• Insert a lubricated finger into the anus and make a circular motion until the sphincter relaxes. This may take a few minutes.

• After you have done the stimulation, sit in a normal posture for a bowel movement. If you are able to walk, sit on the toilet or bedside commode. If you are confined to the bed, use a bedpan. Get into as close to a sitting position as possible, or use a left side lying position if you are unable to sit.

• Try to get as much privacy as possible. Some people find that reading while sitting on the toilet helps them relax enough to have a bowel movement.

• If digital stimulation does not produce a bowel movement within 20 minutes, repeat the procedure.

• Try to contract the muscles of the abdomen and bear down while releasing the stool. Some people find it helpful to bend forward while bearing down. This increases the abdominal pressure and helps empty the bowel.

• Perform digital stimulation every day until you establish a pattern of regular bowel movements.

• You can also stimulate bowel movements by using a suppository (glycerin or bisacodyl) or a small enema. Some people drink warm prune juice or fruit nectar to stimulate bowel movements.

Like any training regimen, consistency is crucial for the success of a bowel retraining program. Establish a set time for daily bowel movements that fits into your schedule and one that will not be compromised. An optimal time is 20 to 40 minutes after a meal as feeding stimulates bowel activity.

While results vary, the majority of those who initiate bowel retraining and develop a positive routine usually establish a regular routine of bowel movements in a few weeks.