Dr. Lacey White
Lacey White
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If you poop every day, you may be thinking this article on constipation isn’t relevant to you. And you may be very, very wrong! Most people say they are constipated when they haven’t pooped in a few days. However, there are a LOT more factors to consider. You can poop every day and still be constipated. You can actually have diarrhea because you are constipated! Furthermore, considering that millions of Americans are suffering from chronic constipation, there is work to be done!

Constipation Pin

What is Constipation?

In order to discuss constipation, let’s first get acquainted with normal bowel function. If things are functioning optimally, you should

  • Have 1-3 bowel movements per day
  • Not strain or push to poop
  • Feel fully empty without effort
  • Not have to be sitting on the toilet for hours
  • Type 3-4 on the Bristol Stool Chart

Bristol Stool Chart

What does constipation feel like?

Constipation feels different to different people. Here is a list of various symptoms you may be experiencing, and some may surprise you!

  • Abdominal pain/ cramping: PICTURE OF COLON HERE showing location of pain
  • Bloating
  • Decreased appetite
  • Constantly feeling full
  • Feeling gassy, but passing gas does not relieve symptoms
  • Lethargy
  • Bad breath or bad taste in your mouth: As things back up, food is not moving out of your stomach as quickly and can lead to this.
  • Diarrhea: This one surprises people the most. If you are having diarrhea, you may think there is no possible way you would be constipated. However, constipation is a common cause of diarrhea. At a certain point, it is the only way their body can remove wastes around larger, harder stools.

When is constipation an emergency?

If you are experiencing any of the below symptoms, I suggest visiting the doctor immediately.

  • Intense abdominal pain
  • Nausea/vomiting
  • Blood in your stool
  • Stool is black

How does constipation impact your pelvic floor?

Gastrointestinal TractYour abdomen and pelvis house many organs and nerves. These structures require a certain amount of movement in order to function properly. 

When you become constipated – especially when it is a chronic condition – the poop takes up more space. This can cause restrictions and decreased movement for all other organs. Your gut does not work in isolation!!

Furthermore, constipation can worsen all other pelvic floor symptoms. This is because it places extra pressure onto your organs, nerves, and your pelvic floor.

What are specific examples of how constipation can affect pelvic floor conditions?

Pelvic organ prolapse

  • Extra weight from your poop can push organs further down
  • Habitually straining on the toilet instead of being able to relax – pushing your waste out but also pushing your organs down
  • Vicious cycle: prolapse → constipation → further difficulty emptying → worsened prolapse

Incontinence (peeing your pants)

  • Your stagnant poop can be placing more pressure through your bladder, making it more likely to occur! It doesn’t have as much room
  • Bad toileting habits can lead to decreased coordination and strength through the pelvic floor muscles → less able to control → leaking urine

Dysmenorrhea (Painful Periods)

  • Uterus moves throughout your cycle and lowers during menstruation and ovulation. If constipation is leading to restrictions through the abdomen, it cannot perform normal motion, which can increase pain!

How do I know if I am constipated?

If you relate with ANY of the above symptoms, take this quick quiz to further confirm constipation! (Provided by the Rome II Criteria)

Scoring: If you said yes to TWO or more of the following symptoms, you need some work! Let’s dive right into treatment options.

What are constipation remedies/treatment options?

There are so many ways to get long-lasting relief from constipation! Among those include laxatives, lifestyle changes, and (my obvious favorite) pelvic physical therapy!

Laxatives

Meh. In my opinion, laxatives are extremely overused and so overrated. Many people believe these are the only way to relieve constipation. However, you may not be aware of certain drawbacks to taking laxatives:

  • Not all laxatives are safe to use daily!
  • Decreased bowel function (lost muscle and nerve response) which leads to reliance on medication
  • Electrolyte imbalances which can lead to more serious issues such as weakness, confusion, and abnormal heart rhythms.
  • Interference with absorption of nutrients and certain medications
  • Uncomfortable side effects
    • Bloating
    • Gas
    • Abdominal cramping/pain
    • Diarrhea
    • Thirst
    • Nausea
    • Even INCREASED CONSTIPATION

Now, I am not saying laxatives should never be used – they have a time and a place. They can provide immediate constipation relief in some cases. However, use them temporarily and not habitually. Focus on lifestyle changes to address the root cause of your constipation. This will help you have the most long-lasting relief from constipation.

Lifestyle Changes

These methods are often overlooked because they take more work and time; however, these will have the most lasting effects! In order to have the best results, incorporate these gradually over time.

Diet Changes

Fruit and Vegetables

  • Eat a variety of whole foods, plant-based. Try for 30 different plants per week!
  • Avoid processed foods and dairy products
  • Drink plenty of water

Yeah, yeah, yeah. We alllll know that we should “eat more veggies.” This is true. You should eat more veggies. However, you should understand that not all fiber is created equally! There are actually different types. You may need more of of one and less of the other. Here are specific examples of common constipation complaints along with which fiber type you should increase:

“My poop is too big to come out and it hurts.” 

  • You need more soluble fibers.

“My poop is sticky and won’t come out.”

  • You need more insoluble fibers.

I’m not going into more detail in this post. But if you are curious to learn more, read HERE. At least now you are aware there are different types!

Exercise

Movement is medicine. Seriously, even stand or walk more often. Nothing crazy. Our bodies were meant to be vertical, not horizontal! Any extra movement you do will be beneficial.

Changes in Prescription Medications

Some prescription medications can make constipation worse. You may need to discuss constipation issues with your doctor so they are aware. This may warrant an adjustment to your medications.

How can pelvic physical therapy help?

A pelvic physical therapist can help decrease your constipation and give you tools to improve so you can better “go with the flow.” When you make an appointment, they will be able to make a program designed specifically for your needs! This might include:

  • Manual (hands-on) techniques to decrease restrictions through pelvis and abdomen
  • Tools to manage stress
  • Unique exercise program to address your needs
  • Tips and Education

Here are some following questions/common complaints and ways a pelvic therapist can help you!

How to decrease constipation on the toilet?

  • Toileting mechanics (how should you sit on the toilet)
  • Don’t ignore the urge
  • Bowel massage

My poop is stuck halfway out. How to make poop come out when stuck?

  • Pelvic floor awareness – HOW to relax pelvic floor to evacuate waste

Why do I have to push my poop out with my fingers?

  • You may have extremely hard stools and need diet changes. You may also have a different pelvic floor dysfunction such as prolapse that makes it harder to evacuate. You can work on this with a pelvic therapist too!
  • Create a regular schedule for eating and attempting to have a bowel movement

For more information on what to expect at pelvic physical therapy, click HERE.

Summary

Constipation is a very common problem and there are many contributing factors. Constipation can affect every other organ and aggravate pelvic floor issues as well. There are many effective treatment options – you do not have to rely solely on laxatives! Long-lasting relief from constipation will take time. This is because the root cause must be addressed such as diet, exercise, pelvic floor issues, and other lifestyle factors. Even if it takes time, the important take-away is this: You can find lasting relief!

If you have any additional questions, comment below! Remember to subscribe so you can learn expert tips and save yourself time, money, and energy in your healing journey.

I am honored to be a part of your journey as you restore your health from the bottom up!

Dr. Lacey White, PT, DPT

This material is presented for informational and educational purposes only. This information does not constitute medical advice and is not intended to be a substitute for professional medical advice. You should always seek the advice of a physician or other qualified healthcare provider before beginning any exercise program. If you experience any pain or difficulty with these exercises, stop and consult your healthcare provider. PELVIC REHAB MAKES NO WARRANTIES, EXPRESS OR IMPLIED, THAT THE INFORMATION CONTAINED IN THESE MATERIALS WILL MEET YOUR NEEDS.

Sources

  1. https://www.researchgate.net/figure/Rome-II-criteria-for-constipation-in-adults_tbl1_7972380
  2. https://www.mayoclinic.org/diseases-conditions/constipation/in-depth/laxatives/art-20045906

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