Emptying your bowel more effectively

Some people find it difficult to empty their bowel completely after surgery to the bowel. It’s important to tell your doctor if you’re having problems as there are lots of things that can help.

When you go to the toilet, you shouldn’t need to strain or sit down for a long time before anything happens. It’s best to wait until you really feel the need to go. Most people find the best time is about 30 minutes after a meal. Sitting in the right position on the toilet can help get things moving. Lean forward and rest your elbows on your knees – your knees should be higher than your hips. You may need a low footstool, but speak to your doctor about this if you’ve had hip surgery.

If you’re constipated or have soft stools, your doctor can prescribe fibre or medicines to help. You may be given gels or liquids (suppositories or enemas) to put in the back passage. Some people are taught how to empty their bowel using water. This is called bowel irrigation and should only be done with advice from a healthcare professional.

Emptying your bowel more effectively

After bowel surgery, some people may find it difficult to completely empty their bowel. Signs that your lower bowel may not be emptying completely can include:

  • feeling there is still something in your bowel after you’ve passed a stool
  • having smaller, pellet-like stools (fragmented)
  • having leakage of stool after you go to the toilet
  • needing to go back to the toilet several times after a bowel movement.

Try to hold off going to the toilet until the urge to pass a stool is strong. If this is difficult for you, we have some tips that may help you. For most people the best time to empty their bowel is about 30 minutes after a meal.

Straining to try to complete a bowel movement can weaken your pelvic floor muscles. This can cause problems with bowel control in future. If you have to wait for a long time after sitting down you may be going to the toilet too soon. Or it may be a sign that you’re constipated.

Sitting in the right position can help you to empty your bowels effectively. Lean forward a little and rest your elbows on your knees. Have your knees higher than your hips. It may help to place a small footstool or telephone book under your feet. Don’t strain or hold your breath. You may find using a relaxed breathing technique helps.

The diagram below shows the correct position:

The correct position for emptying your bowels
The correct position for emptying your bowels

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Caution - if you have had recent hip surgery don’t use this position, and always check with your doctor first.

If you have constipation, include more fibre in your diet and eat more foods that encourage (stimulate) your bowel to empty.

Some people may need to take laxatives to stimulate their bowel as well as making changes to their diet. Your doctor or a continence adviser can advise you about laxatives.

Bowel motions that are too soft can also cause problems with incomplete emptying. Look at our suggestions on diet and anti-diarrhoeal medicines for help in dealing with this. If you still have difficulty emptying your bowel completely your specialist may recommend using suppositories, enemas or having bowel irrigation. Your doctor or a continence specialist can talk through these options with you and help you to decide which might suit you best.


Suppositories

You put these into your back passage or stoma. As they dissolve they release a lubricant, which encourages the bowel to empty. They usually take about 10–30 minutes to work.

It may be better to take them at night so they have longer to work. You may not need to use them every day.


Enemas

These contain a small amount of gel or liquid that you squeeze into the lower bowel. This stimulates it to empty.


Bowel or colostomy irrigation

This is a way of emptying the bowel by introducing warm water into it. You should only use bowel or colostomy irrigation if it’s recommended by a health professional.

Bowel irrigation may help to control an irregular bowel habit. You can empty your bowel at a time that suits you. You will be less likely to have leakage or incontinence at other times.

You place a narrow, flexible tube (catheter) into your back passage or stoma. You then put water into the bowel through this. You usually do this every day or every other day. It takes about half an hour.

Irrigation can also be used to regulate a stoma. This is called colostomy irrigation. It can mean fewer worries about a stoma becoming active at inconvenient times. Your continence specialist or stoma nurse can tell you more about bowel or colostomy irrigation. If it’s suitable for you, they can teach you how to do it. They will also arrange for you to get the equipment you need on prescription.

Some people find bowel or colostomy irrigation too time-consuming. But, others feel more in control of their bowel and more confident as a result.

You should only use bowel or colostomy irrigation if recommended by a healthcare professional.

Back to Long-term and late effects

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