Are concerns about needing to relieve yourself before leaving home disrupting your daily life? The urgency to empty your bowels can be distressing and embarrassing. Dealing with diarrhea or loose stools, especially when you're away from home, can lead to panic and anxiety. Many individuals avoid social activities or outings with family due to the fear of needing to use the restroom. Fortunately, we’re here to help.
Before we began, let’s make sure you understand normal bowel function.
The brain, pelvic floor muscles, anal sphincters, and anal reflexes collaborate to maintain bowel control until a convenient time for emptying. When a typical, well-formed stool enters the rectum, it exerts increased pressure, creating a sensation of fullness. If it's not the right time to use the toilet, the external anal sphincter contracts to delay bowel emptying, and the urge subsides.
What factors might contribute to your bowel urgency?
Several factors can contribute to bowel urgency, including:
Loose stools
Hypersensitive nerves leading to increased urgency
Poorly functioning pelvic floor and anal sphincter muscles (often caused by childbirth, straining during bowel movements, surgery, stress, pelvic pain, or aging)
Changes in how the brain interprets signals from the bowel, often influenced by emotions, especially anxiety and fear
Reduced rectal and anal sensation
Previous bowel surgeries
Medications like antibiotics or diabetes medications
Inflammatory bowel diseases like diverticulitis or Crohn's disease
What Can You Do?
Here are some steps to regain control of your bowel movements:
1. Speak to your doctor and make sure they’re part of your team
Visit your general practitioner to rule out infections or food poisoning as causes of diarrhea or loose stools. If you notice blood in your stool or an unexplained change in your bowel habits, seek medical attention. Discuss any medications you're taking, as they may play a role.
2. Monitor Your Diet
Maintain a healthy diet and optimal gut microbiome to promote regular bowel movements. Consider starting a fiber supplement (we recommend psyllium husk) to form more solid stools, enhancing control. Some people respond really well to fiber. For others, adding fiber can be contributing to the problem. Food intolerances, such as gluten or dairy, can also affect your gut, so consult a nutritionist to get to the root cause.
3. Establish Good Bowel Habits
Establishing a regular bowel routine is crucial for healthy bowel function. Predictable bowel movements and effective emptying can reduce urgency and boost your confidence when leaving home. A pelvic health therapist can assist you in developing a personalized routine.
4. Optimize Bowel Emptying
Efficient bowel movements involve complex muscle coordination, including pelvic floor and abdominal muscles. Proper mechanics, combined with the correct toilet posture, are essential for effective emptying.
5. Strengthen Pelvic Floor Muscles
For some experiencing urgency, pelvic floor muscles may be weak, while others may have tense pelvic floor muscles. A pelvic health therapist can assess and teach you how to correctly engage and relax these muscles, a vital step before starting a pelvic floor muscle training program. Biofeedback can also aid in controlling urges and preventing accidents.
6. Manage Anxiety and Emotional Responses
Anxiety triggers the "fight or flight" response, speeding up gut movement, resulting in loose stools and increased urgency. Managing anxiety and returning to a "rest and digest" state can help slow gut movement and reduce diarrhea and urgency. A pelvic health practitioner can assist in breaking this cycle and regaining control.
There are several factors to consider when addressing bowel urgency, and a pelvic health physiotherapist can assess and manage them, enabling you to live your life without the constant worry of finding the nearest restroom!
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