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Health and Nutrition

Moving your bowels; taking advantage of the previously undescribed cystocolic reflex

by David Sirkin

9 September 2008

A friend recently had the following experience. He realized while driving to work that he had to urinate, and his need became increasingly urgent as he continued to drive. By the time he reached his destination, he not only needed to urinate, but he had a powerful urge to move his bowels as well.

I had a similar experience one morning about ten years ago. My medical-school roommate was showering in our only bathroom. I wanted to urinate, but I waited until he finished his shower. By the time he finished, I was having difficulty not only in holding back urine but in holding back a bowel movement as well. I was very pleased with this outcome, because I had been developing a mild constipation problem and the beginnings of anal fissures that frequently caused stinging pain when I did move my bowels. Ever since then, I have deliberately refrained from urinating on arising in the morning, waiting until, as the need to urinate becomes more urgent, I feel my bowels start to move (I typically feel a bowel movement coming on about 10 to 40 minutes after rising from bed). My problem with constipation and fissures has never returned.

The effect of holding urine on moving the bowels seems to be a reflex, which I call the cystocolic (bladder-bowel) reflex. It is present in me and perhaps a sizable percentage of the population to a greater or lesser extent. In me it is a much more powerful effect than the gastrocolic reflex, which is the well-known movement of the bowels that occurs about 30 minutes after a meal. Unlike the gastrocolic reflex, which diminishes in intensity after some minutes if one does not use the toilet, the cystocolic reflex, in my experience, typically increases in strength the longer one postpones urinating.

A possible set of standard recommendations for having regular bowel movements:

  1. Drink enough fluids (water)

  2. Get enough fiber in your diet

  3. Exercise

  4. Take advantage of bowel reflexes, both conditioned and pre-programmed

By conditioned bowel reflexes, I mean trained rhythms. For example in some people, the bowels have been “trained” to move every morning. The pre-programmed reflexes include the well-known gastrocolic reflex and the cystocolic reflex, which to my knowledge I am describing here for the first time.

(If anyone knows of any previous documentation of the cystocolic reflex I have described here, please send me an e-mail to inform me!)

Health and Nutrition

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