The word constipation means many different things to different people. To some it means hard, pellet like stool, or difficulty passing stool, or just not going every day. Constipation can be defined in a variety of ways including opening the bowels less than three times a week, needing to strain to open your bowels on more than a quarter of occasions or passing a hard or pellet-like stool on more than a quarter of occasions. 
 
Many people have been educated or brought up to believe that we MUST empty our bowels on a daily basis and that it is harmful not to do so. This is not the case, the normal range for opening your bowels can be between three times a day, and once every three days. Very few people actually go regularly every day, and in fact some people will take regular laxatives or spend long periods of time on the toilet trying to go due to this misconception of needing to go daily. 
 
Constipation can occur in babies, children and adults, and affects twice as many women as men, and affects between 3% and 15% of the population. It is thought that up to one in six people may suffer with constipation. Older people are five times more likely than younger adults to have constipation, usually because of diet, lack of exercise, use of medication and poor bowel habits. Approximately 40% of pregnant women experience constipation during their pregnancy. 
 
What can be done to help? 
 
Lifestyle: Bowels benefit from routine. Allow yourself time and privacy to empty your bowels. When you feel the need to empty your bowel - respond! If you keep ignoring the bowel you can make yourself constipated. Often people will find that they need to go about thirty minutes after a meal or a warm drink. 
 
Exercise: Regular exercise, within your limitations, can stimulate the bowel to work regularly. 
 
Diet and fluid: It is important to make sure that your diet has adequate fibre in it. The best advice is to eat 5 portions of fruit and vegetables a day. Avoid skipping meals, especially breakfast as this can lead to a sluggish bowel. It is also possible to have a diet that is actually too high in fibre and this can slow your gut transit time down too much, leading to bulkier and harder stool. 
 
Examples of foods which can act as natural laxatives for some people include prunes / prune juice, figs / fig juice, molasses, liquorice, chocolate, coffee, alcohol (within recommended limits!) and spicy food / curry. Porridge oats are a natural stool softener and the best fruits are kiwi, pears and oranges. Linseed seeds can be useful, one to two teaspoons on your cereal each day. 
 
Drinking the correct amount of fluid for your body weight can help constipation. The job of the last part of the gut is to absorb fluid back into the body. It will do this even if you are drinking very little. If you are not drinking enough, this makes the waste hard and makes it difficult for you to get rid of waste. Fluid helps the waste to remain slippery and therefore easier to pass. Ensure you drink at least 1 ½ litres (3pints) of caffeine/alcohol free fluid in a day. 
 
Probiotics: The bacteria within your intestines are key to a good digestive health. It may help some people to maintain a favourable balance by taking a probiotic product each day. This tops up the 'good' bacteria you should already have in your large intestine. Acidophilus capsules are a very good probiotic as they are a slow release capsule and can be purchased at any health food shop. 
 
Medication: Some medicines you take may upset your bowel habit. Do not stop medication, but ask your nurse, doctor or pharmacist if you suspect this, for advice. 
 
Laxatives: Long term laxative use can be quite harmful. The nature of long-term use is that the bowel becomes progressively less responsive to all these agents, meaning that increasing doses are required. 
‘Pooing Posture!’ 
When you do open your bowels, it is important to get into a good position to get as empty as possible. Unfortunately, modern toilets are not ideal for this, as the most natural position is squatting. You can get close to this by supporting your feet on a stool, such as a Squatty Potty ® so that your knees are higher than your hips. 
 
Lean forwards slightly with your forearms resting on your thighs, palms uppermost (as if you are reading a book). Take your time - try not to feel rushed. Try to relax your shoulders and allow your tummy to bulge as you gently blow (blow gently, as if trying to blow a candle flame to make it flicker). Only take as long as you need - don't sit for ages. 
 
 
Physiotherapy 
There are many things that a Specialist Physiotherapist can do to help with the treatment of Constipation. Here at Bodyworks Physiotherapy Clinic I treat a lot of patients with bowel issues many of whom suffer with constipation. I have good results advising patients with everything already discussed in this article. I also teach pelvic floor muscle exercises and use biofeedback either with real time ultrasound or the biofeedback machine. 
 
WHEN TO SEEK HELP FROM YOUR GP? 
 
If you have a sudden or unexplained change in your usual bowel habit. 
If you experience unexplained abdominal pains. 
If you have bright or dark red in your bowel motions. 
If you cannot control your bowels, or leak from the back passage. 
 
I get very good results and very satisfied customers. Do not suffer in silence as there is help out there for you. If you would like to discuss your problems with me in complete confidence, then please email me or phone the clinic directly. 
 
Katrina.wade@bodyworksphysio.net 
01206 844410 
 
 
“We Know How Your Body Works” 
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