When it comes to managing bowel health, bowel retraining can be an incredibly effective strategy. In this post, we’ll dive into what bowel retraining is, how it works, and why it can be so beneficial for those dealing with constipation, fecal incontinence, or other bowel-related issues. Whether you’re a healthcare provider looking to guide your patients or someone seeking a better understanding of how to improve bowel function, this post is for you.
What is Bowel Retraining?
Bowel retraining is a structured approach designed to help people regain control over their bowel movements. It works by re-establishing healthy habits and signals between the brain, the digestive system, and the pelvic floor muscles. Much like bladder retraining, bowel retraining focuses on regularity, consistency, and proper function of the digestive system.
Understanding Normal Bowel Function
Before we dive into retraining strategies, it’s essential to understand how normal bowel function works. After food is consumed, it travels from the mouth to the stomach, where digestion begins. From there, it moves into the small intestine, where nutrients are absorbed. The waste material continues into the large intestine (colon), where water is absorbed, and the stool becomes more solid. The stool is then stored in the rectum until the brain signals it’s time to go.
When everything works correctly, the body gives signals when the rectum is full, and a bowel movement occurs. However, when the system gets out of sync, either due to constipation or incontinence, retraining can help restore balance.
Why Do We Need Bowel Retraining?
People who experience bowel dysfunction often have irregular bowel habits, leading to either constipation or fecal incontinence. For example, constipation can occur when stool is held in the rectum for too long, causing it to become hard and difficult to pass. Over time, this can lead to a stretched rectum and desensitized signals, making it harder to know when it’s time to go.
On the other hand, fecal incontinence can happen when the stool is too loose or when muscle tone in the pelvic floor and anal sphincter is weakened, leading to accidents. The goal of bowel retraining is to restore the body’s natural rhythms and regain control over bowel movements.
The Bowel Retraining Process
Here’s a breakdown of what bowel retraining involves:
1. Fiber Intake
To ensure regular, healthy bowel movements, it’s crucial to consume the right amount of fiber. Ideally, this means 25-35 grams of fiber daily, spread out evenly across meals—around 8-12 grams per meal. It’s important not to get this all from one source or rely on processed fiber, such as fiber bars or supplements. Instead, focus on natural fiber from fruits and vegetables. This consistent intake ensures the stool stays soft and easy to pass.
2. Proper Toilet Sitting Techniques
The way you sit on the toilet can make a big difference. When retraining the bowel, it’s recommended to sit on the toilet after each meal for no more than 5 minutes. Ideally, your feet should be placed on a stool to help straighten the puborectal angle, making it easier to pass stool. Even if you don’t feel the urge to go, sitting in this position after meals helps stimulate the body’s natural digestive reflexes and creates an opportunity for a bowel movement.
3. The Role of Peristalsis
Peristalsis is the smooth muscle movement that pushes food through the digestive system. After you eat, the body starts this process, moving stool down toward the rectum. For individuals with constipation, their bodies may not send signals to alert them when stool has reached the rectum. That’s why sitting after meals is essential—it allows the body time to catch up and encourages peristalsis to push the stool out.
Dealing with Constipation and Fecal Incontinence
Bowel retraining can benefit those suffering from both constipation and fecal incontinence:
Constipation:
For people dealing with constipation, it’s critical to first address their diet. In addition to the fiber recommendations mentioned earlier, ensuring proper hydration is key. Drinking 4-6 ounces of water per hour helps keep the digestive system functioning smoothly.
If constipation is combined with overactive pelvic floor muscles, then pelvic floor therapy may be needed alongside retraining. Techniques such as deep breathing, relaxing the pelvic muscles, and learning how to bear down effectively can make a significant difference.
Fecal Incontinence:
For patients with fecal incontinence, the focus is on improving stool consistency. Loose stool or diarrhea is often the culprit, and by bulking up the stool with the right diet, many cases of fecal incontinence can be resolved. Sometimes, pelvic floor exercises or even electrical stimulation may be necessary to strengthen weakened muscles and ensure better control over bowel movements.
How Long Does Bowel Retraining Take?
Bowel retraining isn’t an overnight fix—it requires patience and consistency. Depending on the severity of the condition, it can take several weeks to months to see full results. In cases of severe constipation with a stretched rectum, it may take up to a year for the rectum to regain its normal size and tone. However, with strict adherence to the program, most people see improvement relatively quickly.
Conclusion
Bowel retraining is an incredibly effective way to address both constipation and fecal incontinence. By following a consistent schedule, maintaining proper fiber intake, and practicing good toilet habits, you can help your body regain control over bowel movements. Whether you’re dealing with bowel dysfunction or helping someone else manage their symptoms, remember that patience and consistency are key to success.
If you or your patients are struggling with bowel issues, bowel retraining may be the solution you’ve been looking for. Always consult with a healthcare provider to create a plan that works for you.