Sitting on a toilet is the way most people empty their bladder or bowels.
But, if you are not sitting in a good position on the toilet this can prevent you from fully emptying your bowels or lead to straining and related problems.
Straining or difficulty emptying your bowels is very common, with 1 in 5 adults affected.
This can lead to many long term problems including:
- Constipation
- Pelvic pain
- Urinary infections
- Bladder leakage
- Pelvic organ prolapse
- Faecal incontinence
- Haemorrhoids
- Bleeding and pain
Bowel control – how it works:
Your bowel works to absorb nutrients and water, the rest is passed through to be stored until you are ready to go.
Normally this is as a smooth, soft, formed stool (type 3-4 on Bristol Stool Chart).
This is stored in your rectum by your anal spincter muscles. The pelvic floor muscles also helps to keep active control over storing your stools – until you get an urge to empty.
This picture shows why sitting position is so important when you are on the loo.
Sitting upright your rectum is naturally “ kinked” which helps you keep control. However if you squat, this helps open up your back passage, relax your pelvic floor and make emptying your bowel easy.
Emptying your bowel – how it works:
- Normally you will feel an urge to empty your bowels – this is from the sensors in your rectum that notice this area is full.
- You go to the toilet to empty.
- Your pelvic floor and anal spincter muscles relax allowing your bowels to empty.
- This process should not require straining or pushing.
So – what can you do about it? Good bowel habits!
- Adapt your sitting position to help your body – see the instructions below. Maybe print a copy off to have on the toilet door!
- Relax and breath, remember this is a normal body function and doesn’t need you to push and strain to get there.
- Aim for number 4 stools (on the Bristol stool chart) – soft and smooth, easy to pass. To help with this you can try to meet the recommended dietary goals for health eating, see this website for details. Aim for at least 1.5L of fluid per day (more if its hot or you have exercised), plenty of fresh veggies and fruit as well as wholegrains – this will help provide your body with fibre and enough fluid to avoid hard and dry stools.
- Exercise at moderate intensity, 30min five times a week. This helps to stimulate bowel activity as well as providing health benefits for your whole body
Jane Rothe
myPhysioSA Senior Women’s Health Physiotherapist
