Navigate Up

Seniors Center - A-Z Index

#
Q
Y
Z

Print This Page

Bowel retraining

Alternative Names

Fecal incontinence exercises

Information

A program of bowel retraining, Kegel exercises , or biofeedback therapy may be used by people with:

The bowel program has several steps that help with regular bowel movements. Within a few weeks of beginning a bowel program, most people can have regular bowel movements.

Before starting a bowel training program, get a thorough physical examination. Your health care provider can find the cause of the fecal incontinence and treat any correctable disorders, such as a fecal impaction or infectious diarrhea . The doctor will use your history of bowel habits and lifestyle as a guide for setting new bowel movement patterns.

DIET

The following dietary changes can help promote regular, soft, bulky stools:

  • Add high-fiber foods to your diet, including whole-wheat grains, fresh vegetables, and beans.
  • Use products containing psyllium, such as Metamucil, to add bulk to the stools.
  • Try to drink 2 - 3 liters of fluid a day (unless you have a medical condition, such as kidney or heart disease, that requires you to restrict your fluid intake).

BOWEL TRAINING

You can use digital stimulation to trigger a bowel movement:

  • Insert a lubricated finger into the anus and make a circular motion until the sphincter relaxes. This may take a few minutes.
  • After you have done the stimulation, sit in a normal posture for a bowel movement. If you are able to walk, sit on the toilet or bedside commode. If you are confined to the bed, use a bedpan. Get into as close to a sitting position as possible, or use a left side lying position if you are unable to sit.
  • Try to get as much privacy as possible. Some people find that reading while sitting on the toilet helps them relax enough to have a bowel movement.
  • If digital stimulation does not produce a bowel movement within 20 minutes, repeat the procedure.
  • Try to contract the muscles of the abdomen and bear down while releasing the stool. Some people find it helpful to bend forward while bearing down. This increases the abdominal pressure and helps empty the bowel.
  • Perform digital stimulation every day until you establish a pattern of regular bowel movements.
  • You can also stimulate bowel movements by using a suppository (glycerin or bisacodyl) or a small enema. Some people drink warm prune juice or fruit nectar to stimulate bowel movements.

Consistency is crucial for the success of a bowel retraining program. Establish a set time for daily bowel movements. Choose a time that is convenient for you, keeping in mind your daily schedule. The best time for a bowel movement is 20 - 40 minutes after a meal, because feeding stimulates bowel activity.

Within a few weeks, most people are able to establish a regular routine of bowel movements.

KEGEL EXERCISES

Strengthening the tone of the rectal muscles may help achieve some degree of bowel control in people who have an incompetent rectal sphincter. Kegel exercises strengthen pelvic and rectal muscle tone. These exercises were first developed to control incontinence in women after childbirth. To be successful with Kegel exercises, use the proper technique and stick to a regular exercise program.

BIOFEEDBACK

Biofeedback gives you sound or visual feedback about a bodily function, such as muscle activity. In people with fecal incontinence, biofeedback is used to strengthen the rectal sphincter.

A rectal plug is used to monitor the strength of the rectal muscles. A monitoring electrode may be placed on the abdomen. The rectal plug is then attached to a computer monitor, which displays a graph showing rectal muscle contractions and abdominal contractions.

You are taught how to squeeze the rectal muscle around the rectal plug. The computer display guides you to make sure you are using the correct technique. You should see an improvement in your symptoms after three sessions.

References

Camilleri M. Disorders of gastrointestinal motility. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 138.

Cook IJ, Brookes SJ, Dinning PG. Colonic motor and sensory function and dysfunction. In: Feldman M, Friedman LS, Sleisenger MH, eds. Sleisenger& Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa:Saunders Elsevier; 2010:chap 98.

Updated: 8/10/2012

David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.


©  UPMC | Affiliated with the University of Pittsburgh Schools of the Health Sciences
Supplemental content provided by A.D.A.M. Health Solutions. All rights reserved.

For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.

UPMC is an equal opportunity employer. UPMC policy prohibits discrimination or harassment on the basis of race, color, religion, ancestry, national origin, age, sex, genetics, sexual orientation, marital status, familial status, disability, veteran status, or any other legally protected group status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations.

Medical information made available on UPMC.com is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have. Further, UPMC.com is not a tool to be used in the case of an emergency. If an emergency arises, you should seek appropriate emergency medical services.

For UPMC Mercy Patients: As a Catholic hospital, UPMC Mercy abides by the Ethical and Religious Directives for Catholic Health Care Services, as determined by the United States Conference of Catholic Bishops. As such, UPMC Mercy neither endorses nor provides medical practices and/or procedures that contradict the moral teachings of the Roman Catholic Church.

© UPMC
Pittsburgh, PA, USA UPMC.com