Tuesday, September 4, 2012

How Do You Poo?

Yes, I asked it. It's a topic no one wants to talk about. Even though there is a children's book out there called "Everyone Poops," grown-ups just don't want to discuss it. Studies have shown that people would rather talk about sex than their bowel movements. Apparently, to poo is taboo. It's crazy! We all know that every one has to, yet no one wants to fess up to it. And its unfortunate, because difficulty with bowel movements, or constipation, is one of the most common gastrointestinal complaints in the United States. In fact, more than 4 million Americans have frequent constipation, so you are not alone!

Constipation is a symptom that has different meanings to different individuals. Most commonly, it refers to infrequent bowel movements, but it may also refer to a decrease in the volume or weight of stool, the need to strain to have a movement, a sense of incomplete evacuation, or the need for enemas, suppositories or laxatives in order to maintain regularity.

And just because you are not going every day, does not mean you are constipated. For most people, bowel movements can occur from three times per day to three times per week.

So what affects your bowel movements?

Diet - The average American diet includes 12 to 15 grams of fiber per day, although 25 to 30 grams of fiber and about 60 to 80 ounces of fluid daily are recommended for proper bowel function.

Exercise - When you don't move your body as much as you should, your bowels become less stimulated and you may find that you eliminate less frequently.

Position - Believe it or not, the current toilet seat is a relatively new invention. It was developed during the Industrial Revolution by people who thought it was much more dignified to sit on a throne rather than squatting. However, many doctors at the time were worried about this causing health problems because it went against nature. If you have ever felt, as many do, that after you have evacuated, there is still something left, here is the reason:


The anal canal is not straight when we are seated and bowel evacuation when seated results frequently in obstructive constipation. If you get into a relaxed, full squat position, the anal canal straightens.


Now, I'm not suggesting you should go squat in the woods whenever you need to have a bowel movement. There is an easier way to get in a squatting position while still on the comforts of your throne. The solution is raise your knees. By getting your knees in a position where they are above your hips, you are mimicking a squatting position. I tell my patients to use a stool or even a stack of telephone books (really what else are you using those for?), but a company has come out with a convenient and more attractive solution that you don't have to hide when company comes over. It's The Squatty Potty! Check out their great video.



As a pelvic floor physical therapist, I educate my patients about everything that I've shared with you here and more. If a patient also has pelvic floor dysfunction, I may treat them with biofeedback, which is a retraining technique that helps you learn how to coordinate the muscles appropriately so that you have a successful bowel movement.

If you have problems with your bowel movements, talk to your doctor. This is an important conversation to have and remember everyone poops! Even your doctor!  There are other things that can contribute to constipation that you should discuss, including medications that you are taking. Take control of your health and discuss your options and whether seeing a pelvic floor physical therapist could be beneficial for you.

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