CONSTIPATION

‘Tis the season for great foods and stuck bowels… This holiday year its time to talk all things constipation! From roast and potatoes to holiday cookies, add in a pandemic and an election year… this year has been full of overeating and STRESS! A major theme I continue to hear from my patients is constipation. Constipation can be defined as:

  • Passing fewer than 3 bowels / week
  • Straining to have a bowel movement
  • Hard or lumpy bowels
  • Incomplete emptying, feeling as if you cannot fully empty bowels
  • Feeling of a blockage in the rectum or having to use hands/press on abdomen to empty rectum (yes this can happen)

When talking about constipation I like to break things down into three simplish categories:

  1. Motility: how is bowel moving through the piping system of your intestine
  2. Exit: how are you relaxing the exit space a.k.a. the rectum
  3. Stress Management: how stress slows the system down


First let’s discuss great ways to first get things MOVING!

  • Chewing food: starting from the very beginning of digestion it so important to start things off with pre-digesting the food through chewing! The simple act of chewing more to make food particles smaller can aide the digestion and help bowel glide and slide! Try to increase chew time to around 20-30 chews a bite to make sure food becomes nice and small before swallowing.
  • Water: This one makes sense. Dry things don’t glide and slide, but well moisten things move! In general 64oz of water a day is sufficient. But more specifically about 15 cups (3.7 liters) of fluids for men and 11.5 cups (2.7 liters) for women.
  • Exercise: Of course one of the TOP things to do to get bowels moving is MOVE! Cardio (walking, running, cycling), yoga can be so helpful to get things MOVING through the system.
  • Diet: Try to limit processed foods and increase SOLUABLE fibers (fiber that dissolves in liquid, basically helps keeps bowel gel-like). This can include oats, pears, apples, broccoli. My favorite to include in smoothies/oatmeal is psyllium husk! ALSO MAGNESIUM can make a huge difference. Attached are my favorite brands!
  • Massage techniques: Manually help bowel through massage! (below is a picture of how to do it) Basically you can help the natural movements of the intestines by doing small circles tracing the large intestine! This is best to do lying down on your back with legs up on the wall or couch for about 1-5mins! Below is an image of how to massage abdomen!

Second lets talk about the EXIT!

The next step is exiting the bowels out of the rectum. Even if you turn on a hose and water is moving, if the hose is kinked or has a small nozzle less will come out…So we need to unkink the hose or change the opening of the nozzle (this is the same for our bowels!). For improving the exit of our bowel, we need to relax our pelvic floor muscles and sphincters. To keep things simple stretching and posturing are the 2 best options for this!

  • Stretching: to relax the pelvic floor try getting your knees above your hips with these positions (great to try for 40 secs ea before bowel movement)
  • Posture: getting your knees above your hips while toileting helps “unkink” your rectum and allow open space for exiting bowel. Don’t forget to BREATH (big inhale letting belly rise and exhale feeling belly fall back towards spine). Linked are some great brands of toilet stools!

Third and Final: Stress Management!

When talking about motility we have to talk about stress management. This part of our nervous system that causes our feelings of stress/anxiety is called our autonomic nervous system. This nervous system can be broken down into two categories; sympathetic (fight or flight) vs parasympathetic (rest and digest) they are constantly a battle with each other over who has more control over us. With a pandemic, election year, and work/life changes many of many of us are more influenced by our sympathetic (fight or flight) system than ever! When we are in more of a sympathetic/anxious/stressed state a few major changes happen to name a few decreased libido, decreased GUT MOTILITY (if you are running from a bear no time to digest food), increased heart rate, and sweating. Now we need to combat the “fight or flight” with the parasympathetic nervous system. We can activate the rest and digest through cardio, movement, mindfulness, and breathing. Here are some great youtube links of mindfulness and breathing!

Now all of the above sounds great, but if things still don’t help PLEASE reach out to your local pelvic physical therapist to address and discuss options. I offer a free 15 minute phone consult as well if you would like to discuss any of these feel free to reach out!! Last check out my Pinterest page for more options on constipation combat!

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