Day 2 – Controlling Constipation
Before the advent of cellphones, many home bathrooms had baskets of reading materials available. For the older generations, you may remember Reader’s Digest and the Bathroom Reader book series as popular reading materials to take into the bathroom if we expected to be there for awhile. Nowadays, cellphones do the trick much more easily – they’re handy, portable, and we can read the news, play a game, catch up on social media or even chat with friends. If this sounds gross to you, you may be onto something, and it has nothing to do with germs on your hands or your phone.
Sitting for prolonged periods on the toilet is a big NO-NO when it comes to pelvic floor health. When we are sitting on a toilet, the pelvic floor muscles, which act like a basket to support and hold up the internal organs, are suddenly without any extra support whatsoever. Having to sit like this for a few minutes each day isn’t a big deal, but extend that time to half an hour catching up on funny cat videos, and repeat this most days of the week, and suddenly the pelvic floor muscles are doing a lot more work than they’re cut out for. If you find yourself sitting on the toilet for more than 5 minutes at a time, please get up and go do something else until your poop is truly “knocking at the door”.
While prolonged sitting is one way we can weaken the pelvic floor muscles in the context of bowel movements, another one occurs whenever we push to empty our bowels. Sure, we’ve all had the occasional mishap where we realize that we ate sub-optimally yesterday and we’re experiencing a bit of constipation, but if hard to pass, bulky stools are your norm, it’s time to work on getting rid of the constipation for pelvic floor and overall health.
The Bristol Stool Chart is a commonly used scale that people can use to describe their bowel movements. The scale goes from from 1-7, with a grade 1 stool being tiny, hard lumps (a.k.a. severe constipation), and a grade 7 being soft, runny stools (a.k.a. severe diarrhea). While normal stool varies by day based on our diet and activity levels, we want to aim for most of our stools to be a type #4 – think a long, smooth snake.
If you can’t recall the last time you had a nice, easy to pass stool, or if you have bowel movements so rarely that they coincide with the lunar eclipse, it may be time to consider how you can improve your bowel health.
Here are some easy ways you can help your bowels and pelvic floor in the day-to-day:
1. Avoid sitting on the toilet for prolonged periods of time. After five minutes, get up and do something else if the poop just isn’t ready to come out.
2. Don’t push or strain to empty your bowels. Exhale through your mouth if you have to push to get the bowel movement started a bit. This reduces the amount of pressure that goes down onto your pelvic floor muscles, some of which are located around the rectum.
3. Drink enough water. Dehydration can lead to harder stools. If you struggle with constipation or hard-to-pass stools, try increasing your fluid intake during the day.
4. It’s all about Fibre. Well, maybe not all, but it’s pretty important. Adults need between 25 and 38 grams of fibre per day. But most of us fall woefully short of this target. It might be worth tracking your fibre for 2-3 days to see where your intake sits, but it can also be as easy as choosing the higher fibre options at the grocery store (think multigrain cereals and crackers instead of the lower fibre options, whole fruits and vegetables, brown rice and multigrain pasta, foods that don’t compromise taste but sneak a bit more fibre into your diet).
5. Get a Squatty Potty. Or borrow your toddler’s step stool, use your old textbooks, heck, grab two full rolls of toilet paper. Use anything on hand to prop both feet up and out (think a nice V-shape with the knees wide and feet elevated). This position is anatomically better for having a bowel movement and can reduce the feeling of straining or discomfort.
6. Relax and don’t rush it. This might sound like a contradiction to the advice not to linger on the toilet, but if we aren’t relaxing our pelvic floor muscles, they simply won’t let the poop come out easily. If you’re under a lot of stress, or have trouble relaxing your posterior pelvic floor muscles, try taking some deep breaths while you void.
7. Listen to your body. At the end of the day, all of this advice needs to be placed in the context of your own body. Do your bowel movements feel easy to pass and regular? Do you feel energized and empty after you poop? Or do you sometimes experience hemorrhoids or discomfort “down there”? Perhaps you are taking a prescription medication that can cause constipation. Try incorporating some of the tips above, and please reach out – your family doctor or other primary healthcare provider, a registered dietitian or a holistic nutritionist, can help. And as always, pelvic physiotherapy is here to help you optimize your bowel, pelvic, and overall physical health.