Gastrointestinal doctors suggest that spending more than five to ten minutes during a bowel movement may indicate underlying health issues and can lead to problems such as hemorrhoids, anal fissures, and pelvic floor damage. Experts recommend aiming for a bowel movement that takes no more than five minutes, with some advising as little as three minutes.
"You should sit down, you should easily pass a bowel movement, feel empty, you get cleaned up and you leave," said Leslie Waid, a nurse practitioner in gastroenterology at the University of Pittsburgh Medical Center. "There shouldn’t be any straining or spending time sitting there waiting for stools to pass."
Straining can cause significant discomfort and injury, according to Dr. Melissa Hershman, an assistant professor of medicine at Oregon Health and Sciences University. "Straining and excessive pushing motions can create pelvic trauma, injury," she stated. Waid added that straining can also lead to painful tears in the anal canal, known as anal fissures, and can weaken pelvic floor muscles.
If a bowel movement does not occur within about five minutes, doctors advise getting off the toilet and waiting for the urge to return. This can help avoid straining and unnecessary time spent on the toilet.
Improving Bowel Health
Several lifestyle adjustments can help reduce the time spent on the toilet and improve overall bowel health. Positioning is key, and tools like a squatty potty can be beneficial by aligning the body to facilitate easier evacuation, according to Waid. Dr. Valentine Millien, a gastroenterologist at Houston Methodist Hospital, noted that squatting positions, common in many Asian and African countries, can help remove pressure from the rectum and utilize gravity.
Distractions, such as using a smartphone, can prolong bathroom visits and increase the risk of developing hemorrhoids. Experts suggest leaving phones outside the bathroom to encourage shorter, more efficient trips.
Consistent healthy habits also play a crucial role. Waid emphasized the importance of adequate fluid intake and regular exercise. "Exercise is an excellent way to promote bowel motility. I often tell patients that your gut doesn’t move if you don’t," Hershman said.
A diet rich in fiber is essential for bowel regularity. Waid recommended consuming fruits, vegetables, whole grains, beans, and fiber supplements to achieve a daily target of at least 25 grams of fiber. Fiber adds bulk to stool, making it easier to pass.
When to Seek Medical Advice
Changes in bowel habits, such as persistent constipation or diarrhea, or the presence of blood in the stool, can sometimes be signs of more serious conditions, including colorectal cancer. Millien stressed the importance of consulting a physician if any changes or bleeding are observed, as these symptoms can overlap with issues caused by straining but may also indicate colon inflammation, obstruction, or even cancer, particularly in younger adults where rates are rising.