Anxiety about toilet use is more pervasive than most of us think, and a Victorian researcher has set out to prove it.
Clinical psychologist and senior lecturer at Swinburne University, Dr Simon Knowles, said toilet anxiety was a condition "we know very little about", but one that affects up to 32 per cent of Australians.
"Research that has been done in this field is associated with being unable to urinate - what we call the 'shy bladder syndrome' - but there is no research that looks at shy bowel syndrome," he told Fairfax Media.
Dr Knowles, who specialises in gastrointestinal conditions, said toilet anxiety was most likely a very common disorder which caused "minor anxiety in most people" but could be overwhelming and very stressful for a small proportion of the population.
"It means that some people will actually avoid going out because of the fear of the possibility of having to go to the toilet in a very public area," he said.
"In my clinical practice, I've seen a number of people who experience severe toilet anxiety - in the most extreme cases, people are not going to the toilet at all, and as a result experience significant physical pain."
Dr Knowles' work encouraged him to begin a national conversation about bowel movements, leading to the creation of the website toiletanxiety.org.
The site, which is being developed to "help identify and provide support for individuals experiencing a common but unspoken condition", includes a link to a survey about personal bowel habits.
"I'm developing this website to distribute information about toilet anxiety and to offer people free psychological treatment services," he said.
"It's about the bowel, and we just don't talk about the bowel."
Dr Knowles said the fear of public urination and defecation could be so crippling that some people were unable to work.
"They fear they might end up going to the toilet, and that their colleagues will know they need to and think badly of them because of the potential smell or sound," he said.
As with other anxiety disorders, some people were more predisposed to the condition than others, and could develop toilet anxiety after something as small as an "off-the-cuff comment made by a friend", Dr Knowles said.
One cause of toilet anxiety was many people's reluctance to discuss anything to do with bowels, despite the common occurrence of bowel conditions in Australian society.]"Conditions like irritable bowel syndrome affect one in 20 Australians … and even though [going to the toilet is] a completely natural thing we do, for a sub group it can be significantly distressing," Dr Knowles said.
