Bowel health

Bowel retraining

Techniques for resisting the urge and gaining control of bowel movements.

1. 1Time yourselfOn the toilet, time how long you can hold on. Start by adding a few seconds, up to one minute.
2. 2Build to 5 minutesOnce you succeed, increase the delay up to 5 minutes.
3. 3Build to 10 minutesProgress from 5 to 10 minutes before allowing a bowel movement.
4. 4Move away from the toiletSit near the toilet, on the tub edge or a chair, and hold on for 5, then 10 minutes.
5. 5Leave the bathroomThe goal is to hold on for 10 minutes at any distance from the toilet.

Bowel movement control techniques

Unless you are experiencing incontinence, you should always listen to your body when you feel the need for a bowel movement. If you are experiencing incontinence (you cannot hold the stool in before you get to the toilet, or you need to rush to the toilet to make it on time), there are retraining techniques for resisting the urge and gaining control. They work best when you are also doing regular exercises to strengthen the sphincter and pelvic floor muscles.

Retraining helps your rectum and anal canal (where you store stool), your pelvic floor muscles, and your sphincter muscles learn to overcome the problem. When you have some success holding on, you become more confident, experience less panic, and feel less urgency. The less you panic, the easier it is to make the urge go away.

Resisting the urge in order to gain control

These steps help you become aware of your current ability to control the urge and begin practicing urge delay while on the toilet.

1. FirstTime your current ability to hold on to a bowel movement. Take a watch to the bathroom and time your delay.
2. NextThe next time you feel the urge, sit on the toilet and try to hold on for a few seconds longer, up to one minute, before having a bowel movement. Remember that you are sitting on the toilet and are therefore “safe” if you are not able to do this the first few times.
3. ThenOnce you succeed with your first hold-on time, increase the delay up to 5 minutes.

Progression techniques

These steps are more challenging, but remember that you are still “safe.” Gradually, you will be able to increase the distance and time away from the toilet. It will take time to master, but the more you practice this program along with pelvic floor and sphincter exercises, the sooner you are likely to succeed.

1. Hold longerProgress from 5 minutes to holding on for 10 minutes before allowing yourself to have a bowel movement.
2. Move awaySit near the toilet when you feel the need, on the edge of the bathtub or a chair, and hold on for 5 minutes. Once you can, repeat and increase to 10 minutes.
3. Leave the bathroomYour muscles are becoming stronger and your awareness of sensation changes is increasing. Your goal is to be able to hold on for 10 minutes at any distance from the toilet.