A behavioural approach to retraining bowel function after long-standing constipation and faecal impaction in people...

The authors describe a behavioural programme--involving prompted toilet-sitting after meals, rewards for appropriate evacuation and increased fibre--for four people with severe learning disabilities. Although treatment times were long, such training resulted in near-normal bowel function. While this behavioural approach does not ignore the biological aspects of the problem, soiling in intellectually disabled people should not be attributed to the handicapping condition alone. Training at an earlier age should be considered.