Simple Tips to Reduce Constipation

I recently asked on my Instagram stories which topics folks would like to learn more about. I was surprised to see that a lot of people voted to learn more about bowel dysfunction. I realized I haven’t done many posts or blogs about bowel dysfunction or how to improve bowel function. So here we are!

More often than not, I find that patients in my office experience some level of constipation. Even those who have daily bowel movements will report that sometimes they have hard stools or have to strain in order to have a bowel movement. First, let’s talk about a few things we need to address when it comes to constipation.

1) Your pelvic floor muscles and bowel movement mechanics (yes, that’s a thing!)

Your pelvic floor muscles play an important role in bowel movements, and how we pressurize our core to have a bowel movement also makes a huge difference. While having a bowel movement, we want to use pressure from our abdomen to push stool down and out of the rectum, while the pelvic floor muscles lengthen to allow for stool to pass. A lot of folks will hold their breath, creating too much pressure in their abdomen and causing the pelvic floor muscles to contract (and therefore make it harder for stool to pass through their rectum). It is also helpful to elevate your knees above your hips to help your pelvic floor muscles relax. See below to learn more!

2) Organ motility

How quickly stool moves through the digestive tract plays a big role in the consistency once it reaches your rectum. If your organ motility is slow, you may have multiple days between bowel movements. As food moves through your digestive tract, more water is absorbed and the stool is harder (and more difficult to pass) by the time it reaches your rectum.

3) Stool consistency

The consistency of your stool can tell you a lot about what areas need addressed to improve your bowel health. Below is a picture of the Bristol Stool Chart. Types 1, 2, and 3 are common in folks who are constipated (type 1 being the most severe and type 3 the least). Type 4 is what we are shooting for to have easy bowel movements. Types 5, 6, and 7 are loose stools that are often due to illness or food sensitivity.

Now that we know more about what needs to be addressed when it comes to constipation, here are a few tips to improve bowel health 

Tip #1: Use a Squatty Potty and optimize bowel mechanics

A squatty potty is a stool that you set your feet on during bowel movements. Using a squatty potty puts your body in a squat position, allowing your puborectalis muscle (a muscle that wraps around your rectum) to relax and reduce straining.

I recommend to my patients to use the “big belly, hard belly” technique during bowel movements. With this technique, you take a deep diaphragmatic breath in (ribs expand 360 degrees) and relax your pelvic floor muscles (think about your sit bones separating). Then as you exhale make your belly hard using your abdominal muscles while keeping your sit bones separated. The increased pressure in your abdomen will help to evacuate stool while keeping your pelvic floor muscles lengthened.

Tip #2: Stay Hydrated

Hydration is a key component to healthy stool consistency. Being well hydrated helps to keep stool softer as it moves through your digestive tract. Try drinking half of your body weight (lbs) in ounces each day. I also highly recommend checking your urine to assess how hydrated you are. We want urine to be a pale yellow color.

Tip #3: Consider a magnesium supplement

Magnesium has a lot of health benefits, and has been shown to help increase the amount of water in the intestines, which in turn improves stool consistency (see above). As with any supplement, I recommend talking with your doctor or other health care provider to determine if a magnesium supplement is appropriate for you.

Tip #4: Massage your abdomen

Visceral Manipulation can be very beneficial in improving organ motility. I also love to teach patients this simple self colon massage to improve motility.

Tip #5: Don’t sit too long

Sometimes it is tempting to stay on the toilet and keep trying, especially if you feel like you still have to go. But sitting and bearing down for too long places a lot of pressure on your pelvic floor muscles and pelvic organs. If you have been trying for 5 minutes and it’s not happening, get up and walk around for a bit before you try again.

Tip #6: Exercise

Regular exercise can help stimulate your digestive tract and get things moving. If you aren’t already, try adding a daily walk.

Tip #7: Increase fiber intake

Most people have heard that fiber can help with constipation, but I figured it was still worth a reminder!

Tip #8: Drink hot liquid in the mornings

Hot liquids can help to stimulate your digestive tract as well. Many people will notice that their morning coffee stimulates their bowels. It’s not something I encourage folks to rely on, but it can definitely get things moving!

Tip #9: Have a routine

Knowing when you most commonly feel the urge to have a bowel movement is a great way to develop a bowel routine. For example, if you generally feel the urge in the morning after your coffee, try to use that to your advantage. Get up, hydrate, maybe walk or exercise a little, have your warm drink, then when you feel the urge to have a bowel movement go try! Developing a routine can be key in bowel health and reducing constipation.

As always, this blog post is not intended as medical treatment and is for informational purposes only. If you have been struggling with constipation and other symptoms that often go along with it (pelvic pain, hemorrhoids, fistulas, etc), I highly recommend seeing a pelvic floor therapist for an evaluation!

Blog post written by Dr. Alexis Hutchison, PT, DPT, OCS