Going number two might seem like a harmless way to kill time, but experts caution that extended sitting on the toilet can have negative health effects. Dr Lai Xue, a colorectal surgeon at the University of Texas Southwestern Medical Center in Dallas, explained that it has even been linked to weakening pelvic muscles and an increased risk of haemorrhoids.
“When patients present to me with complaints, one of the main areas we have to delve deeply into is spending a lot of time on the toilet,” Xue said.
According to Dr Farah Monzur, assistant professor of medicine and director of the Inflammatory Bowel Disease Centre at Stony Brook Medicine, people should aim to spend just five to ten minutes on the toilet. But what’s the harm in staying longer? Let’s break it down with a quick physics lesson: Gravity does more than keep us on solid ground—it also pulls blood downward, meaning your body has to work harder to get blood back up to the heart. The longer you linger, the harder your circulation has to work, which can eventually lead to some unwelcome physical side effects, explains Dr Xue.
In contrast to sitting on the sofa, the open oval-shaped toilet seat keeps the rectum lower by compressing the buttocks. Your blood circulation is impacted by the elevated pressure caused by gravity pulling your lower body downward.
“It becomes a one-way valve where blood enters, but blood really can’t go back,” Xue said.
This raises the risk of haemorrhoids by causing the veins and blood vessels around the anus and lower rectum to expand and swell with blood.
Dr Monzur notes that spending extended time on the toilet can lead to increased strain on muscles and higher rectal pressure, potentially contributing to the development of haemorrhoids. Activities like scrolling on a phone can cause people to lose track of time, leading to prolonged sitting, which exacerbates this strain and heightens the risk.
And you know what? Your physicians are aware of it. “Nowadays, we’re seeing an increase in people spending more time on the toilet, and that is very much unhealthy for the anorectal organs and the pelvic floor,” Xue added.
In addition to weakening anal muscles and increasing the need for straining, Monzur noted that prolonged sitting on the toilet can also elevate the risk of rectal prolapse—a condition in which the rectum, a part of the large intestine, slips down and protrudes through the anus.
Prolonged sitting also affects the pelvic floor muscles, which play a crucial role in coordinating bowel movements. Xue explained that these muscles work in sync with the body to facilitate smooth stool passage. However, extended sitting applies gravitational pressure on the pelvic floor, straining these muscles over time and potentially impacting their function.
Dr Lance Uradomo, an interventional gastroenterologist at City of Hope Orange County in Irvine, California, suggested keeping books, periodicals, and phones out of the toilet to prevent excessive time spent on the porcelain throne.
“You don’t want to go with the mindset that you will be there for a long time. Because then you’ll want to bring something to keep the mind occupied,” Monzur said. “Make sitting on the toilet bowl as uninteresting as possible.”
If you’re struggling to relieve yourself, Xue suggested limiting your time on the toilet to 10 minutes. Afterward, try walking around, as physical movement can help stimulate gut muscles to promote a bowel movement. Staying hydrated and consuming high-fibre foods like oats and beans can also support regularity and reduce the need for straining.
As for amounts, the National Academy of Medicine recommends drinking 2.7 to 3.7 litres of water per day. Additionally, the U.S. Department of Agriculture advises consuming 14 grams of fibre for every 1,000 calories of food intake. Xue explained that adequate fibre and water intake work together to soften stool, making it easier to pass.
However, there are instances where people must use the restroom for an abnormally long period of time. Constant discomfort or trouble passing faeces may indicate gastrointestinal disorders including Crohn’s disease and irritable bowel syndrome.
Worsening constipation or the need to sit on the toilet for extended periods may signal a more serious health issue, such as cancer. Uradomo explained that if a growth in the colon becomes large enough, it can block the stool’s passage, leading to constipation and bleeding.
The American Cancer Society has noted a rise in colorectal cancer rates among people under 55 since the mid-1990s. This year, the nonprofit estimates 106,590 new cases of colon cancer and 46,220 new cases of rectal cancer. Uradomo shared that throughout his career, he’s seen a growing number of younger patients seeking treatment for haemorrhoids or constipation, only to later be diagnosed with rectal cancer.
According to Monzur, it could be time to discuss your problems with your doctor if you’ve experienced constipation or prolonged sitting on the toilet for longer than three weeks. Your primary care physician may recommend that you see a colorectal surgeon or a gastroenterologist for a more thorough examination, depending on the severity of your symptoms.
