It is actually quite common for people to involuntarily poop or pass gas while under anesthesia during surgery. This embarrassing situation is usually not discussed openly but happens more often than you might expect.
Anesthesia causes the muscles in your body to relax, including the anal sphincter muscles that control your ability to hold in stool. This makes it easier for stool to leak out when you are under. In addition, factors like bowel prep before surgery, medications, duration of surgery, and surgical manipulation of the abdomen can increase the chances of pooping during the procedure.
While it may be alarming and awkward to learn that you pooped on the operating table, it is a normal and understandable reaction to anesthesia for many people. The good news is that the surgical team is used to this and handles it professionally by cleaning you up afterwards.
What causes pooping under anesthesia?
There are several reasons why you might lose control of your bowels when under anesthesia:
Relaxed anal sphincter muscles
One of the effects of anesthesia medications is to relax the muscles throughout your body. This includes the anal sphincter muscles that allow you to control bowel movements. When these muscles relax, it becomes harder to maintain continence and hold in stool. This makes it more likely that stool will leak out involuntarily.
Impact on the gastrocolic reflex
The gastrocolic reflex is a normal physiological reflex that stimulates movement of waste through your intestines after eating. Anesthesia depresses this reflex, which causes the intestines to become less active and can result in constipation. However, when you wake up from anesthesia, the gastrocolic reflex may overreact and trigger very strong intestinal contractions that can result in an urge to defecate.
Bowel prep before surgery
Many types of surgery require the patient to do a bowel prep the day before, which completely empties the colon. This can leave behind stool remnants that may still leak out during surgery even after prepping. Bowel preps involve taking strong laxatives and enemas that leave little solid matter left in the colon.
Medications given for anesthesia
Some medications used for anesthesia directly impact gut motility and relax smooth muscle in the colon. This can result in less coordinated intestinal activity, making it harder to control bowel movements. Examples are medications like propofol, inhaled anesthetics, and opioid pain medications.
Long duration of surgery
Long or complicated surgeries that last several hours increase the chances of involuntary pooping. The longer you are under anesthesia, the more time the medication has to work on relaxing the anal sphincter muscles. In addition, longer surgeries are associated with increased surgical manipulation of the abdomen.
Surgical manipulation of the abdomen
During abdominal surgery, the direct handling of the intestines and abdominal organs can stimulate activity in the colon and rectum leading to involuntary voiding of stool. The rectum may react to surgical trauma or irritation by emptying itself.
How common is pooping under anesthesia?
It is difficult to know exactly how often people poop while under anesthesia since it depends on many factors and often goes unreported due to embarrassment. However, various sources estimate it may occur in up to one-third of surgical patients.
Some research studies looking at specific surgeries found the following prevalence:
| Surgery Type | Rate of Involuntary Defecation |
|---|---|
| Colon surgery | 16% |
| Vaginal prolapse surgery | 13% |
| Hip replacement surgery | 4% |
Factors that increase the chances of pooping under anesthesia include:
- Bowel surgery – highest risk due to direct manipulation of bowels
- Rectal surgery
- Gynecological procedures
- Older age
- Spinal or epidural anesthesia
- Use of muscle relaxants
- Intravenous anesthesia
- Longer surgeries over 2 hours
So while it can be distressing to learn you had a bowel accident under anesthesia, take comfort that it is relatively common and there is usually no underlying medical problem. It is an expected side effect of anesthesia for some patients.
Will I know if I pooped during surgery?
You will most likely remain unaware and have no memory of pooping while under general anesthesia. This is because:
- You are in a state of total unconsciousness under general anesthesia and have no awareness.
- The poop is cleaned up rapidly by the surgical team before you wake up.
- It is not recorded in the surgical notes or mentioned after surgery since it is considered a normal event.
- The surgical drapes covering your body prevent you from seeing it happen.
- Any smells are promptly removed from the operating room.
In some cases, you may become aware you pooped if:
- You have residual fecal soiling around your anus after waking up.
- You have irritation or skin discomfort from contact with stool during surgery.
- You are told by staff for specific medical reasons.
- You have loose stools or diarrhea continuing after surgery.
- You notice odor on your body even after cleaning up.
However, in most instances your surgical team will maintain your privacy and dignity by discretely cleaning up any stool without you knowing. They do not consider it a serious medical concern.
Can pooping under anesthesia be prevented?
While there is no foolproof way to guarantee you will not poop after being given anesthesia, certain precautions can lower the risk:
- Follow pre-surgery bowel prep protocols to empty bowels.
- Avoid eating for 6-8 hours before surgery.
- Ask anesthesiologist to use short-acting anesthetics.
- Consider non-general anesthesia options like local or regional anesthesia.
- Stay hydrated before surgery to avoid hard stools.
- Keep surgery time short if possible.
- Avoid opioid pain medicine before surgery.
Talk to your doctor about antidiarrheal medication or anti-gas options that may help reduce bowel activity during surgery. Maintaining good bowel habits around your surgery can also lower risks.
While precautions can reduce the chances, there are no guarantees when it comes to the effects anesthesia has on your body. Do your best to limit risks then accept that involuntary pooping can still happen.
What is the outlook after pooping under anesthesia?
The outlook is very good if you have an accidental bowel movement under general anesthesia. Some key points to keep in mind:
- It is a temporary effect of the anesthesia wearing off and does not indicate an underlying problem.
- Your surgical team is trained to discretely clean and handle it without compromising your surgery.
- It will not affect your recovery from surgery or health following the procedure.
- Try not to feel embarrassed since it is an expected side effect for many patients.
- Your doctors have seen this many times before and will not judge you for it.
- It does not mean you have poor bowel control when not under anesthesia.
- Make sure to communicate with your surgical team if you have ongoing bowel issues after surgery.
Focus on having a smooth recovery and don’t dwell on whether you pooped during the procedure – the surgical team will make sure you never even know it happened. The outlook is excellent and it should not impact your health going forward.
Conclusion
Involuntary pooping or passing gas while under general anesthesia is surprisingly common during all kinds of surgeries. Factors like muscle relaxation, bowel prep, surgical stimulation, and anesthesia medications make it challenging to maintain continence while knocked out.
Although it can be mortifying to imagine pooping on the operating table, the surgical team is unfazed by it and handles it professionally as a routine event. They understand it is an expected side effect of anesthesia for many patients. While you can take precautions to lower the chances, it cannot always be prevented.
The good news is that it has no negative impact on your health or recovery from surgery. Your doctors will make sure you remain completely unaware it occurred and have no memory of it afterwards. Try not to feel self-conscious about this natural bodily function. Focus on recovering comfortably, both physically and mentally.