Advice and Exercises for People with Bowel Evacuation Disorders

Everyone expects going to the toilet to open their bowels and have a poo, to be a simple and easy body function that doesn’t take much thought or effort. However, if you have a bowel evacuation disorder, going to the toilet can be a much more difficult (and often daunting) process. However, don’t be dismayed, there are some simple things that can help!

General Advice

• Try to establish an un-hurried toileting routine
• Make time to go to the toilet every day:
  • A good time is 30minutes after breakfast (or evening meal)
  • Regardless of an urge being present, keep to this routine
• Relax before opening bowels and breath normally
• ‘Brace’ or widen the waist for effective propulsion
• Relax the muscles instead of squeezing them
• Do not sit on the toilet for longer than 10minutes in total

Sit correctly on the toilet:

• ensure your legs are slightly apart, knees approximately in line with your shoulders, with your feet up on a small stool or step so that your knees are slightly higher than your hips.
• Rest your forearms on your knees and relax your shoulders to release tension in your jaw.

Image courtesy of Elaine Miller, Physiotherapist.  Creative Commons Attribution-No Derivatives 4.0 International Public License.  https://www.evidentlycochrane.net/feet-up-constipation/

There are also some simple exercises you can do whilst on the toilet, to make opening your bowels easier:

• When you are opening your bowels, ensure you are relaxing your pelvic floor and sphincter and not inadvertently tightening it
• Gently bulge your tummy forward and breath out through pursed lips
• Some people find making a ‘shhhh’ or ‘hisssssss’ sound helpful
• A number of people find it helpful to use their fingers or hand to apply pressure to the perineum – the area between your anus and scrotum or anus and vagina, to help initiate and/or empty the bowels more effectively
• In females, it can also be helpful to apply pressure with their fingers or thumb to any bulging areas of the vaginal walls to help with emptying

With thanks and acknowledgement to Emily Hoile, Specialist Pelvic Health Physiotherapist at Torbay and South Devon NHS Foundation Trust for allowing permission to adapt her work.