Bowel Retraining - Principles and Steps

What Is Bowel Retraining?

Retraining bowel refers to a definite behavioral program designed to help individuals with bowel disorders, and establish control for people who have symptoms of inability to control bowel movements, chronic constipation, and incomplete emptying. Bowel training helps by teaching new skills and strategies that develop a routine and schedule that is predictable for evacuation.

What Are the Basic Principles of Bowel Retraining Programs?

Basic principles include:

• Improving the Consistency of the Stools: Hard stools are difficult to eliminate, and liquid-like stools cause leakage. So a well-balanced and regular meal high in fiber can help in forming a good consistency of stools. With increasing fiber, it is also important to increase fluid intake. The amount of fiber and fluid intake varies from person to person.

• Regular Eliminating Time: The retraining needs to be established at the same time each day. This helps in establishing routine and time for elimination. An appropriate time for a person is considered by keeping in mind their work pattern, habits, and schedule of lifestyle. Time should not be rushed but convenient. Planning retraining after a meal is very successful in getting the wave-like movements within 20 to 30 mins after a meal.

• Stimulating Emptying: Some kind of stimulation is required to empty the rectum. Varies from person to person. They create wave-like movements in the colon. A hot drink or a meal may stimulate them. Also, in some cases, using an enema and laxatives can be done.

What Is Included in the Bowel Training Program?

The bowel training program included comprehensive bowel history it is taken into account:

• Present and past bowel elimination patterns.

• Diet.

• Medications taken.

• Medical history.

• A physical test to access factors involved in bowel control.

• Simultaneously a food diary may be kept.

What Causes Constipation and Diarrhea?

Constipation and diarrhea are both concerns with stool passage. Constipation is infrequent bowel activity and difficult stool passing, and diarrhea refers to watery loose stools. Many factors trigger either symptoms, like:

• Medications.

• Food intolerance (Caused by the body when it is not able to digest certain food or ingredient content of the food).

• Gastrointestinal tract conditions.

• Diet.

Constipation and diarrhea occur when the contraction of the intestine either slows down or speeds up regardless of the underlying cause. When muscles contract more than usual, diarrhea occurs, and less than usual constipation occurs.

What Are the Tips to Prevent Constipation and Diarrhea?

Tips to prevent diarrhea and constipation are:

Diarrhea:

• Drink plenty of water and electrolyte to stay hydrated.

• Increase fiber intake.

• Avoid foods that irritate the stomach.

Constipation:

• Increase physical activity level.

• Use the bathroom as soon as you get the urge to go, do not hold it.

• Take at least 25 to 31 grams of fiber a day.

What Are the Conditions That Gain Help From Bowel Retraining?

The conditions that get benefit from bowel retraining are:

• Severe constipation.

• Fecal incontinence causes stool to pass unexpectedly. Loss of bowel control and sometimes leak in passing gas and stools, fail to control bowel movements.

• Fecal impaction.

• Infectious diarrhea.

What Is the Purpose of Bowel Retraining?

Bowel retraining helps to regain bowel control patterns in passing stools and helps to hold on to expected stool passing. This can be effective in many individuals like :

• Individuals receiving cancer treatment and gastrointestinal tract are affected.

• Individuals with weakened anal sphincter.

• Unable to drink eight glasses of liquid a day.

• Unable to eat three meals a day.

What Are the Steps of Bowel Retraining?

Steps of bowel retraining are the steps to get your body into a regular schedule.

• Keeping a diary of bowel movements for two weeks helps in determining particular times of day to specific situations in the body to initiate a bowel movement.

• Regular and consistent meal times and having a regular schedule will encourage digestion in a pattern.

• Changing food habits that may contribute to softening stools and having plenty of fluids helps in digestion and help stools to become softer. Fibers can also help to soften stools.

• Picking a regular time for bathroom visit:

• Advantage time is 20 to 30 mins after the meal and the optimal time is morning for most individuals.

• Try stimulating gastrocolic reflex.

• Drinking hot beverages and caffeine without irritating the digestive system.

• Have a comfortable and possible position to sit on the toilet that helps in stimulating and relaxing the body to ease and calm.

• Do not force the stool out, do not strain the rectum. Use the abdominal muscles. Leaning forward and contracting muscles of the lower abdomen can be helpful.

How Is Bowel Retraining Done?

Digital stimulation is done to trigger bowel movements:

• Insert a lubricated finger in the anus and move it in circular movements until the sphincter muscle relaxes.

• After the muscles get stimulated, sit in a normal bowel position. If confined to bed, use a bedpan. If unable to sit, lie on the left side.

• If the bowel movements do not start within 20 mins, repeat the process.

• Bowel movements using a suppository or enema. Or any drinks like fruit nectar or prune juice.

• Maintaining this regular pattern is much more important for retaining programs to succeed. Maintain a daily schedule, and the best time for bowel movements is 20 to 40 mins after meals.

What Is Kegel Exercise?

It is an exercise done to strengthen the rectal muscles that help in bowel control and movements in individuals with incompetent rectal sphincters. This exercise strengthens the rectal and pelvic muscles. These were first developed to control incontinence in women after giving birth to children.

What Are the Risks of Bowel Retraining?

Bowel retraining programs do not affect the work and show results instantly, so in the initial stages, it may be frustrating and stressful. Approaching the same program with a more relaxed attitude can lead to better success. The program does take a long time but can be effective eventually.

Conclusion

Bowel retraining is a way to work with the body's natural rhythm and schedule regular bowel movements; this can help individuals who suffer from diarrhea, irregular bowel movements, and chronic constipation. Bowel retraining does not provide immediate results. In chronic conditions, the causes and progress can result slowly. Bowel retraining is not the treatment for constipation, and it is used to set up the body's optimal conditions and regular rhythm.