I'm not bowel incontinent, but I'm in diapers 24/7, so when I have to go, I just kind of use it. I mean, if I"m in a situation where changing a poopy diaper would be insanely hard, then I'd just use the toilet...I still have to change then b/c the diaper is almost always wet, and honestly just any kind of change can be problematic in the wrong situation. That said, if I'm at home or something, I just use the diaper. It means changing about 10 dirty diapers a week, but it is what it is. They'd get changed anyway, I suppose.