Tips From a Pelvic Floor Therapist on Managing Constipation
I treat a lot of people with constipation: those who’ve struggled with it all their lives, pregnant and postpartum mamas who’d never struggled with it previously, those having pain and infrequent bowel movements during times of increased stress, men in their 70s who’ve never had a normal bowel frequency, and on and on.
And while the root cause of constipation can be different, there are things that can help anyone struggling with it.
1. Hydrate.
I know, I know. You’re tired of hearing “drink more water.” But staying hydrated really is of primary importance, and often there’s more to it than just drinking more water. A good goal is half your body weight in ounces unless you have a medical condition and your doctor has advised against this. There’s other factors that play into hydration, however, such as how much you sweat, how active you are, whether you’re breastfeeding, the weather, etc. I typically advise people to aim for having a urine color of light yellow. Too dark, and you’re likely dehydrated. Too clear, and you may need to supplement with some electrolytes.
2. Diet and stool consistency.
It’s actually a healthy habit to check the consistency of your stool. It should be smooth, formed, and stick together (think of a sausage or a snake). Unless you have other gut issues, the best way to ensure this is to stay hydrated and include fiber in your diet (foods like fruits, vegetables, and whole grains). Many people find supplements helpful, such as magnesium citrate, psyllium husk, or Benefiber.
3. Go with the urge.
It’s important to only sit on the toilet when you have the urge to go, but it’s equally important to avoid suppressing the urge. Go when you need to go (even if that means going at work, school, or the grocery store). Everybody poops.
Our bowels do like routine, however. Everything from eating at or near the same time daily, having some consistency in the foods you eat, having a warm beverage or small breakfast first thing in the morning, going to bed at the same time daily, and doing an ILU abdominal massage at the same time daily can help.
4. Toileting posture and breathing.
We weren’t put on this earth with toilets, and our bodies actually prefer to be in more of a squatting position when we poop. Sitting with knees over hips and slightly leaned forward with elbows resting on knees provides an improved angle for stool to pass. At home, use a squatty potty or stool. If you’re out or on vacation, often you can use a trash can or suitcase to prop your feet on. Think of using your breath and lower abdominal muscles to move stool down and out. You should never hold your breath as you bear down or strain. Rather, blow out as you try to keep your lower belly big. Avoid crunching your rib cage down toward your pelvis.
5. Managing stress.
Your bowels really don’t like stress. They’re less likely to move when you’re stressed and in a hurry. Stress also keeps our body on high alert and locked down, it worsens our breathing patterns, and it prevents routine. Two of the best ways to manage physical stress are to take 10 minutes daily to go for a walk, move, or do some yoga and to take 5-10 minutes daily to work on diaphragmatic breathing.
For those struggling with constipation, a pelvic floor PT can help by assessing how your pelvic floor is working, training you in toileting posture and pressure management, providing manual therapy techniques to improve how your body functions, and by building a bowel routine that works for your life.
Trust me, pooping well can change your life!
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