Parcopresis and IBS:
Things that Can Help...

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Going on anecdotal evidence from the message board, it seems that a lot of people who suffer from shy bowel also suffer from IBS. It also seems that these two conditions become two halves of a vicious circle: if your IBS is playing up, you are less likely to be relaxed about defecating; likewise if you are unable to defecate because of social circumstances, your IBS is more likely to flare up. So treating one condition is probably going to help in improving the other. Recovery will cost time, money and effort and there are no hard-and-fast guarantees on how much progress you will make. Depending on how much you are willing and able to spend will inevitably dictate which therapies you can engage in, but even if money is very limited there are still a couple of things that you should be able to try from the selection below. Perhaps a good starting place is to ask yourself how much shy bowel and IBS have cost you (and will cost you) in terms of jobs, money, holidays, relationships, and life enjoyment generally.

Telling People About It
If your shy bowel is affecting your close relationships (and chances are it is), it can be a huge relief to tell the people involved the reason for your apparently bizarre behaviour. 'Coming out' about your condition means you don't have to waste so much energy maintaining a false 'mask' of who you are.

Become your own Expert
There is little if any research done on shy bowel, and there is continuous debate about how best to treat IBS (especially given that the symptoms vary from person to person). In these circumstances your best bet is perhaps to rely on yourself as much as you do on outside experts, cultivating an interest in yourself in as detached a way as possible. Think of your conditions as enigmas which you - in the role of scientist - are dispassionately investigating (always of course with the aim of finding improvement). The mainstream press sometimes run good articles on IBS, and there is also a links page on this site.


Hypnotherapy
This covers a wide range of techniques and tools that can be used by the hypnotherapist and by the client him or herself; some hypnotherapists specialise in phobia and/or IBS treatment. Anyone can call themselves a hypnotherapist so if in doubt, ask what qualifications (and certificates to prove it) they hold. A good one will not be offended by your asking. In the UK you may be able to find one through the National Phobics Society
(www.phobics-society.org.uk).

Cognitive-Behavioural Therapy (CBT)
Focuses on thoughts (cognitive) and actions (behavioural) and looks at ways of modifying both to achieve change and improvement. If you live in the UK, you can ask your doctor for this kind of treatment (waiting period varies). Otherwise you might be able to find one through the National Phobics Society.For help in getting a recognised psychologist privately (in the United Kingdom) go to:
http://www.bps.org.uk/e-services/find-a-psychologist/directory.cfm

Desensitisation
This will probably form an integral part of your CBT or hypnotherapy work but the concept is worth mentioning on its own. Desensitisation (or graduated exposure) is often used in the treatment of phobias generally. In it, you begin by breaking down your long-term goal (e.g. being able to defecate anywhere) into smaller steps, starting at the level where you feel almost completely comfortable and progressing onto the most challenging situtation you can imagine. You then practice defecating in the situation right near the bottom of the 'ladder' (resisting the temptation to try harder situations too soon). When you feel comfortable - and only when you feel comfortable - at this level, you move on to the next level. The key concept in this approach is 'Building on your Successes' (and not worrying about any misfires you may have along the way). Practising exposure to the situation in this manner helps to gradually build up confidence and steadily reduce the phobic reaction you experience. Having said that, one problem with using this approach with shy bowel is that you can't easily produce the phobic reaction at will when you want to work on it; when it comes to defecation, you just need to go when you need to go! As a consequence it is much more difficult to desense in a controlled environment, which is the ideal way of doing it.

Medication
Please see posting at the top of the message board, or by clicking HERE.

Biofeedback
Especially useful for people who suffer with anismus (unconscious tightening of the anal sphincter when trying to defecate under ANY circumstances). Biofeedback therapy is sensory retraining: it involves putting an air-filled balloon into the rectum, which is then either withdrawn or pushed out by the patient - to create awareness of which muscles need to be activated and which relaxed. Electromyography is used simultaneously to measure muscle activity and display the result.