Constipation is a miserable condition that can worsen situations like lower back pain and muscle tone problems in individuals with neurological conditions and confusion in individuals with dementia. It’s a condition that needs to be understood and managed.
One of the primary issues is encouraging people to seek help. A lot of people are too embarrassed to see their GP about bowel problems, which is a problem because one of the initial signs of colon cancer is a disruption in bowel habits that lasts for more than three weeks.
What is normal?
Normal bowel function is:
When you first feel the urge to poop, you can hold on long enough to get to a toilet without any accidents.
You defecate within a minute of sitting on the toilet, it doesn’t hurt, and you don’t have to strain.
You empty your bowel, and you don’t have to go back again – or have a feeling of some “left.”
It is usual for you to feel an urge to stool within half an hour of your meal. This is the gastrocolic reflex, and it’s what prompts individuals to want to go to the toilet in the morning. Most people’s regular pattern can range from several times a day to several times a week. It’s a great idea to pay attention to your bowel habits.
How it works
The indigestible parts of our food move into the colon, which absorbs water and electrolytes. The large intestine is full of bacteria that turn the food remnants into fecal matter. The period it takes for food to move from one end of the digestive tract to the other is known as “bowel transit time.
” It’s usually 1-3 days on average, and 90% of that time is spent in the bowel. A slow bowel transit time means the stool spends longer in the large intestine and becomes dehydrated, making it harder to pass.
The stool passes from the colon into the rectum, through the internal sphincter muscle and then through the external one on its way out of the body.
The internal sphincter muscle then automatically relaxes the top of the anal canal, triggering nerves in the process to signal that you need to go. The control of the external sphincter is voluntary as it can push the feces out of the anal canal if there’s isn’t any suitable place to stool.
Unfortunately, withholding stool repeatedly could result in a constipated state, especially in children. And that’s why it’s best to evacuate your bowels when you feel the initial urge to go.
The Poo Position
You can quickly help in reducing strain and the stress on the tissues by squatting to pass stool. This position in question encourages the pelvic floor muscles to relax. It can be mimicked on a Western-style toilet by placing your feet on a low stool/chair. A “stool” stool, if you must.
Sitting with your hips at 90 degrees means that the puborectalis muscle isn’t relaxed, resulting in the kink in the upper rectum not straightening out. Raising your feet so that your hips are flexed beyond 90 degrees tends to straighten out where the colon and rectum join, allowing feces to pass more quickly. Feel free to make use of toilet rolls to rest your legs on, or even a small specially-made stool.
Leaning on the elbows and creating a “moo” (or other sounds) helps reduce the urge to strain.
Most physiotherapists tend to teach people to imagine they are widening their waist and pushing their tummy forward, like a barrel – or like Shrek and asking them to pay attention to their anus as they do so. Try leaning forward and resting your elbows on your knees – almost like the crash position on an airplane.
Why is straining considered harmful?
One of the reasons it’s considered harmful is that straining increases the intra-abdominal pressure and results in congestion of the soft tissues.
When you strain, you’re more likely to develop prolapse, piles, or vaginal varicose veins. There have also been known cases of individuals fainting or having heart attacks due to the situation (Ask Elvis).
Similarly, we know that a full bowel can irritate the bladder. A lot of cases involving incontinence are usually related to constipation. In my experience, it’s best to deal with the bowel first before anything else.
What about your diet?
Most experts suggest that we aim for 30g of fibre each day. Always incorporate fibre into your meal plans. Increase daily fibre intake gradually (at least 5g a day) to avoid bloating. And also remember to drink enough water.
Keep a Bowel Diary
It’s usually a good idea to keep track of your bowel movements, or, to make the obvious joke, a ‘log’ log. Try jotting down when you stool, and if there was straining involved, leaking of gas or faecal matter, the appearance of the poop, etc.
You could always use the Bristol Stool Scale (BSS) to monitor and classify your stool’s health and function. Types 1-2 indicate constipation; 3-4 are ideal; 5-7 indicate diarrhoea or urgency.
Adjust diet and fluid intake to be a 3-4 if you are prone to diarrhoea, a 4-5 if you are inclined to constipation.
Medication
Most times, it’s best to ask your doctor or pharmacist for advice on such matters. We don’t want people buying over-the-counter bulk-forming laxatives if they’re suffering from chronic constipation.
If you are already blocked up, you don’t need to add any more volume to your stool.
Pregnancy and Childbirth
This particular scenario tends to be a bit challenging because the growing fetus tends to squash the colon. And the hormonal changes tend to make it sluggish.
Most pregnant women are prescribed iron supplements by their doctors, which increases the risk of constipation.
The fear of post-delivery pain from tears or episiotomy sites can result in anxiety around bowel movements.
These issues tend to be missed in antenatal appointments and classes due to time constraints. It is imperative, however, that women get the right information about proper bowel management ? especially if she has had an episiotomy or anal-tear.
Worry and discomfort are going to impact maternal happiness and breastfeeding negatively. The right education and information on matters like these might help in reducing the need for medication in this generation.
Toilet straining places stress on pelvic tissues and are associated with piles, vaginal, and rectal prolapse, none of which are remotely funny.
