Logan Steele
The bowel is part of the digestive system and is made up of the small bowel and the large bowel. The small bowel absorbs nutrients and minerals from food, while the large bowel, or colon, absorbs water and contains bacteria that break down food into waste. The colon moves the waste into the rectum, which is the final section of the large intestine. The rectum and anal canal are embedded in the pelvic floor muscles, which support the openings of the vagina, rectum, and urethra. The anal canal is closed off by the internal and external sphincter muscles, which control the opening of the bowel (anus) and can be voluntarily or involuntarily controlled. The colon is lined with a thick layer of muscle, and the rectum contains nerves and muscles that help hold waste until it is ready to be passed through the anus.
| Characteristics | Values |
|---|---|
| Definition | The bowel is part of the digestive system, made up of the small bowel and the large bowel. |
| Parts | The bowel consists of the small bowel, large bowel, rectum, anal canal, and anus. |
| Function | The bowel absorbs nutrients and minerals from food, with the small bowel absorbing nutrients and the large bowel absorbing water. |
| Muscle Control | Bowel control depends on the strength of the muscles around the anus, including the internal and external sphincter muscles. |
| Nerve Function | Sacral nerves, such as the pudendal nerve and pelvic splanchnic nerve, play a vital role in coordinating the activities of the rectum, muscles, and sphincters for bowel function. |
| Leakage Prevention | The external sphincter muscle, supported by the internal sphincter, prevents leakage by keeping the anus closed until defecation. |
| Dietary Impact | A high-fibre diet with fruits and vegetables can impact bowel control by affecting stool consistency and ease of control. |
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What You'll Learn
The bowel is part of the digestive system
The bowel is indeed part of the digestive system. It is made up of the small bowel and the large bowel. Food leaving the stomach enters the small bowel, which absorbs nutrients and minerals from the food. The small bowel is a long tube that sits in the abdomen and leads to the large bowel. The large bowel, or large intestine, is a wider tube that starts on the lower right side of the abdomen, goes up, then across the top of the abdomen and down the left side of the body.
The food then moves from the small bowel into the colon, which is part of the large bowel. The colon absorbs water and contains bacteria that break down food into waste matter. The colon moves the waste into the rectum, which is the final section of the large intestine. The rectum is about 20 cm long, and this is where the indigestible parts of food collect until the bowel is emptied. The rectum and anal canal are embedded in the pelvic floor muscles, which support the openings of the vagina, rectum, and urethra.
The pelvic floor muscles, when well-toned, ensure the anus remains closed until it is time to go to the toilet. The anal canal is situated between the rectum and anus and is closed off by the internal and external anal sphincters, which are made of smooth muscle and striated muscle, respectively. We have voluntary control over the external anal sphincter, which allows us to hold on in case of wind or diarrhoea. The internal anal sphincter works automatically to keep the anus closed until we are ready to have a bowel movement.
The pudendal nerve and the pelvic splanchnic nerve are vital to the functioning of the bowel. These nerves coordinate with the pelvic floor muscles and anal sphincters to store bowel contents until it is time to go to the toilet, and then allow complete bowel emptying.
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The small and large bowel
The intestine, also called the bowel, is a muscular tube that extends from the lower end of the stomach to the anus, the lower opening of the digestive tract. The intestine is divided into two sections: the small intestine and the large intestine.
The small intestine is made up of three segments: the duodenum, jejunum, and ileum. The duodenum is a short section that takes in semi-digested food from the stomach and continues the digestion process, using bile from the gallbladder, liver, and pancreas. The jejunum is the middle section of the small intestine, which carries food through rapidly with wave-like muscle contractions towards the ileum. The ileum is the longest part of the small intestine, where most of the nutrients from food are absorbed before emptying into the large intestine. The small intestine carries out the majority of the digestive process, absorbing almost all of the nutrients from food into the bloodstream.
The large intestine, or colon, is a long tube that starts at the small intestine and turns food waste into stool. It includes the cecum, colon, rectum, and anus. The large intestine absorbs water and salts from the material that has not been digested, and gets rid of any waste products left over. The large intestine is much broader than the small intestine and takes a straighter path through the abdomen.
Bowel movements are controlled by the rectum, anal sphincter muscles, and hemorrhoids, which are embedded in the pelvic floor muscles. The internal anal sphincter (IAS) is made of smooth muscle and is not under voluntary control. It works automatically to keep the anus closed until a bowel movement occurs. The external anal sphincter (EAS) is made of striated muscle and can be controlled voluntarily, allowing one to hold in stool or release it.
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Nerves and muscles in the rectum
The bowel is not a muscle but the last part of the bowel, the rectum, is surrounded by muscles and nerves. The rectum is the final section of the large intestine (colon) and is about 20 cm long. It is where indigestible food collects until the bowel is emptied.
The rectum is surrounded by the puborectalis muscle, which forms the anorectal flexure, contributing to faecal continence. The rectum is also surrounded by the internal and external anal sphincters, which are ring-like muscles that close off the opening of the bowel (anus). The internal sphincter is made of smooth muscle and we do not have voluntary control over it. The external sphincter, on the other hand, is made of striated muscle, similar to the pelvic floor muscles, and we can voluntarily control it to hold in or release stool.
The pelvic floor muscles are layers of muscle stretched like a sheet from the pubic bone to the bottom of the backbone (coccyx). In women, there are three openings through the pelvic floor for the urethra, vagina, and anus, while in men, there are two openings for the urethra and anus. The pelvic floor muscles support these openings and relax when we have a bowel movement, allowing the muscle in the rectum to push out stool.
The rectum and anal canal are richly supplied with nerves that send signals to the brain about the consistency of stool and whether the bowel is full. Two key nerves that are vital for bowel function are the pudendal nerve and the pelvic splanchnic nerve. These nerves coordinate with the pelvic floor muscles and anal sphincters to store bowel contents and allow complete emptying during defecation. The S1 nerve rootlet is also important for innervating the anal canal and rectum, as seen in rat studies.
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The role of the pelvic floor
The bowel is made up of muscles, including the internal and external anal sphincters. The pelvic floor is also made up of muscles, ligaments, and connective tissue. It plays a critical role in the body's ability to function.
The pelvic floor supports the pelvic organs, including the bladder, bowel, and uterus (womb) in women. It also supports the urethra, the tube that carries urine out of the body, and the vagina in women. The pelvic floor muscles wrap around these passages to help keep them shut.
The pelvic floor muscles give you the ability to control the release of urine, faeces, and flatus (wind) and to delay emptying until it is convenient. When you contract the pelvic floor muscles, they lift the internal organs of the pelvis and tighten the openings of the vagina, anus, and urethra. Relaxing the pelvic floor allows the passage of urine and faeces.
Pelvic floor muscles can weaken over time due to injury, trauma, childbirth, surgery, and the ageing process, leading to conditions like incontinence or pelvic organ prolapse. They may also weaken due to hormone changes during menopause, diabetes, and cancer treatments such as chemotherapy and radiation.
Exercising the pelvic floor muscles can help to combat the negative effects of weakness in this area. Pelvic floor exercises involve squeezing and releasing the muscles used to stop the flow of urine or to prevent passing gas. It takes 12 to 16 weeks to strengthen any muscle, and improvements in pelvic floor strength take three to four months of daily exercise.
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Bowel control and incontinence
The bowel is made up of several parts, including the rectum and anal canal, the sphincters (circular muscles), and hemorrhoids. These parts are embedded in the pelvic floor muscles, which are layers of muscle stretched like a sheet from the pubic bone to the bottom of the backbone. The pelvic floor physically supports the pelvic organs and closes off the lower part of the pelvic cavity.
Bowel control is maintained through the coordination of the rectum, anus, pelvic muscles, and nervous system. The rectum is the final section of the large intestine, where indigestible parts of food collect until the bowel is emptied. The anal canal, situated between the rectum and anus, is closed off by sphincter muscles and hemorrhoids. The inner (internal) sphincter is ring-shaped and made of smooth muscle, and we do not have voluntary control over this muscle. It works automatically to keep the anus closed until we are ready to have a bowel movement. The outer (external) sphincter supports the inner sphincter and can be controlled voluntarily, allowing us to hold or pass stool when needed.
Bowel incontinence, or fecal incontinence, is the loss of bowel control, leading to unexpected passing of stool. This can range from minor leaks to a complete lack of control over bowel movements. It is important to address bowel incontinence with a healthcare provider, as it is often treatable and can even be cured completely. Non-surgical treatments are typically recommended as the initial approach. These may include dietary changes, such as increasing fiber intake to make stool more manageable, avoiding caffeine to prevent diarrhea, and staying hydrated by drinking enough water. Bowel training, which involves scheduling bowel movements at specific times each day, can also help regulate bowel functions.
In addition to dietary adjustments and bowel training, exercises to strengthen the anal and pelvic muscles can improve bowel control. Kegel exercises, for instance, can be practised to enhance the strength of the pelvic muscles. Biofeedback, which involves placing a sensor inside the anus and on the abdominal wall during exercises, provides real-time feedback to improve bowel control. If non-invasive treatments are ineffective, surgery may be recommended. Surgical options include sphincteroplasty, muscle transposition, sphincter cuff devices, colostomy, and radiofrequency anal sphincter remodelling.
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Frequently asked questions
The bowel is part of the digestive system and is made up of the small bowel and the large bowel. Food leaving the stomach enters the small bowel, which absorbs nutrients and minerals from food. The food then moves into the colon, which absorbs water and contains bacteria that break down food into waste matter. The colon moves the waste into the back passage (rectum).
Muscles in the bowel include the anal sphincters, which control when you empty your bowels. There are two rings of muscles around the anus, which form the anal sphincters and act to hold in the bowel contents. The internal anal sphincter (IAS) is made of smooth muscle, while the external anal sphincter (EAS) is made of striated muscle. The pelvic floor muscles are also important for bowel control.
The nerves in the bowel coordinate with the pelvic floor muscles and anal sphincters to store bowel contents until there is an appropriate place to go to the toilet and then to allow complete bowel emptying. When the rectum fills, the nerves sense the pressure and inform the brain whether it is due to gas or stool. The brain then sends signals to keep the external sphincter closed until it is time to open the bowels.
To improve bowel control, it is important to have strong muscles around the back passage. This can be achieved through exercises that involve squeezing the area many times each day to strengthen the muscles.
