STEP 5: DEVELOP A VOIDING STRATEGY
How and when we use the restroom can have a big effect on our bodies and our incontinence. The way we position ourselves, how much and when we drink can make a big difference. See below for some tips to incorporate.
Did you know that our ancestors typically used a squatting position when eliminating? The squatting position is the most natural position to void, as it relaxes the pelvic floor, allowing for easier and more effective elimination. Yet, due to the modern advances of toilets, it is more common for people to sit vs. to squat. There is a simple solution, however. By utilizing a small foot stool when you use the restroom, you can position yourself in a "squatting" position, making it easier for you to eliminate. See www.squattypotty.com for stools specifically designed for this purpose (but know that any small foot stool will work).
BLADDER RETRAINING STRATEGIES
Strengthening and training your bladder and sphincter muscles can help prevent you from running to the restroom every five minutes. There are a couple of ways you can do this:
- Schedule Bathroom Visits. Once you’ve determined how frequently you use the bathroom, you add 15 minutes to that time. Let’s say you go to the bathroom ever hour. During retraining, you will aim to go every hour and fifteen minutes. Even if you don’t have to go, you still want to make the trip to the bathroom. This trains the brain and body. After a set number of days, gradually increase the amount of time between bathroom breaks.
- Delay Urination. Easier said than done. But when you feel the need to go, try holding off for at least 5 minutes. Then 10. And so on until you can make it 3-4 hours between urination. The key will be to stay on schedule, which keeps the training on track.
BOWEL RETRAINING STRATEGIES
The idea of bowel retraining is to stimulate bowel movements so that your body begins to establish a more regular voiding pattern. Most people who initiate bowel retraining begin to see more regular patterns within a few weeks.
- Insert a lubricated finger into the anus and make a circular motion until the sphincter relaxes. This may take a few minutes.
- After you have done the stimulation, sit in a normal posture for a bowel movement. If you are able to walk, sit on the toilet or bedside commode. If you are confined to the bed, use a bedpan. Get into as close to a sitting position as possible, or use a left side lying position if you are unable to sit.
- Try to get as much privacy as possible. Some people find that reading while sitting on the toilet helps them relax enough to have a bowel movement.
- If digital stimulation does not produce a bowel movement within 20 minutes, repeat the procedure.
- Try to contract the muscles of the abdomen and bear down while releasing the stool. Some people find it helpful to bend forward while bearing down. This increases the abdominal pressure and helps empty the bowel.
- Perform digital stimulation every day until you establish a pattern of regular bowel movements.
- You can also stimulate bowel movements by using a suppository (glycerin or bisacodyl) or a small enema. Some people drink warm prune juice or fruit nectar to stimulate bowel movements.
Like any training regimen, consistency is crucial for the success of a bowel retraining program. Establish a set time for daily bowel movements that fits into your schedule and one that will not be compromised. An optimal time is 20 to 40 minutes after a meal as feeding stimulates bowel activity.