Sitting on the Toilet Too Long? Why It Hurts Your Pelvic Floor

It can feel impossible to tear ourselves away from our phones. That becomes a problem when we can’t even part with them during bathroom visits.

Can Scrolling on the Toilet Really Be Dangerous?

How dangerous is it to use your smartphone on the toilet? Well, besides the fact that it is deeply unhygienic, you may pass out and become paralyzed. In 2014, The Mary Sue reported that a man who was supposedly perfectly healthy fainted and became paralyzed (allegedly). He had been on the phone while on the toilet. According to BroBible, the man’s father reported the diagnosis as cerebral edema and brain herniation. Scrolling was not the main reason (that would be oxygen deprivation). But the lack of circulation while not moving for 30 minutes may have contributed.

Why You Might Feel Faint When You Finally Stand Up

I know, I know, that example seems extreme. But no one wants to be the exception in a story like that. And granted, reports say the man was also in a tight area with sparse ventilation. But fainting while sitting too long on the toilet can also happen even in a well-ventilated space. This is due to postural hypotension, also known as orthostatic hypotension. And, in fact, one neuroscientist theorized that was what happened to the man in 2014. According to the American Family Physician, 5% of middle aged adults and 20% of older adults have OH. Society generally considers middle age to be 40-59, and AFP defines older adults as 60 and over. This means that their blood pressure tends to drop when they transition from sitting to standing.

Straining Takes a Toll on Your Pelvic Floor

Sitting on the toilet too long is also not a good idea if you want to maintain pelvic floor health. As Real Simple notes, straining to have a bowel movement will also strain pelvic floor muscles.

Hemorrhoids and Rectal Prolapse

Sitting on the toilet for extended periods of time and straining to have a bowel movement may cause hemorrhoids. You can irritate and put pressure on your veins when straining. You could also increase your risk of rectal prolapse. Rectal prolapse is when you can actually view your rectum. Why it happens is a mystery. But according to Health.com, “structural problems with nerves or muscles in the pelvic region and lower gastrointestinal (GI) tract likely play a role.”

How to Make Bowel Movements Easier

You can pass bowel movements more easily by adding more fiber and water, says The Mayo Clinic. You should also go when you have the urge rather than ignoring it. Go even if that means using a public restroom. Heck, I even joke around with my patients that I’ll poop on a plane if I have to! Don’t mess around when the urge comes a calling. Waiting will only make it more difficult to pass a BM later on.

When the Phone Is the Real Problem

Maybe you aren’t struggling with constipation. But social media sucks you into its black hole when you’re on the toilet. If so, you may need to speak with a mental health professional.

Make the Bathroom a Screen-Free Zone

Remember that the toilet isn’t a place to hang out. It’s a place to have a bodily function. It may be hard to pause that video game or stop texting your friend while on the throne. But the consequences of sitting there too long simply aren’t worth risking. There are many places that we already consider screen-free zones. The sidewalk, so we don’t bump into people. The car, so we can concentrate on the road. The ocean or pool, so we can focus on swimming. Your job, so you can lock in on work. The bathroom is simply another one to add to the list. Think of it not as a punishment but as a relaxing vacation away from your smartphone. Chances are, you could use it!

Dr. Riva Preil, pelvic floor physical therapist, pointing to the pelvic floor muscles on an anatomy chart to show what sitting on the toilet too long can strain
Your pelvic floor does a lot of work. Don’t make it work overtime on the toilet.

How to Handle A Real Pain in the Butt

Here’s how to handle a real pain in the butt! When I say “pelvic floor,” what do you envision? Most people think of a vagina, but the pelvic floor isn’t the vagina. Rather, it’s “a group of muscles and tissues that support important organs like the bladder, urethra, anus—and in women—the uterus, cervix and vagina,” according to the FDA.

So yes, the pelvic floor involves your back door. And while you may not want to bring up back door pain, bleeding or discomfort to your pelvic floor therapist (because you think of her as the vagina expert), she might just be the key to solving it, or at least understanding it better!

And what exactly can cause this? Let’s explore.


Levator Ani Syndrome

Let’s start with levator ani syndrome. Levator ani syndrome is caused by muscle spasms and is a type of pelvic floor dysfunction. Getting its name from the levator ani itself, it’s a group of muscles located around your butt and vagina. They can range from mild pelvic or rectal pain to something way more intense than “pain in the butt”. It can even cause you to awaken from a dead sleep! It can also feel like pressure that mimics “sitting on a ball,” according to the Cleveland Clinic.

What causes it? There are theories: Everyday activities can be likely culprits, from prolonged sitting while working or traveling, to sex, to life stress, to painful bowel movements. But a definitive cause hasn’t been found.

Pelvic floor physical therapy can treat this condition, along with muscle relaxers, warm baths and rectal dilation (ideally taught to you by your awesome pelvic floor PT!).


Hemorrhoids

You’re probably pretty familiar with hemorroids already, maybe a little too familiar! What you may not know is that there are three types – internal, external and thrombosed, as the Mayo Clinic explains.

Hemorrhoids are just another way of saying your veins are swollen. Internal and external are exactly like they sound, either in the rectum (internal), which is the last stoop for stool on its way from the large intestine to the toilet, or external, typically viewable from the outside, where the anus is. Both can involve bleeding and pain. Thrombosed hemorrhoids may be located externally or internally, according to the Cleveland Clinic. The pain can be much worse and you develop a clot.

The same causes of pelvic floor dysfunction can also cause hemorrhoids – aging, pregnancy and/or constipation. Do your best to avoid constipation, whether that means more water, more fiber or exercising. Never strain to have a bowel movement.

There are many hemorrhoid prevention exercises, like Child’s Pose and pelvic floor contractions that your physical therapist may be able to help you master. The Mayo Clinic recommends over-the-counter cream, Tylenol and warm baths to treat.


Fissure

A fissure is a tear in tissue around the anus. And again, constipation is often the culprit. Bowel movements may not be the simple process they were before you had the fissure, as now you’ll experience pain and bleeding. You may also experience spasms near the anal sphincters. The good news? It doesn’t take much to treat this condition – a warm bath and avoiding constipation can do the trick.


Anal Fistula

An anal fistula is a connection that has sprung up between your anus and the external skin, according to the Cleveland Clinic. This leads to pain, swelling and possibly pus. Most often, the cause is a perianal abscess which typically happens when an anal gland is infected. Surgery is the main way to treat anal fistulas. An MRI that shows the pelvic floor may be needed in the diagnosis stage. There is also a rectovaginal fistula, which, according to the Mayo Clinic, is an unnatural connection bonding the rectum or anus and vagina. Stool or gas is then able to emerge from the vagina once this happens. Childbirth, Chron’s disease, surgery and radiation are a few causes.


Rectal Prolapse

In a rectal prolapse, a person’s rectum leaves their anus and is actually visible. It is part of a larger category known as POP or pelvic organ prolapse. In more severe cases, you may even see pink tissue emerging from the anus. Fecal incontinence, constipation, bleeding and incomplete emptying of the rectum are all symptoms, says the Mayo Clinic. As with hemorrhoids and pelvic floor dysfunction, advanced age (over 50) and constipation could be to blame. Treatment might be as simple as a laxative or as complex as surgery.


While many of us don’t want to think about anything related to the anus, as the symptoms tend to be uncomfortable and private, it is important to listen to our bodies when they speak to us. Colon and anal cancer are real risks. Screening is important if your doctor recommends it. Take care of that pain in the butt now before it becomes a bigger one later. And that’s … the bottom line.

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