Chronic Constipation: Part II

Pushing and straining to get it out? Sitting on the toilet for what seems like hours? Here are some tips to help deal with chronic constipation from the point of view of pelvic floor physiotherapy. You have probably already been told a thousand times to eat more fiber and, don’t worry, this post is not about that.

The pelvic floor muscles act as a sling, supporting the bowel, bladder, and uterus. In the first blog post, we went over what is normally supposed to happen with a bowel movement. In this article, we provide you with tips to help with chronic constipation (given that it may be coming from pelvic floor muscles and not stomach/digestion issues!).

1. NO STRAINING BUT DO BREATHE, PLEASE

Wait...what? Aren't we supposed to push with bowel movements? Excessive straining can lead to hemorrhoids, prolapse, and pelvic muscle dysfunction. Instead, practice doing long belly inhales and exhales, focusing on relaxing and letting go the pelvic floor muscles.

2. USING A STOOL

These days, toilet seats have been going higher and higher, for comfort. Especially with the population in the mid 50s to elderly having more knee and hip replacements, this makes complete sense. However, the pelvic muscles are more relaxed if you are in a squat position versus standing (pretty hard to poop in standing!). So, using a stool under your feet can help with relaxation of the muscles, so you have to work less hard at getting that bowel movement out. 

Note: Use a stool that can accommodate your feet a few inches apart and brings your knees slightly higher than your hips - see above picture.

3. POSITIONING

For some, the toilet seat is low and using a stool can make you feel like you are sitting in a budget airline flight, with your knees up against your chest. In this case, chuck the stool and just lean forward so your forearms are on your thighs.

4. DO BOTH

Or...you can do both. As in, use a stool AND lean forward, only if this feels comfortable. For some, this can be the best position to relax in.

If you try the above and your constipation is not improving, seek out the help of a Pelvic Floor Physiotherapist to assess the muscles and give you appropriate exercises.