Improving bowel function

Introduction

Taking control of your bowel habit may seem difficult at times, especially when you feel under stress or when the problem has continued for a long time. There are many factors that affect bowel function, these include diet, lack of exercise and fluids. Avoid a diet high in insoluble fibre such as bran and wholemeal products. Try to increase your fluid intake to between 1.5-2 litres a day. Take regular exercise where possible.

The following routine will help you to open your bowels regularly and with ease so that your bowel problems no longer interfere with your daily life.

Think of your bowels as a container which you are trying to empty. You need to push the contents downwards and you need to open the muscle in your bottom (the anal sphincter) to allow the contents to pass out. Every day set aside 10 minutes for this, at a time when you will not be interrupted (preferably 15 to 20 minutes after your breakfast).

Check your sitting position on the toilet. If possible sit with your knees slightly higher than your hips. It may help to use a small stool or some books to raise your feet. Lean forward with your forearms resting on your thighs and your back straight.

Identify the different muscles you will use

1. First your waist muscles. These are the muscles you use to push/propel with. Place your hands either side of your waist. Now cough. Can you feel the muscles work? When you push down you need to feel these muscles expand so that your waist becomes wider.
2. Now your anal sphincter or back passage muscle. When you go to the toilet you must relax and open this muscle. Insert your finger just inside your back passage. Squeeze your back passage as if you are trying to stop yourself going to the toilet. It should tighten around your finger. As you push down you should feel the muscle open and relax.

Make sure that you control this muscle and learn to recognise when you are squeezing and relaxing. Sometimes it helps to think of the muscle like a lift on the ground floor. By squeezing you can take the lift up a floor and by relaxing you can take the lift down to the basement.

Relax

Lower your shoulders. Breathe slowly and gently. Try to let go with all of your muscles and breathe so that your tummy moves up and down not your chest.

Now try to open your bowels

Do not hold your breath ie do not take in a big breath first.

• Slowly brace outwards (widen your waist). Then push from your waist backwards and downwards into your back passage. At the same time make sure that your anal sphincter is relaxed and open. Do not strain.
• Relax for one second but only slightly. You should maintain a level of pressure with your brace, whilst not pushing with it.
• Brace outwards and push downwards again. This should be repeated.

You should be using your brace as a pump.

Remember

This will take time and practice.

Do not spend more than 10 minutes on the toilet.

Do not return to the toilet unless you have a definite urge to open your bowels.

Benefits

This leaflet is designed to help you improve your bowel function. If you have any problems with the exercises, or if you do not understand any part of the information sheet, please ask your nurse to help you.

Follow your routine daily and you should begin to see good results within a few weeks.

Risks

There are no risks associated with any of these exercises.

Contacts/ Further information

Biofeedback team - 01223 348106