By: Dr. Tanvi Maharaja PT, DPT At Signature Healthcare
Now that we know what constipation is (check out this article), let us discuss what we can do to optimize gut health and manage it.
The following are key points in maintaining healthy bowels:
1. Consistency:
Our bowels love consistency: with the timing and type of food intake, with the timing of bowel movements (BM); the bowels love it if we go to the same toilet in the same bathroom around the same time every day. Routine is everything for healthy BM, which explains why everything is so off when we travel (hydration, lack of movement, and stress also play a role when traveling).
2. Do not ignore the urge.
Colorectal urge is the urge to evacuate the bowels. When this happens, the body generates a wave life force across the colon that helps push stool out. Our body is trying to help us evacuate and is giving us the signals to get to a toilet. If we ignore this urge and delay using the toilet, we have to create intra-abdominal pressure to push, which if persistent and long-term, can create pelvic floor muscle dysfunction.
Another fallout of ignoring urges is the progressive weakening of the sensation of urge, so it gets to a point that we don’t even know when the body is ready to go!
So, when nature calls, we drop everything and go!
3. Hydration
Staying well hydrated, and pacing water intake regularly throughout the waking hours helps to keep the stools soft and easy to pass.
4. Fiber
Whole grains, fruits, and vegetables are some fiber-rich foods that improve stool consistency and prevent constipation.
Our blogger Lindsay Schwartz RD, LDN has published this article on our blog with great ideas on fiber-rich diets. Check it out!
5. Movement and Exercise
My dog poops every single time I walk him! That is because physical activity stimulates the passage of food through the bowels. Regular physical exercise, something as simple as walking, can help prevent constipation.
6. Toileting posture
The end of the rectum has a sling that keeps the anorectal angle closed. This muscular sling is called puborectalis. In order to pass stool, this sling needs to relax. Using a squatty potty brings the sling in an anatomically relaxed position, allowing easier evacuation. The idea is to place something under your feet so that the knees are higher than the hips.
7. Avoid straining
Sitting too long on the toilet seat and straining too hard not only causes pelvic pressure but can sometimes backfire, causing the pelvic muscles to contract instead of relax. Gently breathe out through the mouth, as if making bubbles through a small straw, as you bear down to manage the extra pressure.
8. Abdominal massage
Massaging the abdomen 10-15 minutes before the regular bowel movement time can be helpful and here is how it is done:
Start by placing your hand just inside of the hip bone on the right side, making small circles with gentle pressure, moving up towards the region just below the ribs on the right side, then across to the center, and then to the area just below the ribs on the left, finally moving down to the left hip bone and the soft tissue on the inside of the hip bone.
Due to the direction of the massage, it is called the I Love U (ILU) massage! So remember to give your belly a little love next time!
9. Pelvic Floor Physical Therapy
See your provider if constipation does not resolve with the conservative measures stated above. There are several reasons for constipation, ranging from gastroparesis (slow gut) to functional disorders of the gut-brain interaction (DGBI) to functional outlet obstruction. Physical therapy is valuable for the management of constipation, especially for functional outlet obstruction. Pelvic floor physical therapists can also perform visceral mobilization of the GI system, and anorectal balloon training for sensory/ motor/ coordination training to manage some forms of constipation.
While constipation can be distressing, with the right diagnosis and treatment, it is manageable. Chronic persistent constipation is not something that will just go away. It is a very common condition and speaking to your provider is the first step in the journey to get rid of it for good!
Happy pooping!
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