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Bowel incontinence, or faecal incontinence, is a common problem, affecting 36% of adults in the United States. It occurs when you leak stool, wind, or liquid. Fortunately, there are exercises to strengthen and tighten your anal sphincter, which can help treat or prevent incontinence. These exercises are also beneficial for patients who are due to have a colostomy or ileostomy (stoma) reversal operation. This paragraph will discuss how to train the sphincter muscle.
How to Train the Sphincter Muscle
| Characteristics | Values |
|---|---|
| Purpose | To treat or prevent faecal incontinence/bowel leakage |
| Muscle Location | Thick bands of muscle surrounding the entrance of the anus |
| Muscle Function | Open and close to keep stool inside the body until a bowel movement is required |
| Muscle Weakness Causes | Childbirth, constipation, straining, ageing, lack of use |
| Muscle Weakness Effects | Leakage of wind, liquid, or solid stool, difficulty cleaning after using the toilet |
| Muscle Weakness Solutions | Sphincter exercises, also known as Kegel exercises or pelvic floor muscle training |
| Exercise Frequency | 3 times a day |
| Exercise Positions | Sitting, standing, or lying down with legs slightly apart |
| Exercise Technique | Contract and release the sphincter muscle, squeezing for up to 10 seconds, repeating up to 10 times |
| Additional Techniques | Biofeedback therapy, electrical stimulation, rectal stimulation, bowel retraining |
| Professional Support | Healthcare provider, continence physiotherapist, specialist continence nurse, physical therapist |
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What You'll Learn
Kegel exercises
Pelvic floor muscles can weaken with age, obesity, or due to other factors such as pregnancy, childbirth, or surgery. Weak pelvic floor muscles can cause accidental gas passing, and urinary or faecal incontinence.
To perform Kegel exercises, sit, stand, or lie down with your legs slightly apart. Squeeze the muscles for as long as you can, up to 10 seconds, and then relax. Repeat this 10 times, and then do a set of squeezes as hard as you can, relaxing after each one. Repeat this set 10 times as well, and perform each set of exercises 3 times a day. As you get more comfortable, you can gradually increase the number of Kegels you do in each session.
If you are pregnant, Kegel exercises can make delivery easier by giving you greater control over your pelvic muscles during labour. However, doing too many Kegels can cause your muscles to become too tense, so be mindful of this.
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Pelvic floor muscle training
Once you have located the correct muscles, contract them by squeezing and lifting. Avoid tightening your abdomen, buttocks, or thighs. Hold the contraction for about 5 seconds, then release and relax for another 5 seconds. Repeat this process 10-15 times, aiming for three sets per session.
There are also specific exercises that focus on the anal sphincter muscle, which can help improve bowel control. These exercises can be done in various positions, such as sitting, standing, or lying down. You can also use a vaginal cone, which is a weighted device inserted into the vagina, to strengthen the pelvic floor muscles. If you are unsure whether you are doing the exercises correctly, a healthcare professional, such as a physiotherapist, can guide you through the routines and help you keep track of your progress.
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Biofeedback therapy
The effectiveness of biofeedback therapy for incontinence depends on how well the patient responds to the advice and exercises. It is important to measure gains on an individual basis, using a patient-specific baseline to assess improved muscle control.
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Electrical stimulation
The purpose of electrical stimulation is to improve muscle function by transforming fatigable fast-twitch muscle fibres into less-fatigable slow-twitch fibres. This therapy can be administered in different ways, using a variety of stimulation parameters, and is often used alongside other therapies. Electrical stimulation can be applied via anal, perineal, and perineal-to-suprapubic electrode montages, with the anal montage evoking pelvic floor muscle contraction at a lower current intensity than perineal montages.
In a study by Mahony (2004), there were contradictory findings, with no difference found between biofeedback and exercises compared to the same treatment plus electrical stimulation. However, the absence of a non-treatment control group and long-term follow-up leaves room for uncertainty regarding the true effectiveness of electrical stimulation in this context.
Another study by EndoStim, the manufacturer of the LES stimulation system, conducted an open-label trial using electrical stimulation of the lower oesophageal sphincter (LES) in patients with GERD. The system was implanted laparoscopically and programmed to deliver intermittent stimulation to the LES. The trial showed positive results at the 2-year follow-up, with patients experiencing improvements in their symptoms.
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Bowel retraining
Before starting a bowel retraining program, it is important to speak with a doctor to rule out other disorders that may cause constipation or incontinence. A doctor will take a full medical history, including bowel patterns, diet, and medications. They may also recommend a physical exam to assess bowel control, which could include a rectal exam or an anoscopy.
To begin bowel retraining, set a regular time for daily bowel movements. The ideal time for a bowel movement is 20 to 40 minutes after a meal, as eating stimulates bowel activity. Choose a time that fits your daily schedule and when you can relax and have privacy.
It is important to maintain a regular pattern for the success of a bowel retraining program. Most people are able to establish a regular routine of bowel movements within a few weeks. In addition to bowel retraining, eating nutritious, well-balanced meals with plenty of fiber and fluids may help promote regular bowel movements and improved stool consistency.
Some bowel retraining programs also involve working with a therapist on biofeedback, which helps you learn more about how your body works and gain control over bodily functions, including bowel movements. Biofeedback can also help you differentiate between stomach pain and the need to go to the bathroom.
Kegel exercises can also be used to increase pelvic and rectal muscle tone to improve bowel control. These exercises were initially developed to control incontinence in women after childbirth.
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Frequently asked questions
Some exercises to train the sphincter muscle include Kegel exercises, pelvic floor muscle training, and biofeedback therapy. These exercises can be done in various positions such as sitting, standing, or lying down. It is important to do these exercises regularly and correctly to see effective results.
If you are experiencing fecal incontinence or leakage of stool and gas, you may benefit from training your sphincter muscle. This is a common problem that affects 36% of adults in the United States. Training your sphincter muscle can help you improve your bowel control and quality of life.
It can take several months of regular and correct exercise to see effective results in sphincter muscle training. It is important to be consistent and patient with your training routine. Additionally, seeking guidance from a healthcare professional or physical therapist can help you achieve better results.
