Leaving constipation in 2023
It’s January, and lots of people are making resolutions to kick off the new year. Whether or not you are a person who participates in yearly commitments, there’s one thing I would LOVE for you to strive to make part of your daily habits. Even though getting to the gym is a habit everyone should pick up, especially women, that’s not what I’m talking about. This habit has to do with how you poop!
If you talk to anyone who I’ve ever worked in clinic with, I’m a little obsessed with pooping. I noticed that for me, if I’m eating a diet rich in soluble fibers (fruits, veggies) and drinking lots of water, I’m pooping at least 3 times a day. I feel good during those times, not backed up. But everyone’s normal may not match up. “Normal” bowel frequency can be anywhere from three times per week up to three times per day. If we use myself as an example, if I were to go a day without a bowel movement, you would say I’m constipated because I would have missed 3 movements that I would normally have. However, for some people, it is normal to go a day or two without a movement. This is to say know your normal for gut motility.
Speaking of normal, when, you do go, what does your stool look like? In the Bristol Stool Guide, it shows a variety of stools and numbers them from 1- 7. The harder, smaller stools start at 1. If your stool is a 1 or 2, most likely you are dehydrated and probably constipated. The more liquid your stool is at a 6 or 7, you’re probably lacking fiber and have a case of diarrhea. An optimum stool is around a 4, sausage-like and smooth.
What if your stool looks like a 4, but you have to strain to get it out? Are you holding your breath and, or pushing very hard to evacuate your stool? There could be some pelvic floor dysfunction. Your pelvic floor muscles may be overactive, or too tight- squeezing the area the stool is supposed to come through. Or you maybe closing off your sphincters (what keeps the stool in), when you really need to be relaxing them (pelvic floor dyssynergia). Do you have pelvic floor heaviness or pressure? Maybe there is a rectocele or pelvic organ prolapse that is blocking the pathway of your stool, making it more difficult to come out.
So, we’re getting daily movement, lots of water, fiber, but still having difficulty evacuating your stool. OR everything is fine, but you want to prevent dysfunction that can lead to hemorrhoids or that progresses your prolapse.
Use a squatty potty/ step stool/ shoe box/ dictionary/ full toilet paper rolls under your feet to get your hips higher than your knees while you are voiding! This helps relax your pelvic floor muscles (specifically the puborectalis, that acts like a sling around the rectum to help keep stool in). Next step- try to inhale as you push stool down towards the sphincter (anus), and then exhale (blow out of your mouth) as you actively push further. DO NOT hold your breath while pushing- this tightens up your pelvic floor muscles and makes it harder to evacuate the stool.
