There are few things in life more satisfying than a well-formed bowel movement. You feel lighter, your stomach is at ease, and there's a sense of freedom that at least one task has been accomplished for the day. But when you miss a day (or seven) or you feel like you can’t completely empty your bowels? Well, that’s constipation my friend, and it sucks.
When I was experiencing health issues many years ago, one of the first signs I noticed was constipation and bloating (I looked like I was in my third trimester). I was so physically uncomfortable, that it really did interfere with my daily life. I went from being a regular twice-a-day pooper to an are-you-pregnant-non-pooper. I would actually jump rope daily until the jarring movement would finally produce some poo. It was never a satisfying bowel movement; just enough to take the edge off. This is a colorful way to tell you I feel your constipation pain, and I’m here to help.
Constipation is often characterized by the following, so if you’re experiencing these symptoms, you’re probably constipated:
You aren’t having daily, or at least every other day, bowel movements (we all have different bowel rhythms)
Stool is dry and hard, often resembling either rabbit pellets or lumpy, shaped like the inside of your intestines (I’m good at the graphics.)
Stool is hard or painful to pass, often feeling like you haven’t completely emptied your bowels
You may experience stomach aches, cramps, bloating, and nausea.
Now that you know what constipation may feel or look like, let’s look at what causes it and how we can get things movin’ and groovin’ again. Here are some factors that may contribute to constipation:
Eating low fiber. Not only does fiber feed our healthy gut bacteria, but it also adds bulk to help pass stool. Aim for ~40 grams of fiber daily, including vegetables, fruits, beans, nuts/seeds, and whole grains.
Dehydration. We are mostly composed of water and need it for many processes in our body. If you don’t drink enough water throughout the day, then your digestive tract will pull water from your stool, making it—you guessed it—hard, difficult, and painful to pass. Focus on drinking half of your body weight in ounces of water daily, drinking more if you’re sweating or drinking dehydrating fluids such as alcohol and coffee (or any caffeinated beverage). For example, if you weigh 200 lbs, then drink at least 100 ounces of water daily (~12.5 cups). Start slowly and sip throughout the day.
Not Moving. Movement gets things… well, moving. Choose an exercise activity you enjoy and move your body daily throughout the week. If you haven’t exercised in a while, start slowly with 5, 10, or 20 minutes.
Routine Change. Have you every traveled and noticed you don’t poop for a day or two? That’s actually normal. Changes in routine, even waking/going to bed at different times can throw off the natural rhythm of your body, so stick to a schedule whenever possible. If you are traveling, focus on eating plenty of fiber and drinking water, knowing that you may just be off for a day and that’s okay.
Stress. Stress effects everything, I swear. Pain in the butt. I encourage you to eliminate what you can (i.e. saying “no” when you don’t have the time or simply don’t want to), practice deep breathing or other activities that help you find calm, and work with a therapist to uncover the root issue.
Not Allowing Yourself to Poop. Let it out, friend. If you resist the urge to poop, it will train your muscles not to poop. Yes, there are times when you have to poop and there’s no toilet in sight, so you gotta hold it. No one wants to poop their pants. But if you’re holding it because getting up seems inconvenient or you don’t want to poop in a public restroom, just line the toilet and poop. Everyone poops.
Poor Positioning. Just like keeping your hips square can improve your golf swing, so too can adjusting your pooping position improve your bowel movements (and possibly golf swing). Which leads me to the Squatty Potty. It’s one of my most favorite things and was the first gift Josh bought me when we were dating (true story; I knew he was my perfect man). However, you don’t have to purchase a special product. Any sort of step stool will help raise your legs and bring you into a more natural, squat-like position for easier pooping.
Medications & Supplements. Narcotics, anti-inflammatories, antacids, iron supplements, antidepressants, allergy meds, blood pressure meds, and anti-nausea meds may cause constipation. Don’t stop taking these meds, but please incorporate the lifestyle changes listed above (unless contraindicated) and see if you notice any positive improvements (some of those simple changes may even help you get off your medication). As always, bring your concerns and questions to your doctor, pharmacist, and/or dietitian.
Bacteria, Yeast, & Parasite Overgrowth. When healthy gut bacteria are outnumbered by the harmful bacteria, then many gut issues may arise, including constipation. This is especially of concern if you’ve noticed a change in bowel movements after you’ve recently traveled, spent time in a lake or river, or had food poisoning. This was true of my situation (dang parasite). The best way to support a healthy gut is to take probiotics and/or eat probiotic-rich food, eat fiber, balance blood sugars, drink water, address stress, and move your body. However, if you suspect an overgrowth, then it's best to test than guess. Building better gut health for greater overall health is exactly what I help my clients with, and I would love to help you too.
Life Stages & Health Conditions. Various stages in life and health conditions are associated with constipation, including pregnancy, pelvic floor dysfunction, hypothyroidism, diabetes, diverticular disease, neurologic disorders, structural bowel disorders, bowel obstruction, and more. Older adults also tend to be constipated. They may not eat enough fiber, drink enough water, or be as active as they used to be, which all lead to constipation. Older adults who cannot move about easily, have incontinence, or are reliant on others to help them to the bathroom, tend to purposefully not keep water by their side because getting more water or going to the bathroom is pretty difficult. Regardless of what life stage or condition may be affecting you, please bring your concerns and questions to your doctor and dietitian.
Regardless, always reach out to your doctor if constipation is an issue. I understand it can be uncomfortable discussing your bowel movements; however, bowel health speaks volumes about your general health. I encourage you to reach out to your doctor sooner than later if it’s a new issue, if it interferes with your life, if it has occurred longer than a week, if you experience pain passing stool, if you notice blood in your stool, of if you’re experiencing unintentional weight loss.
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With love, Steph