Ph101 Why is pooping so difficult?

toiletFiona McMahon, DPT

The number of Americans who deal with constipation issues is massive (4 million!)! It seems like every time I mention that I’m a pelvic floor physical therapist, another friend of a friend pulls me aside with bowel movement concerns. Why is it that so many people have issues? And more importantly – what can we do about it? This is the topic of our next Pelvic Health 101 seminar  on  March 30th at 7pm. 

Not only will constipation be discussed but other bowel conditions, such as irritable bowel syndrome, fecal incontinence, bloating and hemorrhoids will be addressed. The lecture will also go in depth on the role of fiber, water intake, toilet posture and pelvic floor muscles in having a successful bowel movement. You will even go home with easy techniques that you can implement immediately to help you get that smooth move! Don’t miss out on this FREE event – it’s a MUST for anyone who struggles on the porcelain throne. Seats are going fast!  Light snacks and refreshments will be served.

Register at pelvichealth-101.eventbrite.com  today.

Location

110 East 42nd Street, Suite 1504

New York, NY

10017

Check out or upcoming courses!

pelvic-health-101-spring-2017

BPPT Health Tip: Best Positioning Tips for Optimal Bowel Movements

By Sarah Paplanus, DPT, PT

Are you among the 4 million Americans who suffer from constipation? Or the 1 in 5 American adults with Irritable Bowel Syndrome? Do you occasionally experience the pain and itchy feeling associated with hemorrhoids? If so, the Squatty Potty or similar stool may be the perfect addition to your bathroom! Even if you haven’t been diagnosed with any of these conditions, it is important to note that straining or holding your breath to complete a bowel movement is never normal and is usually a sign of dysfunction. Colorectal medical conditions can vary in their cause, in their presentation and in their severity, but your pelvic floor muscles will always be affected.

null( Image via: squattypotty.com )

Anatomy!

 

Your colon carries waste out of your body, and where the colon meets your rectum is called your anorectal angle. This anorectal angle is an important factor in continence.

Your pelvic floor muscles work together to support the rectum, change the anorectal angle and control opening/closing. One of your pelvic floor muscles (the puborectalis) forms a sling around your rectum and works to maintain the anorectal angle. If that muscle is tight, it can essentially “choke” your rectum and contribute to straining.

null

What does squatting do?

Squatting straightens the anorectal angle and helps to relax the puborectalis muscle, which helps to facilitate emptying. It also decreases the amount of pressure in the abdomen, which has been shown to decrease the time and effort needed for defecation. This all helps to reduce excessive pressure and strain on your pelvic floor muscles. In cultures where squatting is still prevalent for defecation, such as parts of Asia and Africa, it has been found that bowel movements tend to be more complete and that there is a decreased incidence of colorectal dysfunctions such as hemorrhoids, constipation and hernias.

Why is straining bad?

A principle of elementary mechanics states that “any system exposed to excessive pressures ultimately sustains injury”.These injuries can be in the form of a hemorrhoid, a hernia, a muscle strain or a chronic pelvic floor dysfunction. Straining also increases your risk of the Valsalva maneuver, which is exhaling against a closed airway. This causes a sudden increase in intra-abdominal pressure which can cause abrupt changes in blood pressure.

Toilet Posture

null

Using a squatty potty, stool, or even two yoga blocks can help you assume a “squat” position. Lean forward and rest your elbows on your knees. Take deep breathes in, using your diaphragm. Place your hands on your belly and feel your breathe fill up your abdomen. Keep your mouth open and jaw relaxed!

Other Strategies to Improve Bowel Health

  • Cardiovascular exercise
  • Proper nutrition (see our previous post on fiber!)
  • Make sure you are drinking enough water
  • Relaxation training, diaphragmatic breathing

 

What to do if you are still suffering?

If the above tips are not helping defecate regularly and comfortably, you may be suffering from pelvic floor dysfunction. Pelvic floor dysfunction can occur when the muscles of the pelvic floor become too tight, weak, or both to do their job properly. Physical Therapy can help! Visit us at Beyond Basics Physical Therapy to help better your BM’s.

BBPT Health Tips: Entering Hydration Station

Fiona McMahon, DPT

water-life-crop

 

The dog days of summer are here, folks! Walking from the subway to your apartment feels akin to walking on the surface of the sun and it’s nearly impossible to avoid sweating through the back of your shirt on your way to work. It’s time to think about your water intake.

At Beyond Basics, you can often hear our therapists ask this question over and over, “are you drinking enough water?” But how much is enough? Can you over do it? And lastly, why is it important for me to be drinking so much water?

 

Benefits of Hydration

 

  • Body Temperature Regulation: The body needs water to produce sweat to cool your body, without enough water the body cannot cool itself, which can be dangerous especially in hot weather. This is especially important in children and older adults
  • Physical Performance:  Decreases in athletic performance have been seen with as little as 2% body mass water loss. Ensuring you are hydrated ensures a better workout.Dude running
  • Brain Power: Even mild dehydration can put you in a bad mood, as well as affecting memory and alertness  study lady
  • Bowel Function: Not consuming enough water can slow down the movement of stool and lead to painful constipation  Excellent-toilet-paper-holder
  • Heart and Blood Pressure: Dehydration decreases the volume of blood in the body. With decreased blood, the heart has to work harder to circulate the smaller volume throughout the body, resulting in increased strain on the heart. This is of particular concern in those with heart conditions.  hearthealthy
  • Bladder:  Drinking enough water can reduce risk of urinary tract infection by keeping bacteria in low concentrations in the urinary tract. It can also reduce general bladder discomfort by reducing the amount of bladder irritants present in the urinary tract.

 

 

 

What should I Drink?

How much and what to drink isn’t always clear. I often get asked, what counts. Does decaf coffee count? Does juice count? My answer in the pelvic health world is no, water is the only thing that counts as water (even sparkling water doesn’t count). My aim is to reduce the amount of bladder irritants present in the bladder, in addition to adding all the other benefits outlined above.

So How Much Water Do I Really Need?

–  The advice for how much water to drink is varied. One common adage is to drink 8- 8 ounce glasses a day. This is a great starting point and doesn’t take into account an individual’s size or how much s/he perspires. We also can’t always rely on our own thirst. In both the elderly and children, the sensation of thirst does not always occur strongly enough or frequently enough to prevent dehydration. The common rule of thumb is to drink half your bodyweight in ounces. So take me, for example, your average 140 pound physical therapist:  Half my bodyweight is 70 lbs, so I should drink approximately 70 ounces or 8.75 cups. If I exercise, I should increase my water intake to match the amount of water I lose in sweat. Other reasons to increase water intake include, hot days, history of constipation or if you are breast feeding.

Another little saying I often say to my patients is, “If you are going to pollute, dilute”. What that means is, if you are going to indulge in a little caffeine or alcohol, follow it with an equal volume of water to prevent any dehydrating effects.

 

Sources:

Popkin B, D’Anci K, Rosenberg I. Water, hydration and health. Nutr Rev. 2010 Aug; 68(8): 439–458.