Emptying your bowel more effectively

Some people find it difficult to empty their bowel completely after rectal surgery. 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.

Problems emptying your bowel

After rectal 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 leakage of stool after you go to the toilet
  • needing to return several times after having a bowel movement.


Things you can do to help

It’s best to hold off going to the toilet until the urge to pass a stool is strong. For most people the best time to empty the bowel is around 30 minutes after eating a meal (breakfast or main meal).

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

Sitting in the right position is very important in helping 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.

Brace position
Brace position

This diagram shows the correct position for emptying your bowels

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

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

A food and symptom diary will help you to learn how different foods affect you.

Some people may need to take laxatives to stimulate their bowel as well as making dietary changes. Your doctor or a continence adviser can assess your need for 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; suppositories, enemas or bowel irrigation may be recommended for you. 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, such as glycerin, which encourages the bowel to empty. They usually take about 10-30 minutes to work.


Enemas

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


Bowel or colostomy irrigation

This is a way of emptying the bowel by introducing warm water into it. Some people use bowel irrigation to help control an irregular bowel habit.

It means you can empty your bowel at a time that suits you and that you are less likely to have leakage or incontinence at other times.

Irrigation can also be used to regulate a stoma (this is called colostomy irrigation). This can mean fewer worries about a stoma becoming active at inconvenient times.

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

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

If you want to know more about bowel or colostomy irrigation, ask your continence specialist or stoma nurse. If it’s suitable for you, you’ll be taught how to do it and given the equipment you need to carry it out.

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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There are ways to manage changes in the way your bladder works. It’s important to talk to your doctor if you’re having problems.