47天不拉屎，会发生什么？

You've heard of concealing the evidence, but a man in England took it a step further. Lamarr Chambers refused to poop out drugs he allegedly swallowed, in a bid to avoid prosecution. To accomplish this uncomfortable feat, the prosecutor said he significantly curbed his food intake and simply didn't "go" when the urge struck (Chambers' lawyer denied this, according to the BBC). After 47 days without a bowel action, police dropped the charges, and Chambers was taken to a hospital for treatment.

你也许听说过有些罪犯为了隐瞒证据做出一些令人意想不到的举动，但这个消息就有点特别了。根据BBC的报道，英国一名涉嫌毒品交易的男子为了避免警方起诉而吞噬了毒品。为了不让警方拿到证据，该男子足足47天没有大便，最终警方放弃了指控，该男子被送到医院接受治疗。

News of this "pooping strike" left us wondering how big of a deal this is, in terms of impact on the human body. Turns out, it's a crappy idea.

对于47天不排便的消息，我们都想知道这对人体的影响会有多大?事实证明，这真是一个糟糕的主意。

"I would not recommend that anyone willingly subject themselves to that," says Dr. Ellen Stein, an assistant professor of medicine at Johns Hopkins University. She would know – one of her main areas of study is intestinal motility, or how poop moves through the digestive tract.

约翰霍普金斯大学医学助理教授埃伦斯坦博士的主要研究领域之一是肠道蠕动，或者粪便如何通过消化道。她说：“我不会建议任何人愿意自己接受这一点。”

The thing is, it is technically possible to refuse to defecate, "up to a certain point," she says, but the likely result would be development of a mass of solid, hard-packed stool in the colon, or a "stool ball." And although it could stay put, "Most people would start to leak around the stool ball," she says. Clearly, the guy in England has bigger problems, but in general, anal leakage is no one's friend.

事实是，在理论上人可以拒绝排便，但是可能导致的结果是：在结肠中发展出大量坚实，坚硬的粪便，或者“大便球”。

Another potential complication of a stool ball is that it puts immense pressure on the area behind it, possibly causing a deep and very painful rectal ulcer. It can also injure the delicate tissue in the anal area, potentially resulting in cuts or tears in the lining, known as "fissures." This is exceptionally unpleasant — "like a paper cut, but in a very sensitive area" is how Dr. Stein describes it. Then, without proper blood supply, which the stool ball often prevents, the fissure won't heal, causing it to worsen over time.

大便球的另一个潜在的复杂情况是，它对后面的区域施加了巨大的压力，可能导致深度和非常疼痛的直肠溃疡。它也可能会伤害肛门区域的脆弱组织，可能导致内衬被割伤或撕裂，称为“裂缝”。这是非常不愉快的 - “就像剪纸一样。然后，如果没有适当的血液供应，大便球往往会阻止，裂缝不会愈合，导致它随着时间的推移更加恶化。

These short-term implications are harrowing enough on their own, but pale when compared to potential permanent impact. Damage to the rectum and sphincter muscles, as well as distension (swelling) in both of those organs will almost certainly cause both pain and functionality issues.

这些短期影响本身已经足够让人痛心，但与潜在的永久影响相比，却显得苍白无力。这两个器官对直肠和括约肌的损伤以及膨胀(肿胀)几乎肯定会导致疼痛和功能性问题。

"The rectum itself is supposed to have a certain shape, and if you've got a lot of stool for a long time it can get dysfunctional because it's overloaded," Stein says. "This can cause distension of the belly wall." She adds that this is very uncomfortable and the distension can make it difficult for someone to do even basic tasks, like walking around or bending over.

“直肠本身应该具有一定的形状，如果你长时间有大量粪便，它可能因功能失调而过载，”Stein说。“这会导致腹壁膨胀。” 她补充说，这是非常不舒服的，而这种膨胀可能会让人很难完成基本的行动，比如四处走动或弯腰。

It's also extremely tough for such a sensitive area to bounce back from long-term abuse, and can take months to get back in proper working order, if ever. "Muscles usually coordinate and work together. Having been out of practice, sometimes you might need physical therapy to get back into shape down there," Stein says.

对于这样一个敏感地区来说，长期滥用行为反弹也是非常困难的，并且可能需要几个月的时间才能恢复正常的工作秩序。“肌肉通常协调并协同工作，在实践中，有时候你可能需要物理治疗才能恢复体型，”Stein说。

Physical therapy for this issue typically involves exercises that teach the patient how to relax and tighten the pelvic muscles, thereby increasing control over bowel habits. Do enough damage, however, and all the exercises in the world might not reverse the problem. "If it's been a really long time sometimes you don't get back all of what you lost," she says.

这个问题的物理疗法通常涉及练习，教导患者如何放松和收紧盆腔肌肉，从而增加对排便习惯的控制。然而，做足够的伤害，世界上的所有练习都可能不会扭转这个问题。“如果这段时间很长，有时你不会收回所有丢失的东西”她说。

So, what does the end of the road look like for people who've gone for months without pooping? Turns out, it's somewhat of a juxtaposition. "After a long time of withholding stool, there might be a great sense of relief. However, most patients with severe chronic constipation actually may feel worse for a while after releasing stool," she says. "The colon can get used to accommodating the stool and feel achy and uncomfortable as it contracts back towards normal size. Some folks have lost important sensory input and don't feel much different at all for several weeks until the colon begins to function more normally."

那么，对于几个月没有排便过的人来说，长时间后会是什么样子?。她说：“经过长时间的排便后，可能会有很大的舒缓感，但是，大多数患有严重慢性便秘的患者在放松大便后实际上可能会感觉更糟，结肠可以习惯适应大便，当它恢复正常大小时会感到疼痛和不舒服，有些人已经失去了重要的感觉输入，并且几个星期没有什么不同，直到结肠开始更正常地运作“。