Q: I have a peculiar problem. After defecation, I still feel that I have to clean up my anal canal, else some remnant stools may leak down into my underwear after getting out of the bathroom. With this feeling, I sit in the bathroom for more than 1/2 hour straining and likewise I happen to pass some more remnant stools later. I end up wasting a lot of time. Please give me the details of how the internal and external anal sphincters work and about the length of the anal canal? When does the internal anal sphincter open and when does the external anal sphincter open? Is there really a chance that remnant stools to leak into the underwear in between defecation times? Please give an idea about the physiology of the defecation process?

A:Normally there should not be any leakage. I recommend you increase fibre intake and do KEGEL exercises (most of the times this is secondary to childbirth trauma). Why should men do kegel exercises regularly: Kegel exercises prevent incontinence and other problems that are often associated with aging. Why should women do kegel exercises regularly: Kegel exercises are essential to the treatment of sexual difficulties such as vaginismus and dyspareunia (pain on vaginal intercourse). Kegel exercises prevent incontinence, prolapses, and many other problems of the pelvic floor that are often associated with aging. Kegel exercises strengthen and tone the musculature of the pelvic area in a way that can make vaginal delivery during childbirth easier. How do I find my PC muscles: Go to the bathroom and sit on the toilet (men, it is also a good idea to sit for this). In the middle of your stream of urine, stop and start the stream several times. The muscles you use to do this are your PC muscles. At first, you may find that you are also squeezing your anal muscles; as you become experienced with kegel exercises, try to separate out the muscle groups that you are able to exercise by squeezing. How do I do regular kegel exercises: Now that you have located your PC muscles, you can exercise them while your bladder is completely empty. First, try squeezing your PC muscles as hard as you can for a count of three seconds. Then let them relax. To begin with, see how many times you can do this before the muscles feel tired. Now figure out a suitable exercise routine just as you would if you were trying to tone and strengthen a different muscle group by going to the gym every other day. For example, suppose you start by being able to do only five strong squeezes; try doing three sets of five once or twice a day for a week, and then try increasing this to three sets of eight strong squeezes. If you work up to three sets of thirty or more strong squeezes, you are probably healthy enough for most purposes, and need only to maintain this level of fitness by doing these three sets four times a week (instead of once or twice a day). We also recommend that you experiment by varying the type and timing of the PC squeezing you do as you train these muscles: slow clenches, many quick flutters, and so on. This will make you more familiar with these muscles – notice also when your abdominal muscles or your anal muscles feel like they also want to join in the exercise. Remember, you should try to separate out kegel exercises from anal squeezing. If you are in doubt, go back and refind your PC muscle while urinating. Or consult one of our Institute's faculty.