| Subject | Contents |
| Definition | |
| Alternative Names | Exercises for fecal incontinence |
| Information | People with incontinence '>fecal incontinence resulting from a variety of causes may benefit from a program of bowel retraining, Kegel exercises , and/or biofeedback therapy. The bowel program consists of several steps aimed at producing regular bowel movements. Within a few weeks of beginning a bowel program, most people can achieve regular bowel movements. PRIOR TO STARTING: Prior to beginning a bowel training program, you should receive a thorough physical examination to identify the cause of the incontinence '>fecal incontinence and treat any correctable disorders (such as a fecal impaction or infectious diarrhea ). A history of your bowel habits and lifestyle considerations should serve as a guide for establishing new bowel elimination patterns. DIET: The diet should be modified to include adequate fiber and fluid intake to promote regular, soft, bulky stools. Add high fiber foods to the diet including whole-wheat grains, fresh vegetables, beans. Additionally, psyllium containing products such as Metamucil or similar products can be used to add bulk to the stools. Try to drink two to three liters of fluid a day (unless you have a medical condition requiring you to restrict you fluid intake, such a kidney or heart disease ). BOWEL TRAINING: Establish a set time for daily bowel movements; choose a time that is convenient for you keeping in mind your daily schedule. It is very important to be consistent in the time of day bowel training is performed. The best time for a bowel movement is 20 to 40 minutes after a meal since food stimulates bowel activity. Some people drink warm prune juice or fruit nectar as a stimulus to bowel movements. Additionally, bowel movements may be stimulated by digital stimulation. Digital stimulation is performed by inserting a lubricated finger into the anus and using a circular motion, stimulate the lower bowel until the sphincter relaxes. This may take a one or two minutes. If digital stimulation does not produce a bowel movement within 20 minutes, you may repeat this procedure again. Digital stimulation should be performed every day to stimulate bowel movement, until a pattern of regular bowel movements is established. Bowel movements may also be stimulated by using a suppository (glycerin or Dulcolax) or a small enema. After stimulation has been performed, assume a normal posture for bowel movement. If you able to walk, sit on the toilet or bedside commode. If you are confined to the bed, use a bedpan, in as close to a sitting position as possible, or use a left side lying position if unable to sit. Try to ensure privacy as much as possible. Also, some people find that reading while sitting on the commode helps them relax and aids in bowel evacuation. Try to contract the abdominal muscles and bear down while expelling the stool. Some people find it helpful to bend forward while bearing down, as this increases the abdominal pressure and helps evacuate the bowel. Consistency is crucial for the success of a bowel retraining program. Try to establish a time for bowel movements and stick to this time. Within a few weeks, most people are able to establish a regular routine of bowel movements. KEGEL EXERCISES: Strengthening the tone of the rectal muscles may help achieve some degree of bowel control in those people who have incontinence '>fecal incontinence caused by an incompetent rectal sphincter. Exercises to strengthen pelvic and rectal muscle tone are often called Kegel exercises. These exercises were originally developed as a method of controlling incontinence in women following childbirth. The success of Kegel exercises depends on proper technique and adherence to a regular exercise program. See - Kegel exercises for detailed information on how to correctly perform these exercises. BIOFEEDBACK: Biofeedback is a method of providing audio or visual feedback to a person about some bodily function, such as muscle activity. In people with fecal incontinence, biofeedback is used to strengthen the tone of the rectal sphincter. A rectal plug is used to monitor the strength of the rectal muscles. Additionally, a monitoring electrode may be placed on the abdomen. The rectal plug is then attached to a computer monitor which displays some type of graph showing rectal muscle contractions and inappropriate abdominal contractions. The person is taught how to squeeze the rectal muscle around the rectal plug, using the computer display as a guide to ensure correct technique. The person should see an improvement in symptoms after three sessions. |
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