# Bowel Retraining



## Pinskers (May 16, 2013)

Have any of you worked with this?

I can't seem to go unless I'm very, very relaxed, nothing going on in my life, etc. On the weekends, I will go three or four times a day before it starts back up again during the work week (after not going for three days, I let Ducolax work its magic overnight). Stools are very easy to pass on the weekend, very good shape and consistency, but I just have no urge on the weekends.

Where do you think I should start for bowel retraining? I've already apparently accustomed them to going on the weekends, but I'd love a weekday to be able to go, too.


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## Dreamcatcher32 (Nov 12, 2013)

Mayo Clinic is the only place I know of that actually has a bowel retraining program for those with Pelvic Floor Dysfunction. I attended it in Rochester, MN and it was very helpful. Though most of the work has taken place AFTER leaving. I have been doing the program for 7 months now. I've heard of some that do it for years before they see a big difference. You are basically 'retraining' muscles that have been in a state of tension for lord knows how long...

It sounds like part of your problem could be psychological as well. That's not to say you are 'making it up' in your head. I am sure the psychological aspect of it is exacerbating the physical problem or vice versa. Nearly everyone that has pelvic floor problems has some sort of OCD or anxiety issue, at least that's what studies show. You COULD get assessed by a local women's urology clinic. You would need to ask them if they offer biofeedback specifically for Pelvic Floor Dyssynergia.


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## Pinskers (May 16, 2013)

Good call! I was diagnosed with panic disorder in April and take 100mg of Zoloft for it (I get really debilitating panic attacks associated with my vomiting phobia-not the best phobia to have when you have GI issues, I know). I was diagnosed with OCD when I was around three. I DO feel strangely about using unfamiliar restrooms or places where I might be embarrassed to go.

Do you know if insurance covers bowel retraining? Is there anything I can do at home in the meantime?


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## Kathleen M. (Nov 16, 1999)

A lot of time it is a do at home (but there may be a professional to help guide also if there is testing needed for outlet issues, like tensing when you should relax and then biofeedback to help control that).

http://www.med.unc.edu/ibs/files/educational-gi-brochures/BowelRetrain.pdf is the brochure from the clinic I went to for other GI issues, usually their stuff is pretty up-to-date and has all the usual recommendations.


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## Dreamcatcher32 (Nov 12, 2013)

Pinskers said:


> Good call! I was diagnosed with panic disorder in April and take 100mg of Zoloft for it (I get really debilitating panic attacks associated with my vomiting phobia-not the best phobia to have when you have GI issues, I know). I was diagnosed with OCD when I was around three. I DO feel strangely about using unfamiliar restrooms or places where I might be embarrassed to go.
> 
> Do you know if insurance covers bowel retraining? Is there anything I can do at home in the meantime?


Yep, my insurance covered it. Mayo told me more and more it's being covered! I think a lot of people feel strangely about using unfamiliar restrooms or places, that's pretty common. Your other symptoms are what make me think you might have some pelvic floor problems.

In the mean-time, you really just need to be calm and re-assure yourself that you'll find help for your problem. Just try not to research it or stress out about it. It's only natural to do that to some degree but at the same time, it will do you no good to worry yourself. Just try your best to think positively! I also would be sure not to go 3-4 times a day. That's not really necessary. Maybe just go when you have a VERY strong urge to go. Being a nervous person kind of makes you 'rush' to the bathroom when you get a small urge. But be sure to wait that out until it's strong! If it goes away - it will come back. Just try to relax as much as you can on the pot and push very little.


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## Aidara (May 9, 2014)

Dreamcatcher, why people with pelvic floor dysfunction usually have some sort of anxiety? What OCD or anxiety have to do with pelvic floor muscles? Is this because you get obsessed with bowel movements over the time thus develop an anxiety or is it something else? Thank you for your reply.


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## Dreamcatcher32 (Nov 12, 2013)

Aidara said:


> Dreamcatcher, why people with pelvic floor dysfunction usually have some sort of anxiety? What OCD or anxiety have to do with pelvic floor muscles? Is this because you get obsessed with bowel movements over the time thus develop an anxiety or is it something else? Thank you for your reply.


Aidara, I wish there was an easy answer to this. There are many theories but causation is subjective, unfortunately. What you're saying is definitely one of the theories for those with OCD/anxiety and PFD. Due to anxiety, you're tensing your pelvic floor without even being aware of it, which is easier than a person thinks. Here is a good study on the subject: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3498251/

Think of PFD as a result of brain to bowel connection being lost or 'fogging up.' Different things can make that happen - a chronically tight pelvic floor (most common), a slow colon (also often occuring from PFD) or Colonic Inertia (very rare - according to Mayo Clinic). You can re-form the connections in the brain by relaxing the pelvic floor and 'opening the gates' so to speak. But I guarantee it will take more than 2 weeks of bowel retraining to 'help' matters. It's why so often you see people saying, "Biofeedback didn't work!" and being outraged at Mayo Clinic. It's ridiculous. Even they doesn't prescribe this for enough time. They say 2-3 months and I say you'll need to do it for as long as you've had PFD. People also learn at their own pace and the severity of the condition matters too.

Sorry to hop on my soap box - I just see so many struggling with this condition and not getting a proper diagnosis. Even an Anorectal Manometry did not diagnose me with PFD (I passed it). The biofeedback nurses had to 'check' my muscles. So be sure you go to a woman's urology clinic that deals specifically in diagnosing and treating Pelvic Floor Dyssynergia. Either that or a trip to Mayo Clinic may be in order - I went to Rochester, MN. Wasn't going to mess around anymore.


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