Understanding Constipation: What’s the Hold-up?

Understanding Constipation: What’s the Hold-up?

Ask yourself the following questions. Do you have:

  • less than 3 bowel movements in a week?
  • strain or pain during a movement?
  • hard or lumpy stools?;
  • the feeling you’re not quite empty?
  • the sensation of a blockage?

You may be considered constipated if you experience 2 of the following symptoms for at least 12 weeks within a year. However, some people do not recognize these symptoms and require testing such as x-ray or colonoscopy to diagnose constipation.

Constipated? Yeah, me too.

You would be surprised how many people experience constipation. I hear it all the time as a pelvic health physiotherapist because it’s common in women during and after pregnancy. During pregnancy your digestion slow down and you have pressure from the growing uterus on the rectum. Many women find themselves on iron supplements which can be the source of constipation during pregnancy or postpartum. In the postpartum phase, constipation can be the result of pelvic floor muscle tearing and hormones.

The side effects of constipation.

Well, think of what may happen if there is extra pressure from poop backing up AND straining too much to get it out?

1.    Hemorrhoids (varicose veins at the opening of your anus)

2.    Pelvic organ prolapse, most likely the rectum

Treating constipation.

  • Be active. It will keep your digestion moving.
  • Consider how you sit on the toilet. You want your rectum to provide the best path and the pelvic floor muscles to be able to open. Sit upright or slightly forward with your feet elevated on a stool. 
  • Keep your poops soft.
    • Eat fruits and vegetables
    • Educate yourself on the type of fibre to eat (try to stick with soluble fibres)
    • Consider foods with natural laxative properties like kiwi, dates, prunes.
    •  Drink at least 1.5-2L of water a day. Remember, you need more if breastfeeding!
    • Talk to your doctor or pharmacist about pharmaceuticals that provide laxative effects.
  •  If you get the urge to poop, respond to it! When your bowel movement nears the back door, it signals receptors to prepare for emptying. If you don’t respond, more and more water gets absorbed making the consistency harder and harder and the poop more difficult to pass. Because you didn’t respond to the message when it was sent, all that poop coming down the tube is getting backed up behind the stall and the receptors at the exit are no longer being triggered. The more this becomes a habit, the more the rectum gets stretched creating a vicious cycle.

Your pelvic floor & poop.

As pelvic health physiotherapists, we always ask our clients about their poops because their toilet habits can tell us about their pelvic floor. One of the roles of the pelvic floor is to help support the rectum, the final part of the intestine before your poop passes through your anus. The pelvic floor muscles make sure that nothing sneaks out of there until you are on the toilet but they also need to be able to relax and open so that you can effectively open the back door.

It’s a pretty coordinated system of muscles relaxing (pelvic floor), while others are contracting (abdominal muscles) to have a successful bowel movement. If there’s an issue with any specific muscle, and or trouble with coordination within the system, you may end up being on the constipated side. Constipation can cause pelvic floor problems and vice versa. Chances are if you’re constipated, it’s a bit of both.

If you happen to be on the constipated side, get your butt into gear to eliminate the holdups.

Melissa Dessaulles

Melissa is a pelvic health physiotherapist at Wave Physiotherapy in Kelowna, BC. She is an active mom of 2 young kids. Her own experiences with post partum recovery have made her passionate about helping other moms.

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