Developing a Good Bowel Habit


The best way to expel your faeces

Defaecation is a complex procedure involving colonic peristalsis, and anal relaxation. It is initiated by a centre in the base of the brain and orchestrated by a collection of nerve cells at the bottom of the spinal cord.

The arrival of faeces in the rectum signals the urge to defaecate.  At the same time, it encourages the rectum to contract and the anal sphincter to relax. Movement of faeces down into the upper part of anus intensifies the urge.  So if the time and place are right for defaecation, sit comfortably and breathe deeply, allowing a long expiration. This encourages peristalsis and relaxes the muscles of pelvic floor, opening up the angle between the anus and the rectum and reducing the resistance of the sphincter so that faeces stored in the rectum can be eased out with a gentle push.  

Develop good bowel habits

  • Get your bowels into a regular habit of going in the morning after breakfast.

  • When you have the urge to open your bowels, don’t resist it, go as soon as you can.

  • You don’t have to go every day and it really doesn’t matter if you have to go several times a day.

  • Make sure your toilet is warm and comfortable.

  • Do not strain when you are trying to open your bowels. Relax, sit upright, breathe deeply and let the urge grow stronger, and when you feel ready, give a gentle push.

  • If the urge goes away, get off the toilet, get on with your routine and wait for the urge to come again.

  • Don’t hold on to wind. Find somewhere where you can release it without embarrassment.

The UCH Abdominal Brace

This technique is used by nurses at the University College Hospital to advise effective defecation

  • Think about posture and breathing. Place a box or a pile of books just in front of the toilet and when you sit down, put your feet on it. This may make defaecation easier by reducing the angulation between the anus and the rectum. Relax, sit up straight, put your hands on your hips, breathe in and breathe out slowly. Feel the sensation of stool in the rectum and then push. Do not strain; it will only make things worse.
  • Place your hands at the sides of your waist and cough. Feel your waist widen. These are the muscles to use when pushing to go to the toilet.
  • Take a few gentle deep breaths then slowly brace outward, widen your waist.
  • When fully braced, push down from your waist in to your back passage. Do not strain.
  • Relax for a second
  • Brace outwards and push downwards again, using the brace as a pump to empty your bowels

Does it matter what my stools look like?

The shape and consistency of stools that are passed can vary from loose and soupy to hard and pelletty. Harder and more lumpy and pelletty stools (Types 1 and 2 on the Bristol Stool Scale)  tend to occur when contents are moving more slowly through the colon.  This might be related to a diet low in fibre, lack of exercise, medication or secret stress. More sloppy stools are often indicative of rapid transit.

Stool shape and consistency are for the most part just indicators of colonic function.  But if you are struggling to pass your motions just once or twice a week or if you are passing blood in your motions,  do seek further advice from your doctor.

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