The bowel program has several steps that help with regular bowel movements. Within a few weeks of beginning a bowel program, most people can have regular bowel movements.
Before starting a bowel training program, get a thorough physical examination. Your health care provider can find the cause of the fecal incontinence and treat any correctable disorders, such as a fecal impaction or infectious diarrhea. The doctor will use your history of bowel habits and lifestyle as a guide for setting new bowel movement patterns.
The following dietary changes can help promote regular, soft, bulky stools:
You can use digital stimulation to trigger a bowel movement:
Consistency is crucial for the success of a bowel retraining program. Establish a set time for daily bowel movements. Choose a time that is convenient for you, keeping in mind your daily schedule. The best time for a bowel movement is 20 - 40 minutes after a meal, because feeding stimulates bowel activity.
Within a few weeks, most people are able to establish a regular routine of bowel movements.
Strengthening the tone of the rectal muscles may help achieve some degree of bowel control in people who have an incompetent rectal sphincter. Kegel exercises strengthen pelvic and rectal muscle tone. 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.
Biofeedback gives you sound or visual feedback about a bodily function, such as muscle activity. In people with fecal incontinence, biofeedback is used to strengthen the rectal sphincter.
A rectal plug is used to monitor the strength of the rectal muscles. A monitoring electrode may be placed on the abdomen. The rectal plug is then attached to a computer monitor, which displays a graph showing rectal muscle contractions and abdominal contractions.
You are taught how to squeeze the rectal muscle around the rectal plug. The computer display guides you to make sure you are using the correct technique. You should see an improvement in your symptoms after three sessions.
Fecal incontinence exercises
Camilleri M. Disorders of gastrointestinal motility. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 138.
Cook IJ, Brookes SJ, Dinning PG. Colonic motor and sensory function and dysfunction. In: Feldman M, Friedman LS, Sleisenger MH, eds. Sleisenger& Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa:Saunders Elsevier; 2010:chap 98.
Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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