What are the signs of a healthy bowel?

Being ‘regular’ is a way of describing good bowel habits or normal bowel function. We often talk about our bowels being regular but this is often misunderstood as meaning that you go to the toilet to pass faeces every day. It’s common for people to empty their bowel once a day, although it’s still normal to be more or less often. Being regular really means that soft yet well-formed bowel motions are easily passed and that this happens anywhere from 1–3 times a day to 3 times a week.

The bowel usually wants to empty about 30 minutes after a meal (commonly breakfast), but this can vary from person to person.

Good bowel function for adults

There’s more to good bowel function than just being regular. For example, you should be able to:

hold on for a short time after you feel the first urge to go to the toilet

pass a bowel motion within about a minute of sitting down on the toilet

pass a bowel motion easily and without pain – you shouldn’t be straining on the toilet or struggling to pass a bowel motion that is hard and dry

completely empty your bowel when you pass a motion – you don’t have to return to the toilet soon after to pass more.

Bowel control problems

People who pass bowel motions at the wrong time or in the wrong place may be experiencing poor bowel control, or faecal incontinence. They may also pass wind when they don't want to.

Poor bowel control is more common than you think. About 1 in 20 people experience poor bowel control and it affects both men and women. It's more common as you get older, but young people can also have poor bowel control. In some cases, people with poor bowel control also have poor bladder control and may leak urine (urinary incontinence).

Good bowel function for children

Children usually develop the ability to be toilet trained by about three years of age. Soiling is when the bowels are emptied in places other than the toilet. Even after a child is toilet trained, there may be occasional accidents with soiling (poo) in your child's underwear.

If a child is unable to be toilet trained or has regular poo accidents after the age of three to four years, then they should be medically assessed. If a child has been toilet trained and at a later stage starts to soil, this also needs medical assessment.

How many children get soiling?

About 1-3% of children can have this problem and some of them may have wetting as well. It is more common in boys.

Soiling may vary from a 'skid mark' to larger amounts that need to be removed from underwear before it can be washed.

Why do children soil?

In almost all cases soiling happens because the large bowel is not emptying properly and the child is constipated. Constipation is very common and occurs at some time in up to 25% of children. If it is not recognised and treated, bowel actions may become harder and less frequent. Over time, stretching of the bowel makes it less sensitive, so the child may not feel when poo needs to come out and therefore has an accident. It is quite possible that there is hard poo inside the bowel, but the soiling is soft runny poo leaking around the hard mass, and so you don't realise that constipation is the underlying problem.

SEEK HELP

In many cases incontinence can be prevented, better managed and even cured. Talk to your family doctor or contact the National Continence Helpline on 1800 33 00 66.

The National Continence Helpline is staffed by continence nurse specialists who offer free and confidential information, advice and support. They also provide a wide range of continence-related resources and referrals to local services.