How can one improve their bowel movements? Discover effective techniques for bowel retraining, including Kegel exercises, biofeedback therapy, and dietary changes. Learn to manage issues like fecal incontinence and severe constipation.

Understanding Bowel Retraining

Bowel retraining is a comprehensive program designed to help individuals with various bowel-related issues, such as fecal incontinence and severe constipation. This approach aims to establish regular and healthy bowel movements through a combination of dietary changes, exercise, and other therapeutic techniques.

Causes of Bowel Disorders

Bowel problems can be caused by a variety of factors, including brain and nerve issues (e.g., multiple sclerosis), emotional problems, spinal cord damage, previous surgery, and childbirth. Understanding the underlying cause is crucial in determining the appropriate treatment plan.

The Bowel Retraining Program

The bowel retraining program typically involves several steps to help individuals achieve regular and comfortable bowel movements. These steps include dietary modifications, digital stimulation, and the use of laxatives or other medications when necessary.

Dietary Considerations

Making changes to your diet can significantly improve the consistency and regularity of your bowel movements. Incorporating high-fiber foods, such as whole-wheat grains, fresh vegetables, and beans, can help add bulk to the stool. Supplementing with products containing psyllium, like Metamucil, can also be beneficial.

Bowel Training Techniques

Digital stimulation is a key component of the bowel retraining program. This involves inserting a lubricated finger into the anus and moving it in a circular motion to relax the sphincter muscle. Additionally, techniques like bearing down while sitting on the toilet or using suppositories or small enemas can help trigger bowel movements.

Kegel Exercises and Biofeedback

Strengthening the pelvic and rectal muscles through Kegel exercises can improve bowel control in individuals with incompetent anal sphincters. Biofeedback therapy, which provides visual or auditory feedback on rectal muscle contractions, can also be a useful tool in the bowel retraining process.

Establishing a Routine

Consistency is crucial for the success of a bowel retraining program. Setting a regular time for daily bowel movements, preferably 20 to 40 minutes after a meal, can help establish a predictable pattern. Most people are able to achieve regular bowel movements within a few weeks using this approach.

How important is it to establish a regular routine for bowel movements during a bowel retraining program? Maintaining a consistent schedule for daily bowel movements is crucial for the success of a bowel retraining program. The best time to have a bowel movement is typically 20 to 40 minutes after a meal, as eating stimulates bowel activity. By sticking to a regular routine, most people are able to achieve regular and comfortable bowel movements within a few weeks.

What are the benefits of incorporating Kegel exercises into a bowel retraining program? Kegel exercises are designed to strengthen the pelvic and rectal muscles, which can be particularly helpful for individuals with fecal incontinence due to incompetent anal sphincters. By improving the tone and control of these muscles, Kegel exercises can enhance bowel control and reduce episodes of involuntary stool leakage.

How can biofeedback therapy be used in a bowel retraining program? Biofeedback therapy provides visual or auditory feedback on the strength and coordination of the rectal muscles. During a biofeedback session, a rectal plug is used to detect the strength of the rectal muscles, and a monitoring electrode is placed on the abdomen. The feedback displayed on a computer screen allows the individual to learn how to properly contract and relax the rectal muscles, leading to improved bowel control over time.

What dietary changes can help with bowel retraining? Incorporating more high-fiber foods, such as whole-wheat grains, fresh vegetables, and beans, can help add bulk to the stool and improve the consistency of bowel movements. Using products containing psyllium, like Metamucil, can also be beneficial in this regard. Additionally, aiming to drink 2 to 3 liters of fluids per day (unless there are medical conditions that require fluid intake restrictions) can help maintain proper hydration and support regular bowel function.

Why is it important to address the underlying cause of bowel problems before starting a bowel retraining program? Identifying the root cause of the bowel issue, such as brain and nerve problems, emotional factors, spinal cord damage, previous surgery, or childbirth, is crucial in determining the appropriate treatment approach. Addressing any underlying conditions or disorders that may be contributing to the bowel problem can help ensure the success of the bowel retraining program.

How long does it typically take to see results from a bowel retraining program? Most people are able to establish a regular routine of bowel movements within a few weeks of following a bowel retraining program. However, the timeline can vary depending on the individual’s specific condition and the severity of the bowel problem. Consistency and adherence to the program’s recommendations are key factors in achieving successful and sustainable results.

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A program of bowel retraining, Kegel exercises, or biofeedback therapy may be used by people to help improve their bowel movements.

Problems that may benefit from bowel retraining include:

• Fecal incontinence, which is the loss of bowel control, causing you to pass stool unexpectedly and involuntarily. This can range from sometimes leaking a small amount of stool and passing gas, to not being able to control bowel movements.
• Severe constipation.

These problems may be caused by:

• Brain and nerve problems (such as from multiple sclerosis)
• Emotional problems
• Spinal cord damage
• Previous surgery
• Childbirth
• Overuse of laxatives

The bowel program includes several steps to help you have regular bowel movements. Most people are able to have regular bowel movements within a few weeks. Some people will need to use laxatives along with bowel retraining. Your health care provider can tell you if you need to take laxatives and which ones are safe for you.

You will need a physical exam before you start a bowel training program. This will allow your provider to find the cause of the fecal incontinence. Disorders that can be corrected such as fecal impaction or infectious diarrhea can be treated at that time. The provider will use your history of bowel habits and lifestyle as a guide for setting new bowel movement patterns.

DIET

Making the following changes to your diet will help you have regular, soft, bulky stools:

• Eat high-fiber foods such as whole-wheat grains, fresh vegetables, and beans.
• Use products containing psyllium, such as Metamucil, to add bulk to the stools.
• Try to drink 2 to 3 liters of fluid a day (unless you have a medical condition 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. Move it in a circle until the sphincter muscle relaxes. This may take a few minutes.
• After you have done the stimulation, sit in a normal position 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. If you are unable to sit, lie on your left side.
• Try to get as much privacy as you can. Some people find that reading while sitting on the toilet helps them relax.
• If you do not have a bowel movement within 20 minutes, repeat the process.
• Try to contract the muscles of the abdomen and bear down while releasing the stool. You may find it helpful to bend forward while bearing down. This increases the pressure within the abdomen and helps empty the bowel.
• Perform stimulation with your finger every day until you start to have a regular pattern of bowel movements.
• You can also stimulate bowel movements by using a suppository (glycerin or bisacodyl) or a small enema. Some people find it helpful to drink warm prune juice or fruit nectar.

Keeping to a regular pattern is very important for a bowel retraining program to succeed. Set a regular time for daily bowel movements. Choose a time that is convenient for you. Keep in mind your daily schedule. The best time for a bowel movement is 20 to 40 minutes after a meal, because eating stimulates bowel activity.

Most people are able to establish a regular routine of bowel movements within a few weeks.

KEGEL EXERCISES

Exercises to strengthen the pelvic and rectal muscles may help with bowel control in people who have incompetent anal sphincters. Kegel exercises that increase pelvic and rectal muscle tone can be used for this. 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. Talk with your provider for instructions about how to do these exercises.

BIOFEEDBACK

Biofeedback gives you sound or visual feedback about a bodily function. In people with fecal incontinence, biofeedback is used to strengthen the anal sphincters.

A rectal plug is used to detect the strength of the rectal muscles. A monitoring electrode is placed on the abdomen. The rectal plug is then attached to a computer monitor. A graph displaying rectal muscle contractions and abdominal contractions will show up on the screen.

To use this method, you will be taught how to squeeze the rectal muscle around the rectal plug. The computer display guides you to make sure you are doing it correctly. Your symptoms should begin to improve after 3 sessions.

Fecal incontinence exercises; Neurogenic bowel – bowel retraining; Constipation – bowel retraining; Obstipation – bowel retraining; Bowel incontinence – bowel retraining

Camilleri M. Disorders of gastrointestinal motility. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 127.

Deutsch JK, Hass DJ. Complementary, alternative, and integrative medicine. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 131.

Iturrino JC, Lembo AJ. Constipation. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 19.

Pardi DS, Cotter TG. Other diseases of the colon. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 128.

Updated by: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A. D.A.M. Editorial team.

What’s a Normal Bowel Movement? Plus Tips for Better Pooping

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Some habits, including drinking more water, eating fiber, and moving around, may help stimulate regular bowel movements.

There’s a reason to pay attention to how often you poop: Regular bowel movements can be essential for good health.

Let’s go over why that’s so, as well as some tips to help you have better bowel movements, including how to pass hard stools.

As far as how often to have a bowel movement, there isn’t an exact number. Bowel activity varies for each person. However, medicine and science will often use the “basic rule of three” to describe a typical movement, meaning you have bowel activity anywhere between three times a day and three times a week.

You’ll poop more or less each day (or week) depending on a number of factors, such as your:

• diet
• age
• physical activity level

While the appearance and consistency of a person’s poop can vary from person to person, most people’s poop is formed, brown, and soft. If yours is rarely like this (such as always hard or always liquid), you may want to speak with a doctor.

Pooping shouldn’t be painful. If you frequently have bowel movements that are painful to pass or result in cramping after you make them, it’s time to speak with a doctor. You could have a condition like:

• irritable bowel syndrome (IBS)
• Crohn’s disease
• ulcerative colitis

Many people occasionally experience episodes of diarrhea or constipation, where you can’t go to the bathroom easily or very often. You can try some steps to treat them at home.

Constipation and diarrhea both involve concerns with the passage of stool. But while constipation is infrequent bowel activity or difficulty passing stool, diarrhea refers to loose or watery stools. Different factors can trigger either symptom, such as:

• diet
• food intolerances
• medications
• conditions affecting the gastrointestinal tract

Regardless of the underlying cause, though, constipation and diarrhea occur when intestinal contractions either speed up or slow down. Gut contractions help move stool through the colon. But sometimes, the muscles contract too much or too little. Diarrhea happens when these muscles contract more than usual, whereas constipation happens when they don’t contract enough.

Tips for incontinence or diarrhea

• Avoid foods known to irritate the stomach and cause loose stools (especially caffeine, dairy, and alcohol).
• Drink plenty of water or electrolyte-containing beverages to stay hydrated.
• Increase your fiber intake to add bulk to your stool.

Tips for constipation

• Try to get at least 25 to 31 grams of fiber per day.
• Increase your physical activity level.
• Always use the bathroom when you get the urge to go — don’t try and hold it.

However, if constipation or diarrhea become your consistent stool pattern, speak with a primary care doctor. They may recommend treatments or refer you to a specialist (called a gastroenterologist) who can perform further testing.

Bowel movements (sometimes called BMs for short) are your body’s way of getting rid of waste that doesn’t have any use in the body. While it may not look like it, poop is about three-fourths water. The remainder is a collection of materials that includes:

• bacteria
• fats
• fiber (undigested foods, including nuts and seeds)
• food wastes
• mucus
• salts

Another poop component is bilirubin, a brownish-red substance that’s the result of a breakdown of wastes from the liver and bone marrow. Bilirubin is what gives poop its usual brown color.

A person has to poop to survive because the body doesn’t have a way of getting rid of these wastes otherwise. If a person doesn’t poop for many days, the stool can back up in the intestines. If this goes on for too long, it starts to pose a risk to your safety and can damage your organs. This is why pooping is so important for your health.

Pooping is part physical, part mental. If you aren’t pooping as easily or often as you’d like, addressing these aspects can help.

Drink water

Water and fiber: These are two major components of poop that are part of your diet. Making efforts to drink more water daily can help make your bowel movements easier to pass.

Eat fruits, nuts, grains, and vegetables

In addition, it’s important to eat foods with plenty of fiber. This adds bulk to your stool, which stimulates the bowels to move and propel your stool forward. Foods that contain fiber include:

• fruits, such as strawberries, raspberries, and apples
• nuts and seeds, such as pistachios, almonds, or sunflower seeds
• vegetables, such as broccoli, lima beans, and carrots
• whole-grain breads, such as seven-grain, cracked wheat, or pumpernickel

Add fiber foods slowly

Don’t incorporate too much fiber into your diet at a time — it can have an opposite, constipating effect. Instead, try to add a serving every 5 days to allow your digestive tract time to acclimate itself to the increased fiber.

Cut out irritating foods

In addition to constipation that makes stools harder to pass, some people experience stool that’s too loose. When this is the case, cutting out foods that can irritate the stomach can help. Examples to cut from your diet include:

• alcoholic beverages
• caffeinated drinks, like tea, coffee, and sodas
• fatty foods
• foods that contain sugar alcohols that end in the letters -ol (such as sorbitol, mannitol, and xylitol)
• spicy foods

Try cutting out these foods to see if your bowel movements are less watery. You can also keep a food and symptom diary to identify connections between the foods you eat and the symptoms you experience.

Move more

Your intestines have a natural motion that moves stool forward. If your body isn’t moving stool through fast enough, then you can help it out with increased exercise. Physical activity, such as walking, running, or swimming, can all promote motion that helps you poop better. Even short amounts of activity — 10 to 15 minutes — can help.

Change your bathroom posture

Another tip you can try has to do with your posture on the toilet. Changing the angle of your legs changes the angle of your colon. Toilet footstools are one accessory that you can use in the bathroom to do this. Some people find that it helps them have a more comfortable and effective bowel movement. Researchers even studied their use with the help of 52 volunteers.

Even if you don’t have a footstool to raise your feet, you can still try adjusting your posture. While you’re sitting on the toilet, try planting your feet on the ground so that your knees are higher than your seat or higher than usual.

Find bathroom footstools online.

Keep your bowel movements in mind

Doctors have identified a mind-body connection to pooping. For example, many people cringe at the idea of pooping in a public restroom.

Here are some ways to address the connection between your brain and intestines:

• Remember that pooping is a natural part of every person’s physical needs. Everyone poops. You have nothing to be ashamed of if you have to go.
• Try to poop at the same time every day (such as in the morning at home, after you eat breakfast). This can help to train your body to go at the same time in a place where you’re more comfortable.
• Go to the bathroom when you feel the need. Try to not hold it in or put off a bowel movement. If you feel the need to go, take advantage of your body’s readiness.
• Try engaging in stress-relieving activities if your anxiety levels are creeping up and your stomach starts to cramp. Examples include taking deep breaths, doing seated stretches like rolling your shoulders backward and forward, listening to calming music, or repeating a positive mantra.

Stress and pooping are highly connected. Try to create a calming environment in your bathroom where you have privacy. Avoid rushing yourself — give yourself at least 10 minutes to go to the bathroom.

Bowel movements require food, fluids, and calm to create a more comfortable experience. If you try these tips, and your symptoms aren’t getting better, speak with a doctor. There are lots of medicines and approaches that can help you enhance your intestinal health.

Seven Ways to Improve Gut Health

Gut health refers to the health of the body’s microbial flora involved in digestion. The microbial flora, or microbiome, is made up of trillions of bacteria that not only help digest food, but also affect overall health and even emotional well-being.

If your microbiome is out of order, you will most likely notice it pretty quickly. Some common everyday symptoms of an unhealthy gut include:
– Diarrhea, loose stools or constipation
– Gas and bloating
– Abdominal pain or discomfort

There are also indirect symptoms:
– Trouble sleeping
– Skin inflammation (acne)
– Hormonal imbalance
— Emotional imbalance
— Weakened immune system

As you can see, an unhealthy gut can have a wide range of effects on well-being. Here are seven ways to improve microbial flora and gut health. All of them are based on the recommendations of nutritionists from the International Food Information Council.

1. Get enough fiber

Fiber acts as fuel for healthy bacteria in the gut. In turn, the bacteria produce compounds, including vitamins and fatty acids, that provide health benefits.

The easiest way to include more fiber in your diet is to eat whole grain bread, brown rice and oatmeal.

2. Eat more fermented foods

During the fermentation process, bacteria partially break down foods, changing their state, such as turning milk into yogurt.

Some fermented foods are broken down by bacteria that are also considered probiotics, the “good” bacteria that live in a healthy gut. Therefore, food with probiotics is useful.

Include in your diet:
– Yoghurt with probiotics
– Sauerkraut
– Kimchi
– Kefir
– Kombucha (kombucha)

3. Stay hydrated

90 004 Drinking enough water has many health benefits, from staying healthy skin to improve brain function. The amount of water you drink also affects your microbiome.

One easy way to make sure you’re drinking enough water is to carry a refillable bottle with you. Having a source of water on hand helps make drinking throughout the day a regular habit.

A word of advice: you can set an alarm on your phone to remind you every hour to drink some water or another low-sugar drink.

4. Relax and relieve stress

High levels of stress can negatively affect gut health. A typical example is irritable bowel syndrome, in which stress can be the main trigger for exacerbating symptoms.

5. Exercise

Exercise increases blood flow to the muscles responsible for peristalsis, the contractions of the intestines that move food through the digestive system. And also the load and the body and sports contribute to deeper sleep – the work of the intestines slows down at night, it needs to rest just like other organs.

6. Chew your food thoroughly

Chewing your food slowly and thoroughly is good for intestinal health.

The process of digestion begins in the mouth. If you are in a hurry while eating, it is difficult for the body to properly digest food. Help your gut by chewing your food calmly and mindfully.

7. Diversify your diet

The more varied your diet, the healthier your gut microbiome will be. This ensures that you get different types of fiber and micronutrients.

Ideally, you should aim to eat 30 different plant foods per week.

How to help, improve and establish good digestion – help and advice on improving and normalizing digestion

Co-author, editor and medical expert – Klimovich Elina Valerievna.

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Last updated: 12/20/2021

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The reason is that only the proper functioning of the stomach and intestines allows you to extract the substances necessary for the body from food. Even with minor deviations in their work, the digestion of food and the absorption of nutrients are disturbed. As a result, obvious symptoms of indigestion develop (heartburn, heaviness in the stomach, bloating, nausea).

If the stomach does not work properly, it should be treated with attention. We offer you to listen to some practical and easy-to-follow tips that will tell you how to improve digestion.

1. Follow the diet

Bringing meals to a certain regimen is the main thing to do to improve digestion. Breakfasts and lunches on the go and in a hurry, the lack of first hot meals in the diet are often the main culprits of problems with the gastrointestinal tract (GIT).

Organize your diet so that meals always occur at the same time, 3-5 times a day. This approach will help in the normalization of digestion, as the gastrointestinal tract will “get used” to eating at a certain time and will be ready to produce the necessary enzymes by the appointed hour.

2. Reduce the amount of sweets

To improve digestive processes, you should also give up sweets or reduce their amount in the diet to a minimum.

Sugar contained in sweets, cakes and pastries provokes fermentation in the gastrointestinal tract. As a result, the absorption of nutrients worsens, the balance of the intestinal microflora is disturbed, and symptoms develop that indicate that digestive assistance is needed. If bloating and increased flatulence began to be observed some time after eating sweets, it makes sense to talk about sweets as the main cause of trouble.

3. Refuse dangerous products

Another danger lurking at every turn is delicious and fragrant dishes and products that cannot be refused. But often the effect they have on the digestive system puts them in the category of undesirable and even forbidden foods if you have trouble digesting food.

Smoked meats, spices, fried and spicy foods, carbonated drinks, coffee, and foods containing caffeine can cause stomach heaviness and other discomfort. For good digestion, it is worth replacing fried foods with boiled or stewed ones, eating plenty of vegetables, raw or steamed.

4. Lead an active lifestyle

How to improve digestion and increase the overall tone of the body can be done through healthy activity. Thanks to feasible physical activity – walking, cycling, active games in the fresh air – the blood supply to all tissues improves, including the organs of the digestive system. This means that all functions of the gastrointestinal tract come into a more active state, nutrients are broken down and absorbed more efficiently, and in general, an improvement in digestive processes is observed.

5. Give up bad habits

Bad habits may look harmless enough, but exactly until the question arises: why did indigestion develop against the background of good nutrition and adherence to the regime?

Everything is explained simply: the components of tobacco smoke and alcoholic beverages significantly disrupt the absorption of nutrients in the gastrointestinal tract. In addition, these substances have a toxic effect and, with regular smoking or the consumption of alcoholic beverages, lead to dysfunctions of the mucous membrane of the stomach and intestines.