Bowel Retraining
for Chronic Constipation

OVERVIEW

Bowel retraining defined

Those with dysfunctional bowels find a program of behavior modification will help them to regain normal bowel function.

The reasons for bowel retraining

Bowel training may be able to help individuals to overcome the following bowel conditions:

1) An ongoing constipation problem

2) Bowel incontinence

3) When injury or illness has damaged a person's nerves 

Bowel retraining risks

Fortunately, there is very little risk associated with bowel retraining. The one thing that you need to avoid is straining in an effort to defecate, which could result in injury to the colon.  

Making preparations to retain the bowel

It is best to see your health care provider before starting a program to retrain the bowel. He or she should be able to determine any problems beforehand.

Performing the retraining of the bowel

North Carolina University recommends to:

1. Find a daily time that works for you.
   
   
2. Relax and slowly rock back and forth.
   
   
3. Try not to strain
   
   
4. Use an over-the-counter enema if by the 3rd day you haven't been able to defecate. Perhaps an even better option is a constipation magnesium product.

Each day consistently repeat the above steps. It is an important ingredient of retraining the bowel. Positive results will be seen by most people in a couple of weeks.

Retraining the Bowel

With a few changes in diet and lifestyle it is possible to retrain the bowel. Listed below are FOUR CHANGES which are aimed at producing regular bowel movements.

Usually it will take a few weeks for most people to achieve regular bowel movements, once they have started a Bowel retraining for chronic constipation program.  

1. Diet and fluid intake

Increase Dietary Fiber intake and fluid intake when you start bowel retraining.

• Eat whole grains, fresh vegetables, fruits and legumes
• Drink at least 3 liters of fluid each day

To produce good quality stools that are soft and easy to pass you will need to stay hydrated (water works best) and eat 25g to 35g dietary fiber each day.

2. Exercise

Regular well formed stools will be produced with strong intestinal and abdominal muscles. With 5 minutes of walking, stair climbing and sit ups, you can tone your intestinal and abdominal Muscles.

Information concerning the reflex to defecate:
Whenever the Defecation Reflex is stimulated (when you feel the urge to go), take advantage of it. When you ignore the urge to go, fecal matter builds up in the colon.

3. Train the defecation reflex

About one hour after eating, make time to relax on the toilet for about 15 minutes. Perform this procedure about the same time every day.  Being consistent is crucial for Bowel retraining for chronic constipation success.

A word of CAUTION. Sitting too long with the rectum unsupported can lead to hemorrhoids. It is better to respond quickly to an urge to go, even if that urge is weak, than to sit long periods on the toilet.

4. Create a comfortable environment

Create a relaxing environment in your bathroom.

• Burn a fragrant candle
  
• Have reading material available
  
• Play some music

Public restrooms can be a hindrance because they are an undesirable environment.

When you are working on Bowel retraining for chronic constipation, you need to respond to the urge to go whenever it occurs. This is important even if you have to use a public restroom.

How to Use Bowel Retraining for Chronic Constipation

To establish a regular schedule of bowel movements, retraining the bowel helps a person to cooperate with the natural rhythms of their body. Those suffering from chronic constipation could find bowel retraining to be a big help.

The idea is to try to create the conditions that maximize the possibility of having a successful bowel movement.

Tips for bowel retraining

1. Keep a diary of bowel movements for 2 weeks.
   
   
2. Establish regular and consistent meal times.
   
   
3. Do what you can to contribute to the development of soft, well-formed stools.
   
   
4. Pick a regular time for your bathroom visit.
   
   
5. Before going to the bathroom, try to stimulate the the urge to go.
   
   
6. Make yourself as comfortable as possible in the bathroom.
   
   
7. Use your abdominal muscles, not your rectum.

Chronic constipation has many causes and progress may come slowly. Bowel retraining for chronic constipation is designed to set up the optimal conditions for your body to establish a more regular rhythm.

Dealing with Chronic Constipation

The cause

According to the book,  BODY / The Complete Human, constipation occurs when the feces remain too long in the colon and so much water is absorbed that defecation becomes increasingly difficult.

Mild laxatives may temporarily fix the problem but are not a good long term solution. 

The cure

A high fiber diet is the best choice and cure for constipation.

In his book, Herbal Prescriptions After 50, by David Hoffmann, he says:

"Any long-term approach must include dietary fiber to
provide bulk and "retraining" of the bowel musculature."

"A dietary approach focusing on the rational use of fiber
is also the most effective.  He says " I stress rational;
addiction to oat bran is, after all, an addiction like any other."

Detailed Bowel Retraining Information

Some bowel retraining guidelines

1. Identify any cause of the constipation and address it.
   
   
2. Set a regular time every day for a bowel movement (ideally after breakfast or morning exercise).
   
   
3. Do not delay bowel movements.
   
   
4. Include a high content of fiber in the daily diet.  Fiber is found in whole grains, fresh fruit, and vegetables.
   
   
5. Drink plenty of fluids, preferably water (6-8 glasses a day).
   
   
6. Avoid stimulating chemical or herbal laxatives as much as possible.
   
   
7. Exercise regularly at least 20 minutes three times a week.
   
   
8. Include some type of probiotic.
   
   
9. Supplement daily with magnesium. This can help with an urge to go, plus help keep stools moist. Plus, magnesium has numerous other health benefits.

When bowel retraining is recommended

Biofeedback therapy, Kegel exercises or a program to retrain one's bowel can be utilized by individuals who are dealing with:

• Severe constipation
• Nerve problems, including those with MS
  
• Fecal incontinence

You can use digital stimulation (putting a finger into the anus) to trigger a bowel movement. Perform it every day until bowel movements are more normal.

Steps for bowel retraining

The UNC School of Medicine shares the following steps in bowel retraining:

1. Find a regular time each day without interruption.
   
   
2. After a meal with coffee for example, sit on the toilet for a certain amount of time (15 minutes).
   
   
3. If there is no bowel movement during this time, just get up and go on with regular activities.
   
   
4. If you are unable to have a bowel movement, after 2-3 days, take a Fleets Enema.  This will condition your bowels to go at the same time every day.
   
   
5. Continue taking daily medications prescribed.
   
   
6. Do not become frustrated if you don't have immediate success.
   
   
7. Attempt to relax and be patient.

Research assignments 

1. When you have to defecate, think about what determines the process so you don't misinterpret discomfort or pain.
   
   
2. Learn about the muscle groups used to defecate and your body.

A final note

It is my experience that adding a magnesium supplement to one’s diet can quicken the Bowel retraining for chronic constipation process. Magnesium draws water into the colon. This does a number of things:

• It keeps the stool from drying out
  
  
• It creates hydraulic pressure which helps produce an urge to go AND helps to force the stool on its way
  
  
• A moist stool creates a lubricating effect, helping the stool to move easier through the colon
  
  

(Return from Bowel Retraining for Chronic Constipation to
Treatment for Chronic Constipation)