Have you ever been with someone who simply continues going to the bathroom?  Or may never get to the bathroom in time?  These are basic functions that nearly everyone takes for granted from a young age, usually around the age of 2.  Routine bodily functions are often lost and need to be relearned following a traumatic brain injury and many other illnesses and injuries. 

Often patients are taught bladder and bowel retraining on an inpatient-rehabilitation unit just as the patient is emerging from unconscious states or a coma.

Many levels of brain injury, spinal cord injury, and various illnesses cause these issues.  Often,  patients are expected to deal with the difficult task of learning something they don’t understand.

Bladder and bowel difficulties are common, but not something the average patient or family would expect. It’s rarely talked about.  The patient and family wonder why others are clueless.  Most people have no idea what others encounter during recovery or rehabilitation.

If you or a loved one are dealing with the inability to control your bladder or bowels here are some simple suggestions.

A good rule of thumb, would be to go to the toilet every two hours, 24 hours a day.  If your loved one is sleeping you need to wake them up and take them to the bathroom.  If  you are having this problem and are taking care of yourself, set the alarm clock to get up during the night.  This takes much dedication to the caregiver or the patient.  You need to retrain the bladder and bowels just as you do for toddlers.  With habit, these functions can usually be retrained.

One can’t say how long this takes as every patient is different.  It can occur in a few short weeks or a much longer duration of time. Retraining is not always possible with spinal cord injuries at certain levels, so one doesn’t want to mislead people.

Retraining the bladder

• Toilet every 2 hours
• Run water in the sink nearby
• Wake up during the night

Urinary system Urinary system Kidney Renal pelvis Ureter Urinary bladder Urethra (Left side with frontal section) Adrenal gland Renal artery and vein Inferior vena cava Abdominal aorta Common iliac artery and vein Liver Large intestine Pelvis (Photo credit: Wikipedia)

Our bodies are a mystery and one has seen some who were not expected to be retrained and yet were successful.  And others, that could not be retrained.  Here I would suggest to give it every attempt for a very long time.  You never know what you can accomplish without trying, even if it appears to be impossible according to scientific reports and tests.  Science is not perfection.  Medicine is a practice.

There is only so much anyone can know, and there are extremes on each side of the spectrum. You will always get the comments “you should be able to” or “I can’t find any reason why he/she can’t perform these functions”…these are simply harsh comments that are meaningless in a long run.  They are ignorant comments.  It’s hard enough the patient and family have so many things to deal with that these comments just add to their frustration, anger, and inability to adjust to life altering injuries and illnesses.

The every two hour rule holds true to retraining the body for urination, peeing or bladder functions.  For bowel, feces, poop a good rule of thumb is to sit on the toilet about 20-30 minutes after eating.  This works for most people, but everyone is different.

Bowel Retraining

• Toilet 20-30 minutes after eating (especially in morning)
• Sit as long as you need to
• Quiet time
• Lean forward or Lean backward
• Prop feet on small step stool and lean forward
  

Regardless, time for sitting on the toilet is needed.  Leaning forward, leaning backward, propping or elevating your feet onto a stool are all helpful with eliminating and retraining the bowels, poop, stools, defecation and whatever other terms you call it.

Many patients will not remember the frequency every two hours, but then again they are focusing just on learning basic life skills.  They cannot handle more complex tasks in life.

Doesn’t this make you think and wonder why employers believe these people can return to work and hold down their previous positions? There’s a lot of pressure put on these people that are trying to just figure out what they have to learn next.

Employers want to know why you haven’t returned to work 6 weeks following injury, 6 months after injury or even longer.  How many employers would allow for training all these bodily functions?  Are we forgetting that our bodies are the most complex machines in existence?

This is a simple overview of what people deal with while discovering how they have changed, and what they need to do to live their optimal level of functioning.  In another post I will address more details.  Here, I want you to know you are not alone and as personal of an issue here are the basic steps to retraining your bowel and bladder shortly after illness or injury.  It does get better, it just takes time.

Related articles

• How To Control An Overactive Bladder (answers.com)
• Walking with hope (smh.com.au)
• Ottawa man to get a pacemaker – for his bladder (cbc.ca)