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.

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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.

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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

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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.

Cracking the Colon Color Code

By Riva Preil

Recently, I had the opportunity to discuss the medical information that can be gleaned from one’s urine (refer to What Version is Your Urine? April 11, 2014).  Today, I have a similar opportunity to do so regarding … bowel movements!  Warning: If you are enjoying my blog while eating your lunch, or if you are about to do so, you might want to hold off until you have finished eating.  Just thought you would appreciate that public service announcement.

That being said…stool is the body’s garbage.  Waste products, dead blood cells, bile, gastrointestinal bacteria, and other non-absorbable items (remember that time that you accidentally swallowed that penny?  Yep, that’s what I’m referring to) are excreted in one’s bowel movements. Stool is covered in a mucus sheath to help it slide out of the body.  Those who don’t drink enough water may experience straining and discomfort while passing a bowel movement, because mucus production is dependent on adequate water intake (8 cups a day).

The color of one’s stool may provide valuable information regarding one’s health.

  • GREEN stool may indicate sensitivity to Anise oil, an ingredient found in some licorice candies.  It may also indicate that stool is passing through the large intestine (aka colon) too rapidly for bile (which aids in the digestion of fats) to be fully broken down.  This may also occur when one consumes large amounts of green leafy vegetables and/or artificial food colorings.
  • WHITE or clay colored stool may indicate a bile duct obstruction, perhaps by a gallstone, enlarged lymph node, or scarring of the bile duct.  Other symptoms that accompany bile obstruction include abdominal pain, dark urine, and jaundice.
  • YELLOW stool that smells like sour eggs and appears greasy may indicate excessive amounts of fat in the stool. This is a common symptom of Celiac Disease, during which bile does not properly break down fat
  • BLACK stool could be a result of too much Pepto-Bismol, black licorice, or even beer.  However, if the stool is black, sticky, and foul smelling, it may also be a result upper gastrointestinal tract bleeding.  One should seek medical attention if they experience the aforementioned symptoms.
  • BRIGHT RED stool, as with black stool, may simply be the result of overconsumption of certain foods (ex. beets, cranberries, tomato juice, red gelatin, or Kool-Aid)…or it may indicate lower gastrointestinal tract bleeding.  Once again, one should consult with their physician if they suspect anything “out of the ordinary.”

For more information check out this article, “What Your Poop Is Trying to Tell You,” on Gizmodo!