Defecation

"Bowel movement" redirects here. For the death metal band, see Defecation (band).

Anatomy of the anus and rectum

Defecation (colloquially known as a bowel movement or bm) is the final act of digestion, by which organisms eliminate solid, semisolid, or liquid waste material (feces) from the digestive tract via the anus.

Humans expel feces with a frequency varying from a few times daily to a few times weekly. Waves of muscular contraction (known as peristalsis) in the walls of the colon move fecal matter (called faeces or feces) through the digestive tract towards the rectum. Undigested food may also be expelled this way, in a process is called egestion.

Description

Physiology

The rectum ampulla (anatomically also: ampulla recti) acts as a temporary storage facility for the unneeded material. As the rectal walls expand due to the material filling it, stretch receptors from the nervous system located in the rectal walls stimulate the desire to defecate. This urge to defecate arises from the reflex contraction of rectal muscles, relaxation of the internal anal sphincter, and an initial contraction of the skeletal muscle of the external anal sphincter. If the urge is not acted upon, the material in the rectum is often returned to the colon by reverse peristalsis, where more water is absorbed and the faeces is stored until the next mass peristaltic movement of the transverse and descending colon. If defecation is delayed for a prolonged period the fecal matter may harden, resulting in constipation. If defecation occurs too fast, before excess liquid is absorbed, diarrhea may occur.

When the rectum is full, an increase in intra-rectal pressure forces the walls of the anal canal apart allowing the fecal matter to enter the canal. The rectum shortens as material is forced into the anal canal and peristaltic waves push the feces out of the rectum. The internal and external anal sphincters along with the puborectalis muscle allow the feces to be passed by muscles pulling the anus up over the exiting feces.

Defecation is normally assisted by taking a deep breath and trying to expel this air against a closed glottis (Valsalva maneuver). This contraction of expiratory chest muscles, diaphragm, abdominal wall muscles, and pelvic diaphragm exert pressure on the digestive tract. Ventilation at this point temporarily ceases as the lungs push the chest diaphragm down to exert the pressure. Thoracic blood pressure rises and as a reflex response the amount of blood pumped by the heart decreases. Death has been known to occur in cases where defecation causes the blood pressure to rise enough to cause the rupture of an aneurysm or to dislodge blood clots (see thrombosis). Also, in releasing the Valsalva maneuver blood pressure falls; this, coupled with standing up quickly to leave the toilet, commonly results in the incidence of blackouts.

When defecating, the external sphincter muscles relax. The anal and urethral sphincter muscles are closely linked. Experiments by Dr. Harrison Weed at the Ohio State University Medical Center have shown they can only be contracted together, not individually, and they both show relaxation during urination. This explains why defecation is frequently accompanied with urination.

Vouluntary and involuntary control

Defecation may be involuntary or under voluntary control. Young children learn voluntary control through the process of toilet training. Once trained, loss of control, causing fecal incontinence, may be caused by physical injury (such as damage to the anal sphincter that may result from an episiotomy), intense fright, inflammatory bowel disease, impaired water absorption in the colon (see diarrhea), and psychological or neurological factors.

Cleansing

The anus and buttocks may be cleansed with toilet paper, similar paper products, or other absorbent material. In some cultures water is used (e.g., as with a bidet) either in addition or exclusively. In Japan and South Korea, some toilets known as washlets are designed to wash and dry the user's anus after defecation (see anal cleansing).

Defecation posture

Main article: Human defecation postures

Defecation in squatting position

The positions and modalities of defecation are culture-dependent. The natural and instinctive method used by all primates, including humans, is the squatting position. Squat toilets are still used by the vast majority of the world, including most of Africa, Asia and the Middle East. The widespread use of sit-down toilets in the Western World is a recent development, beginning in the 19th century with the advent of indoor plumbing.

Bockus' Gastroenterology, the standard textbook on the subject, states:

"The ideal posture for defecation is the squatting position, with the thighs flexed upon the abdomen. In this way the capacity of the abdominal cavity is greatly diminished and intra-abdominal pressure increased, thus encouraging the expulsion of the fecal mass."

Mythology and tradition

Some people groups have culturally significant stories in which defecation plays a role. In a Wemale legend from the Maluku Islands, Indonesia, the mythical girl Hainuwele defecates valuable objects.

One of the traditions of Catalonia (Spain) is the Caganer, a figurine depicted in the act of defecation appearing in nativity scenes in Catalonia and neighbouring areas with Catalan culture. The exact origin of the Caganer is lost, but the tradition has existed since at least the 18th century. Another Catalan Christmas tradition associated with defecation is the Tió de Nadal.

In Japan, it is said that visiting a bookstore for a while perhaps has a laxative effect. The effect is called Mariko Aoki phenomenon.

References

• Deeb, Benjamin (2004). Healthy to the Core: How to Measure Effective Defecation. Greenwood Press.
• Widmaier, Raff & Strang (2006). Vanders' Human Physiology, the mechanisms of body function. Chapter 15. McGraw Hill.