It’s private, is mostly uncomfortable to talk about, and too often brushed off as just part of ageing.
But changes in bowel habits, including constipation and loss of control, are more common than many people realise, with 10 per cent of Australian women affected*, according to Continence Health Australia.
At a recent session at the Illawarra Women’s Health Centre, Women’s Health Nurse Practitioner Editt Melgarejo shared practical advice on what’s normal for the bowel, what’s not, and how women can support their digestive and continence health.
“Constipation is very common,” she said. “But people don’t talk about it. And it’s not just about going or not going – it’s about comfort, control, and quality of life.”
(You can find out what Nurse Editt says about bladder control here.)
What does a healthy bowel do?
Bowel frequency can vary from three times a day to three times a week.
“You don’t have to go every day,” Nurse Editt explained. “As long as the stool is soft, formed, and you’re not straining or rushing to get to the toilet, that’s okay.”
She referred to the Bristol Stool Chart (types 3 and 4 are considered ideal) and reminded everyone that bowel movements should feel complete and unforced.
“It shouldn’t hurt, and you shouldn’t be sitting there pushing. If you’re straining, that’s a red flag.”
What else is normal?
You should be able to make it to the toilet in time.
Your body should give you a clear signal, and you should be able to hold on briefly until you get to the toilet.
The final part of the bowel is controlled by the anal sphincter – a ring of muscle that works with the nerves to detect whether what’s coming is wind or stool.
“It might sound simple,” Editt said, “but there’s a lot going on. The muscles, the nerves, the brain, all of them have to work together for bowel control.”
What can affect bowel control?
Common issues like constipation and diarrhoea can make bowel control harder.
“The longer stool sits in the bowel, the more water it loses, and the harder it becomes,” she explained.
Other factors that may affect bowel control include:
- Limited mobility or difficulty getting to the toilet in time
- Neurological conditions like Parkinson’s or diabetes
- Nerve or muscle damage from childbirth or surgery
- Pelvic radiation or cancer treatment
- Weak pelvic floor muscles
What can you do to support your bowel health?
Nurse Editt shared three essential steps:
“Water, fibre, and movement. That’s the bowel’s recipe for success.”
Here are her top tips:
- Drink 6 to 8 glasses of fluid a day (unless your doctor advises otherwise).
- Aim for 20 to 35 grams of fibre daily from whole foods like vegetables, legumes, nuts, seeds, fruit, and whole grains.
- Stay active – any kind of movement helps bowel motility.
- Don’t ignore the urge to go. “With the bowel, when you need to go, go.”
- Use proper toilet posture. “Sit fully, lean forward, and relax. Take your time.”
- Include pelvic floor exercises. “Remember to engage the muscles around the anus too. They’re just as important.”
When to seek help
If you’re straining, rushing, feeling incomplete emptying, or experiencing any form of bowel leakage, it’s time to talk to someone.
“Don’t put up with it,” Editt said. “There’s always something we can try to improve bowel control.”
Finally, if you have ongoing concerns, don’t put up with them quietly. Talk to your GP or book a continence assessment with the Illawarra Women’s Health Centre.
*Continence Australia references a 20-year-old report by Hawthorne G, based upon The Health Omnibus Survey conducted by the South Australian Department of Health and Harrison Research. There is very little research into faecal incontinence in women in Australia.
