Picture this: You’re in the early stages of a new relationship, and after hours of wining and dining on a marathon date, digestion (obviously) happens, and you feel a pang in your stomach. But you opt to ignore the, uh, call from nature, because you’d just prefer to not go number two while in the blissful presence of your new boo. Sure, trying to “keep it cute” for a short duration is one thing, but did you know there are side effects of holding in poop?

According to gastroenterologist Emeran Mayer, MD, author of The Gut-Immune Connection, bowel movement suppression can actually lead to chronic constipation, in which you won’t be able to go when, well, you actually want to. Because of this, he says that regularly suppressing the urge to poo isn’t healthy. And that’s before even considering the psychological effects of suppressed defecation (because, yes, bowel obstruction and holding in poop can mess with your mind).

While you might not think that holding in your poop on purpose is a thing, trust me, it is. I have a friend who never poops around anyone she’s seeing romantically. I’m talking holding in her bowels for up to a week if, say, she goes on vacation with her significant other. She’ll do whatever it takes in order to essentially make it seem like she’s a superhuman who doesn’t have to ever—gasp—defecate.

And she’s not alone in her poop abstinence. Certain bodily functions are better known for being gross than being totally normal, and society has essentially reinforced that it’s a-okay for women to repress and even deny themselves the luxury of letting nature take its course. “Excretions from the body, including those produced for protection (sweat, skin oil, mucus), digestion (saliva), reproduction (semen, breastfeeding), or by-products such as menstrual blood, urine, and feces have been associated with negative connotations and uncleanliness,” explains psychologist Danielle Forshee, PsyD.  To avoid seeming “unclean,” then, some people go to great lengths—like, ahem, physical pain—to simply remove themselves from the whole bathroom narrative while in the company of those they’re trying to impress. But gentle reminder: This charade isn’t so healthy.

Everyone poops, so why pretend otherwise?

While some bathroom activities are glam ways to see out your self care (like primping or taking a luxe bath), the more functional reasons to visit the spot are less… ‘grammable. And especially in the early stages of a relationship, the notion of defecating around an S.O. leading to a drop in sex appeal can be straight-up fear-inducing.

“There’s a smell that’s associated with this act,” says Dr. Forshee. “It’s embarrassing because most do not want to associate themselves or something that comes out of them as repugnant. Most prefer to maintain a positive view of themselves, especially to the person they’re dating.” To maintain that positive view and avoid the shame we’ve been socialized to associate with our poop, we often try to keep it a secret of sorts.

Can holding in poop cause stomach issues?

No surprises here, but fecal retention complications are a very real thing. Denying your body its natural processes can take a toll on your health—specifically in the gut region. “Holding in bowel movements can be thought of as backed-up plumbing in your body,” says Robert Segal, MD, co-founder of medical-test booking platform LabFinder.com. “The major problems associated with this are caused by fecal bacteria overload. Much of this gas-forming bacteria can result in abdominal pain due to gas overload and bloating.”

“The longer one holds in bowel movements, the harder the stool gets, and the more discomfort occurs.” —Dr. Robert Segal

So while holding it is uncomfortable, doing so can also mean bad news for your gut. After all, the buildup of gas and bloating is kindling for where more serious issues start. “It’s behind functional motility disorders like IBS and constipation,” says Dr. Segal, who adds that relief simply comes with passing those BMs. Holding it in for an extended period will only make things rougher for yourself. “The longer one holds in bowel movements, the harder the stool gets, and the more discomfort occurs,” he says.

Other side effects of holding in poop include a higher risk of developing chronic inflammatory bowel disease (IBD), Crohn’s disease, and ulcerative colitis, says Stefanie Helmbrecht, MD, resident gastroenterologist at Lanserhof Sylt, a health resort in Germany. Meanwhile, less common chronic constipation consequences include “intestinal polyps, intestinal adhesions, intestinal cancer, and painful anal fissures, anal abscesses, or hemorrhoids, which usually also have an aggravating effect on bowel movements,” she says.

All in all, bowel movement suppression comes with serious consequences you’ll have to weigh against any potential embarrassment in front of a new love interest.

Are there any psychological effects of holding in stool?

Your body isn’t the only thing that can experience symptoms of holding in poop too long. Your mind can, too. According to a study published in Gastroenterology and Hepatology from Bed to Bench, researchers reported that patients with functional gastrointestinal problems, like chronic constipation, experience a higher rate of mood disorders, including anxiety and depression.

“Our stomach is a hard worker and at the same time very sensitive,” says Dr. Helmbrecht. “It is home to our gastrointestinal tract, which processes what we eat on a daily basis. In this way, it supplies us with nutrients, strengthens our immune system, and releases important hormones and messenger substances. Alongside the brain, our gut is the power and control center of the nervous system, which is why it is often referred to as the ‘gut-brain.’ If our system gets into [an imbalance] due to stress, anxiety, or depression, we tend to develop symptoms in our intestines, such as constipation.” And the opposite can happen too: A problem in our gut can lead to mental health issues. 

“This is a well-known problem in pediatric patients and can lead to megacolon requiring medical intervention,” Dr. Mayer adds. “Behavioral problems are almost always present in such patients that lead to such retention of stool.”

Symptoms of holding in poop too long

If you’re unsure whether or not you’ve held in your stool for too long, there are a number of ways to tell. According to Dr. Helmbrecht, abdominal pain, flatulence, an upset stomach, cramps, and acid reflux can all be signs of incomplete bowel evacuation. 

Of course, proactively holding it in for the sake of your ego isn’t the only culprit here. “There are many different causes that can lead to suppressed defecation and trigger constipation,” she points out. “Possible risk factors for constipation can be a poor diet with a small intake of water (less than 1 liter per day), lack of exercise, pregnancy, breastfeeding, menopause, menstruation, medications, and abuse of laxatives, as well as diseases like cancer, thyroid disease, depression, neurological diseases (e.g., Parkinson’s disease, multiple sclerosis), or muscle diseases (e.g., muscular dystrophy, myasthenia gravis).”

All this to say, holding in your poop may very well not be a conscious choice, but a symptom of your other lifestyle choices and overall medical history. If by evaluating these triggers you don’t find any bowel relief, it’s best to schedule an appointment with your doctor to determine the best next steps to address your bowel suppression and/or constipation. (Yes, those are two separate things, since suppression refers to the idea of willfully holding your poop in, while constipation—though possible to be a result of the former—is involuntary.)

What to do if you simply can’t poo

If you find that after regularly holding your poop in, you can’t go, it’s best to evaluate how long it’s been since your last bowel movement. If you haven’t had a bowel movement in three days and physically can’t, Dr. Mayer says to start with a natural approach. “There are dietary measures (increased fluids, fiber, prunes, etc) that should be the first step, before taking laxatives,” he says. If dietary shifts don’t do anything for your bowels, he suggests buying over-the-counter remedies. Or try moving more: Getting some exercise helps both prevent and ease constipation, according to the Cleveland Clinic. 

“If [none] of these interventions work, you should see your doctor to rule out any organic lesions, like obstruction of the colon,” Dr. Mayer says. Constipation is rarely an emergency poop situation (although it may feel like one), so consider a visit to the emergency room only as a last resort.

Free the feces and deal—here’s how

That oh-so-classic children’s book Everyone Poops was written for a reason. All humans (and mammals, for that matter) have to do it. “For those who find defecating near or around your partner embarrassing, remind yourself that it’s normal and that most people feel that way as a result of the socialization process we’ve been exposed to,” Dr. Forshee says.

With this in mind, it helps to find ways to embrace the natural need to poo. I know some folks who use comedy to make light of the scenario, which is a coping mechanism you could totally cop and share with your partner. Or you could simply excuse yourself, go to the bathroom, and do what has to be done. You don’t need to give a verbal summary of what you’re up to in there, but you also certainly don’t have to prevent yourself from functioning. Another option? Train yourself to have a morning poo each and every day so that come date night, poop will be less likely to be on the radar. The most important thing to remember is that no matter how you approach your BMs, you won’t lose any S.O. worth your time for letting your body do its thing.

“All bodily excretions are normal and not to be ashamed of,” says Dr. Forshee. “It’s a part of who we are, and it gives us life.” So, reclaim the bathroom, my friends, because not everything you do has to be cute.

—reviewed by Jennifer Logan, MD, MPH