Lying Movement Training for Toileting

Lying movement training for toileting can assist in defecation through methods such as adjusting posture and breathing, abdominal massage, using assistive tools, drug intervention, and pelvic floor muscle training. Details are as follows:

Adjusting posture and breathing: When lying flat, place a pillow under the buttocks or use a specialized toilet stool to elevate the knees above the hips, simulating a squatting position and reducing the pressure of the puborectalis muscle on the intestines. Alternatively, bend the knees slightly and separate them gently to relax the puborectalis muscle. At the same time, use abdominal breathing: inhale to expand the abdomen and exhale slowly while contracting the abdominal muscles and pushing downward, avoiding breath-holding to promote defecation.

Abdominal massage: Massage the area around the navel in a clockwise circular motion, starting from the lower right abdomen, moving through the upper right, upper left, and lower left abdomen, with gentle and even pressure for 10 - 15 minutes each time to stimulate colonic peristalsis reflex. Alternatively, lie on your back and relax, using the base of the palm to press slowly from the lower right abdomen, along the ascending colon, transverse colon, and descending colon in sequence, with pressure that feels slightly sore and swollen, for 5 - 10 minutes each time.

Using assistive tools: Choose a soft-padded bedpan that conforms to ergonomics, with an edge height not exceeding 5 cm. If necessary, use glycerin enemas or glycerin suppositories to lubricate the rectal mucosa. For severe constipation, short-term use of osmotic laxatives such as lactulose oral solution and polyethylene glycol 4000 powder under medical advice may be considered. Alternatively, place a bedpan under the buttocks and elevate the upper body slightly to create a 15 - 30 degree incline, using gravity to assist in fecal expulsion. For long-term bedridden individuals, use an inflatable toilet pad or medical care bed to adjust the bed board angle to create a head-up, foot-down position. Apply lubricants such as glycerin or paraffin oil around the anus.

Drug intervention: For persistent constipation, after excluding intestinal obstruction, use prokinetic drugs such as domperidone tablets and mosapride citrate tablets, or bulk-forming laxatives such as wheat bran cellulose granules under medical guidance. For anal fissure pain, short-term topical use of compound carrageenan ointment can relieve symptoms. When physical methods are ineffective, use drugs such as glycerin enemas, lactulose oral solution, and polyethylene glycol 4000 powder under medical guidance.

Pelvic floor muscle training: Perform Kegel exercises while lying on your back, slowly tightening the anal and perineal muscles, holding for 3 - 5 seconds, and then fully relaxing. Repeat 10 - 15 times as a set and perform 3 - 4 sets daily.