Friday, 24 November 2017

There’s Physiotherapy for that? Constipation edition

Constipation is a common thing pelvic health physiotherapists try to address. Firstly, because the person suffering from it is uncomfortable, possibly bloated and in pain. It’s an unpleasant sensation when you need to go to the bathroom but can’t or it’s very difficult to do so. Secondly, constipation puts pressure on the pelvic floor muscles.

When someone suffers from chronic constipation, not only are they high risk for pelvic floor dysfunction, but are higher risk for hemorrhoids, rectal bleeding or mega colon. A mega colon is when the walls of the rectum stretch causing you to store more stool and can lead to an inability to detect that you need to go to the bathroom.

Whether it’s an occasional occurrence or chronic, constipation is not good, period.
Let’s talk about tips to keep constipation away.

One. Never ignore the “Call to Stool”

                I’ll use a story I learned on one of my courses. Think of the sensation of needing to go  as a butler tapping you on the shoulder. The butler walks up to you, gently touches you on the shoulder and says, “dinner is ready.” You decide, no this is not a good time, I’m busy. The butler goes away. He comes back later and says, “dinner is ready” and again its not a good time and you ignore him. If this happens over and over again, eventually the butler will stop coming to tell you, “You need to go to the bathroom.”

So when the butler comes, it’s okay if obviously you are not in a place where you can go to the bathroom but you really don’t want to wait too long before you go. Every time you ignore the butler the stool goes back into the rectum and more water is drawn out. The more water that is drawn out of the stool, the harder it gets.

Two. Hydrate well. 

As I mentioned if too much water is pulled out of the stool it becomes hard. If you are not hydrated well, then you already have very little water. Then if you delay going to the washroom, it can really make pooping difficult.

Three. Eat Enough Fiber

It is recommended that we eat anywhere between 25-40 grams of fiber daily. I often times give my clients a fiber chart that provides a long list of foods, serving sizes and approx amount of fiber so they can make different food choices and track their fiber intake. Veggies, whole grains, fruits, nuts are all foods high in fiber excellent choices.

Not only is fiber good for constipation but making healthier choices can benefit digestion, reducing the risks of heart disease, diabetes, cholesterol and cancer.

This is important to note that when you increase your fiber, you need to increase your water intake. The two work hand in hand.

Four. Get physically active

30 minutes of physical activity daily can help to keep your bowels happy. This could be walking, dancing, weight training, zumba, spinning.

Five: Mindset

Focusing your attention to mindset is an important key to making changes. What is your mindset towards getting healthy? How do you think about it? How do you feel about it? Why do you want to get healthy? For whom do you want to get healthy? Having a positive attitude towards health and setting your mind to the task will help you achieve your goals. Also surrounding yourself around others who have a similar mindset towards health will help you.

So where does physiotherapy come in?

Well, the tips I just provided you are things I go over with my clients. Lots of education on healthy lifestyle changes and why addressing this issue will help with addressing other symptoms that may be a result of the constipation. I teach toilet exercises, positions and abdominal massage techniques to improve bowel movements. If needed I also use manual therapy techniques to stimulate the intestines, reduce tension around the intestines and tension around the pelvic floor.

Some individuals with mega colon or reduced sensations to go to the bathroom may benefit from rectal balloon therapy techniques. While other clients have trouble relaxing their pelvic floor when it comes time to have a bowel movement and these individuals may benefit from biofeedback therapy.

So there are many different techniques a pelvic health physiotherapist can utilize to treat bowel dysfunction but you want to make sure your therapist has taken the training to treat bowel dysfunction.

So yes, there is physiotherapy for constipation J

The Pelvic Health Lady


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