bowel movement
As bowel movements (from Middle High German stuolganc ) and defecation (from Latin Faex , yeast, sediment '), also Egestion ( Latin egerere sth. Empty') or Dejektion ( 'expulsion') is defined as the elimination of feces from the human digestive tract or intestines . The term stool was borrowed from the older medical language (for diseases with increased excretion) into colloquial language and stands for the walk to the toilet chair, a chair with a built-in chamber pot to take in the feces .
In the intestine, feces are mixed up by muscle strength and transported on (non-propulsive or propulsive peristalsis ). The stool is then temporarily collected in the rectum ( rectum ) until stretch receptors in the intestinal wall then stimulate the brain's need for elimination . Most people can consciously control this; responsible for this is the sphincter ring of the anus . This ability is called continence . People who cannot consciously control their bowel movements are called fecal incontinence . Defecation disorders are called dyschezia .
Defecation Physiology
Development of voluntary bowel control
As part of the so-called toilet training, the toddler learns to control the defecation reflex. Cultural factors play a big role in the age for which a child should have successfully completed this process. Most children can have their bowels checked before the bladder, boys usually start and finish later than girls, and it usually takes longer for boys to learn to stay clean all night.
Vegetative background
When the rectum is stretched due to increasing filling, anorectal afferents become active and there is an increased urge to defecate. The inner sphincter , which is part of the smooth muscles, relaxes, while the tone of the striated outer sphincter increases.
If the defecation is successful, the external sphincter must be consciously relaxed. Defecation occurs when the internal sphincter muscle relaxes and the sigmoid and rectum contract simultaneously . This happens through rectal afferents via a spinal parasympathetic reflex , the defecation reflex .
execution
The feces are moved out of the rectum by tensing the abdominal muscles and relaxing the sphincter muscles when defecating. Heavy pressing can encourage hemorrhoidal disease . If the excrement is very difficult to excrete, one speaks of constipation ( constipation , also constipation). In general, in a developed country, a toilet is used to pass stool . For subsequent cleaning, see anal hygiene .
Frequency and severity
Most people have daily bowel movements, but in healthy people the frequency can vary from 3 times a day to 3 times a week. Only when there are significant deviations from individual habits is one speaks of diarrhea or constipation . The consistency varies considerably between hard and soft from person to person and also depending on the physical and mental condition, but depends above all on the food consumed. It can be rated on the Bristol Stool Forms Scale . Europeans usually have stool weights of 100–200 g daily, vegetarians up to 350 g due to the higher fiber content in their diet. When malnutrition stool weight increases accordingly to a few grams from ( hunger chair ). The amount of material excreted in a single bowel movement can be up to 1 kg in individual cases. Bacteria make up about 10–20% of the stool mass. Due to the peristalsis and the storage capacity of the intestine, most people add more faeces in a somewhat softer form about one minute after the first emptying, which is the main part. Medically, a large volume of stool is considered beneficial (the stool should float on the water, at least initially). The brown color is mainly caused by the tetrapyrrole Sterkobilin , which also determines the color of the urine . However, the color of the stool is also influenced by the food ingested and / or diseases of the gastrointestinal tract.
Pathophysiology of Defecation
Defecation disorders can occur through
- Anal disease
- high sphincter tone
- lack of abdominal press
- neurological disorders
- psychological factors
Cultural factors
posture
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Squat toilet in Japan (left) and chair from Schwetzingen Castle , 1880 (right)
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The posture when defecating differs according to type, facility and culture . In Central Europe, sit-down toilets are mostly used for this . In southern Europe or Asia (article: toilet and sanitary culture in Japan ) there are still standing or squatting toilets , which some people consider to be more hygienic. The use of sit-down toilets is spreading, because older people do it much more easily and sitting is an advantage in the case of diarrhea , but also for various voiding disorders .
Intimate cleansing
The type of cleaning after a bowel movement also depends on the culture. It is usually done with toilet paper or directly with hand, soap and water. A bidet or shower toilet can also be used.
Privacy and public
In contrast to urination , which at least in most of Germany's public men's toilets still takes place in an open space (see also: urinal , pee channel ), stool is now usually performed in lockable cubicles. Traditions from antiquity or the Middle Ages show that at that time there were no secrets or feelings of shame when relieving yourself. These emerged later and initially developed in the larger cities, probably also due to the diseases that can be transmitted through feces. But the shamefulness and sinfulness of nakedness of the abdomen, emphasized by the church since the Middle Ages, also inhibits many people from having their stool in the presence of other people. In the countryside, on the other hand, there were communal seats within the family until the 19th century. The thunder bar was also used as a toilet in the field at military and scout camps well into the last century. In the simple Scandinavian weekend houses you can still find external multi-seat outhouses today. In China, but also in some other places, toilets without partition walls can often be found; even those in which you sit across from each other.
In order to maintain intimacy and, on the other hand, to improve public hygiene, public and lockable toilets were set up in the streets of Berlin around 1900 on the initiative of the entrepreneur Protz . These locations offered the possibility of defecating in an emergency in the public street space and complemented the Café Achteck , where only urinating was possible.
vocabulary
Colloquially, but now vulgar , bowel movements are also referred to as poop (from Latin cacare , 'shit') or shit (from Indo-European skei- 'split, separate, separate').
literature
- Anselm A. Nalo: Kot, a shitty advisor. Piazzetta, Reinach BL 2010, ISBN 978-3-9523469-3-8 ( zengarten.com ).
- Rainer Klinke (Ed.): Physiology. 5th completely revised edition. Thieme, Stuttgart / New York NY 2005, ISBN 3-13-796005-3 .
- Mila Schrader: Outhouse, toilet, quiet place (= historical building diversity in detail , volume 5). Edition Anderweit, Suderburg-Hösseringen 2003, ISBN 3-931824-25-X .
- John Gregory Bourke : The rubbish in morals, custom, belief and customary law of the peoples (= accessories for the study of the Anthropophyteia ; Volume 6). With a preface by Sigmund Freud (original title: Scatalogic rites of all nations , translated by Friedrich S. Krauss and H. Ihm). Unchanged reprint of the German first edition (private print, Ethnological Verlag, Leipzig 1913, DNB 363570004 ), Eichborn, Frankfurt am Main 1996, ISBN 3-8218-0503-X .
University publications
- Franz Knoedler: De egestionibus. Texts and studies on late medieval coproscopy. (= Würzburg medical historical research. Volume 18). Wellm, Pattensen (Hanover), now Königshausen & Neumann, Würzburg, 1979, ISBN 3-921456-24-X (also medical dissertation University of Würzburg 1979).
- Michael Kracht: Normal bowel movements - Investigation on a near-population sample in the primary care sector. Ulm University 2016, DNB 110425686X (online dissertation Ulm University 2016 full text, online PDF, 2.2 MB).
- Larissa Elke Thielen: Do patients with obstructive defecation syndrome benefit from the STARR / Transtar operation? State and University Library Hamburg 2016, DNB 1079655255 (online dissertation Universität Hamburg 2015, full text online PDF, 809 KB)
Remarks
- ↑ H. Krammer, C. Kolac, U. Köhler and Stephan C. Bischoff: Taboo topic constipation: What role do lifestyle habits, diet, pre- and probiotics and laxatives play . Aktuel Ernaehr Med. 2009; 34: 38-49, doi : 10.1055 / s-2008-1067563 .
- ↑ For representations of the publicly practiced bowel movements, especially for the humiliation of enemies, from the time of the French Revolution, cf. Martin Höppl (2010): Prints of the French Revolution. Art history, cultural anthropology and collective psyche. In: Helikon. A Multidisciplinary Online Journal, 1. 144-183. (PDF; 7.2 MB).
- ↑ Heribert Jone Katholische Moraltheologie , 1930, 18 editions until 1961 or 1964
- ↑ Toilets without partitions
- ↑ The same toilet facilities were still being operated in the 1980s in military camps and on the grounds of the Grafenwöhr military training area .
