Pooping is not a conversation that we usually have on a regular basis with friends and family. But, if you have experienced constipation then you know the importance of regular bowel movements.
Good digestion is vital to our health and well being. As a pelvic physical health therapist digestion is a conversation I have with everyone who sits in my treatment room. Some of the questions I ask people on their first visit with me: How much water do you drink? Are you eating enough vegetables, fruits and fiber? How often do you have a bowel movement? What do they look like? Do you have to strain to empty your bowels?
The colon (large intestine) is the end of the gastro-intestinal (GI) tract and has three main functions: absorbing nutrients and water and eliminating waste. So what’s normal? I find most people are quite happy when they have a minimum of one bowel movement daily without straining. So that is a goal that I like to achieve with everyone; at least one BM daily that is formed, and no (ok, maybe very little) straining to eliminate.
Even though people come to see me with other primary concerns, constipation is a common issue that people deal with in our American culture. Blame it on diet, stress, or our Westernized thrones, (I mean toilets). For whatever the cause, constipation is rarely life threatening, but chronic constipation can contribute to very troubling issues like pelvic prolapse, hernias and pelvic pain. At the very least, constipation can make you uncomfortable and can ruin a perfectly good vacation when you are feeling bloated and crampy with a full belly.
Most people know that a good diet should include 6-8 glasses of water, vegetables, fruits and fiber definitely helps. And this is a great place to start if any of these things are lacking in your diet. But if you are drinking plenty of water, eating a good balanced diet and are still experiencing constipation, before you go running to the pharmacy for a solution, here are some other cheap and easy tricks for your morning routine that can make a big difference.
1. Drink 8-16 oz of warm water upon waking: Think about it, when you wake up in the morning, your GI tract likely has been without water usually for 6-8 hours. Before your coffee, tea or any other morning beverage, drink (or even chug down) 8-16 oz of warm water. The warm water quickly hydrates your colon and wakes it up and tells it to “get moving”.
2. Use a stool under your feet while sitting on the toilet: Squatting is the best position for pooping. In a squatting position the rectum (end of the colon) straightens out and makes it easier to eliminate. Squatty Potty is a good example of a toilet stool that works great (and has a hilarious video that illustrates this anatomical effect) but a wide kitchen stool 7-9 inches high can work as well (the taller you are the shorter the stool necessary). Any stool, box (or in a hotel room a garbage can on its side) can work as long as you are comfortable, feet are well supported and your knees are higher than your hips.
3. Do some light exercise in the morning for 15-30 minimum: Walking, cycling or yoga are all good options. Exercise stimulates the gut, increases blood flow and wakes up the GI tract.
4. Eat a good breakfast: If you have a dog, you know that after your dog eats, about 20-30 minutes later they need to poop. We have that same gastro-colic reflex which stimulates the colon to eliminate when food enters the stomach. Mom said that breakfast is the most important meal of the day she might be correct because breakfast gets the GI tract moving.
5. Lastly, sit on the toilet about the same time each morning: About 30 minutes after doing you morning routine (hydrating with warm water, doing some light exercise and eating a good breakfast) sit on the toilet if you have the urge to defecate, or not. This practice trains the colon eventually to empty at this time. Take your time in the bathroom, relax with a good magazine article at least 5 minutes, breathe low into your abdomen and relax your pelvic floor muscles. If you have a BM, congratulations! If not, keep doing this same routine in the morning, eventually your colon will get the message that this is the time to eliminate.
If none of these things work for you after days or even weeks of practice then there may be another reason for your constipation e.g. an underlying medical issue ( your thyroid is one possible suspect), pelvic floor muscle in-coordination (the muscles could be contracting when you want them to relax) or you have some food sensitivities or allergies or are taking medications that are keeping you constipated. If your constipation doesn’t improve to your satisfaction (remember at least one BM daily that is formed and easy to eliminate is usually satisfactory) with these daily practices seek advice from healthcare professionals (Pelvic Floor Physical Therapist, Doctor, Nurse Practitioner, Naturopath) until you are comfortable and are pooping on a daily basis without straining. There is no need to suffer in silence any longer.