October 2024 - Jesse Glaze, DPT - Reclaim Your Life: Holistic health + wellness
Pooping is one of the most basic human functions. But despite how simple of a process it is on the surface, a surprising number of people have chronic issues going to the bathroom. At any given time, 15% of adults in the United States report chronic constipation, in which they regularly have difficulty moving their bowels. 3/4 of Americans experience hemorrhoids at sometime in their lifetime according to the US Department of Health. Both of these are signs that the system is not working quite the way that it should. But the good news is, there are easy fixes to make this process as smooth as possible!
A common cause of constipation and straining on the toilet, both of which can lead to hemorrhoids, is dehydration. The recommended fluid intake for an adult is half as many ounces as their body weight in pounds, and 3/4 of that should be water. For example, a 200 pound person would want to drink at least 100 ounces of fluid per day, and at least 75 of those ounces should be water.
Fruits and vegetables contain water, which helps promote hydration. However, they also contain a key ingredient and getting your poops to move more smoothly: fiber. Most Americans do not get enough fiber. The recommended dose is 25 g per day, with those grams being split pretty equally between soluble and insoluble fiber.
Soluble fiber can be dissolved in water, and is found in fruits, vegetables, and legumes. This fiber helps to soften your stool, in order to make it easier to pass. Insoluble fiber is present in whole grains and leafy greens. This type of fiber does not dissolve in water, and it helps to move things along and clean out the insides of your colon.
This chart can help you identify some high fiber foods to include in your diet: https://www.med.umich.edu/mott/pdf/mott-fiber-chart.pdf
What goes in plays a huge role in what comes out, so getting enough water and fiber are essential. But water and fiber alone don’t fix everything—you also need to encourage bowel movements with good timing, regular exercise, and proper posture during toileting.
Timing can be key for easy bowel movements. For most people, getting on the toilet 30-60 minutes after a warm meal will be the easiest time to go. You want to have 10 minutes of uninterrupted toilet time. Your nervous system plays a huge role in your ability to poop, so being rushed or worried can prevent you from going. Your best bet is to try and go at the same time every day. Ideally, pick a regular time for a warm meal during the day and plan your bowel movement for 30-60 minutes later.
Regular exercise, even just going for a walk, is another key component of getting your bowels moving. Bowel movements mostly happen through peristalsis: the activity of your intestinal wall pushing things toward the exit. The more physical movement that you have in your day, especially with weight-bearing activities or activities that involve twisting motions, the easier it is for these muscles to move things along and lead to a smooth bowel movement. General recommendations are for 30 to 60 minutes of activity per day, but you can spread this out so that it fits your schedule. Getting 10 to 20 minutes at a time, several times a day, is a good way to get your activity in.
Finally, proper toileting posture makes it easier to pass your bowel movements and makes it less likely that you’ll incur injuries from straining, such as hemorrhoids or pelvic organ prolapse. Ideal toileting, posture is leaning forward with your knees stacked higher than your hips. The squatty potty is a great option for this, but a thick book or a standard stool can also work. You want your heels to be able to rest down and for the angle between your femur and your torso to be less than 90°. This position allows all of the muscles around your anus relax, so it’s much easier to pass a bowel movement.
Pelvic floor PT can help!
If you have chronic constipation, straining with bowel movements, or other difficulties in going poop, you may need the advice of a professional. Pelvic floor physical therapists directly treat the muscles and tissues surrounding this area, and can give you education, exercises, and manual therapy that may improve your ability to go. Especially if you have been to see physicians and don’t have underlying G.I. issues, pelvic floor physical therapy may provide relief that you’ve been looking for.
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