Ugh, I'm constipated.

If you’re reading this, most likely you’ve been in this situation: you are constipated and feel like everyone can see your belly stick out, you don’t know what to eat because you’re so uncomfortable, and you run to the toilet for any slight urges to poop. Alas, you sit there sweating, straining, spending way too much time waiting for something to happen, and frustrated.  

First of all, you are not alone. Almost everyone experiences constipation in their lives, and about 20% of the US population struggles with chronic constipation which can negatively impact your physical, mental, and emotional well-being. It is well documented that our emotional health is related to our GI health, so if your poop isn't moving you may find yourself to be more irritable, depressed, and anxious. Constipation can be categorized by the following: less than 3 bowel movements per week, pain with passing stools, and dry and incomplete stools.  

If you have been to a GI specialist, you may have been told to take Miralax every day to help with your bowel movements. Sometimes that helps, however it is not approved for long-term use and likely isn’t the solution you’re looking for. Bandaids are totally fine in the short term if they help you find relief, but if you are looking to get to the root of the problem, we may need to dive a little deeper.  

Let’s talk about what could be causing your poop dilemma and ways you can perfect your pooping routine.

You’re dehydrated

• Drinking enough water cannot be emphasized enough! You should be drinking at least half your body weight in ounces daily to increase bulk of the stool, keep your intestines moving waste along, and to flush out any toxins. Sometimes, carbonated water can help to increase gas pressure on stool to get things moving more smoothly.  

You’re not relaxing your pelvic floor when you go

• Try using a stool like the squatty potty!! There is a sling like muscle called the puborectalis wrapped around the rectum. The squatty potty mimics our natural position of deep squatting to poop, which relaxes and lengthens this muscle so there’s not as much pressure on the rectum.

You’re straining  

• Avoid holding your breath to push. Straining causes excessive pressure on the pelvic floor, which can in turn, weaken the pelvic floor muscles and cause potential leakage of stool or urine in the future. Also, this will also tense your colon, rectum, and pelvic floor further, which should be fully relaxed while you pass stools.  

You may not be moving enough

• Try to exercise regularly, whether that just means going for a 10-minute walk, doing a gentle yoga flow, or doing something more intense like resistance training or HIIT. Movement helps peristalsis, which is movement of the colon to push stool through.  

Your colon needs better blood flow

• Drink warm liquids. Heat causes expansion and that applies to our blood vessels and all tissues. By warming up the colon, it allows more room for stool to pass.  

You’re not getting enough fiber

• Ensure adequate fiber intake. 25-40 mg a day is recommended which can be obtained through fruits, vegetables, and grains. Soluble fiber, such as psyllium husk, can bulk up and soften stools by allowing more water retention in stools.

If you’ve tried everything from increasing fiber intake, avoiding drinking cold liquids, increasing your fluid intake, using a squatty potty, breathing through bowel movements and still haven’t seen a change in your constipation, you may need more specific help.  

How can Pelvic Physical Therapy Help?

• Assess the pelvic floor, of course! When the muscles the pelvic floor or muscles surrounding the GI tract are too tight, this can lead to retention of stool. The pelvic floor needs to lengthen and relax when passing bowel movements and stay strong to hold it.  
• Correct posture and biomechanics. The position of our pelvis and trunk are important for how our digestive tract and pelvic floor muscles rest. We may sit, stand, or walk a certain way that contributes to tightness in our trunk and pelvis.
• Manual techniques. Soft tissue mobilization can be performed on the pelvic floor muscles and along the abdomen, as well as specific stretching techniques.

• Correct breathing techniques. It cannot be emphasized enough - DO NOT HOLD YOUR BREATH. However, there may be structural barriers as to why people breathe the way they do and an examination can narrow down any deviations.

Try these tips and see if you can let it all out (pun *definitely* intended). If not, we're here for you babe <3

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