A physiologic approach to bowel training.

Bowel training is an effective management option for many patients with dysfunctional bowel elimination patterns and neurogenic fecal incontinence. To be effective, a bowel training program must be based on sound physiologic principles and must be individualized for each patient. This article includes a review of the structures and physiologic processes controlling normal defecation and the physiologic principles governing bowel training. The steps involved in successful implementation of a bowel training program are discussed, and case studies are used to illustrate the principles.