mixed bowel habits (IBS-M). I have IBS-D, meaning I typically poop around six to seven times a day.

My IBS symptoms cause anxiety over having to pass stools, and that anxiety only worsens my digestive issues.  

Thanks to my anxiety, those bowel movements only happen when I’m at home. Anxiety disorders and IBS are common, and many people also live with both conditions, but not many people experience such a heightened fear of excretion in public bathrooms.

My somewhat unique situation means I’ve relied on the support of my family, but they don’t really understand. When I was 16, I frantically texted my mom to “pick me up ASAP” when I was at a Greek restaurant with one of my closest friends. Either the hummus or tzatziki had too much garlic, causing my stomach to churn. My brain alerted me it was time for fight-or-flight mode, and I quickly discovered this was not an instance I could fight the urge to go.

My mom was at the restaurant in 10 minutes. I offered some strange excuse to my friend and darted into my mom’s car. While my mom whipped down the highway, my sphincter held on for dear life. I clenched my buttocks together as tears streamed down my face. I made it home in time before an accident, but I felt weird for not being able to use the restaurant’s bathroom like the average person, and for feeling too embarrassed to be truthful with my close friends in these moments.

I have countless more anecdotes like the Greek restaurant dine-and-dash. I often rearrange my schedule to avoid having to use facilities outside my home. I’ll go home between outings just to use the bathroom. When we have guests staying with us, I plan the times I’ll have a bowel movement, considering factors like background noise, when the house will be empty, or times when people are busy and not frequenting the bathroom. Before events or a travel day, I’m meticulous about choosing “safety” foods that won’t cause an upset stomach. I carry travel-sized perfumes with me in case I don’t have a choice but to use public facilities. When I’m staying at a friend’s or relative’s house, I take precautions to avoid any lingering smell; I create a toilet paper barrier in the toilet bowl, double flush, and rub soap with hot water in the sink if I don’t have an air freshener. Taking all of these measures to avoid judgment becomes exhausting. 

My IBS symptoms cause anxiety over having to pass stools, and that anxiety only worsens my digestive issues. It’s a really shitty downward spiral. 

What makes it even worse is that I’m a woman. 

Our culture often pretends that women don’t poop, so often that women start to internalize it. Even women who don’t have a particular shame and fear around pooping can relate to being in a place or situation where they didn’t feel comfortable going number two. We are taught to believe that even our bathroom behaviors must be dainty and rose-scented. Social media users react in laughter to a man farting, but when a woman does it? It’s revolting.

Since age eight, I’ve held this deep-seated notion that women shouldn’t produce stinky smells. At least not in public, or in the presence of men. I was in a long-term, committed relationship for four years, and I can recount the few times I pooped in my boyfriend’s house or even the times he was in the same building as me.

The discomfort of the physical and mental symptoms has prompted me to seek therapy. My therapist explained insightful research: In simple terms, the vagus nerve connects the gut to the brain, allowing both systems to communicate. This means anxiety can exacerbate IBS symptoms. So we targeted the anxiety. She led me through exposure therapy, where I worked through a progression of goals. My first goal was to use my own bathroom in the presence of my roommate’s boyfriend. My final goal was to use the bathroom at the public library at least once. Over the course of several months, I eventually reached that goal. 

Everyone poops, and it’s time we start talking about it. It’s the one thing we all have in common; even those with colostomy bags still have excretions and face the stigma around poop. We need to break down the shame around defecation—especially for women.