Sue Serebro offers toileting tips that will ease constipation and assist with healthy bowel movements.
What is constipation?
Constipation can be defined by two or more of the following:
- Hard stools
- Straining when passing stools
- Incomplete emptying
- Less than three bowel movements a week
- Having to push and using your fingers to manually release stools
If this occurs 25% of the time in the last three months, you are clinically constipated.
Dangers of constipation
Constipation may have a major impact on your bladder, resulting in urinary incontinence; urgency and/or frequency; as well as uterine or vaginal prolapse.
If your pelvic floor is dry and the skin is thin and fragile, from hormonal loss due to chemotherapy, hormonal blockers or merely menopause, the fragile pelvic floor skin can tear and may become infected. This can lead to tremendous discomfort.
Normal bowel movements
Normal bowel motion varies from going to the bathroom three times a week to three times a day. Everyone’s bowel habits are unique. Therefore, don’t compare yours with your friends and family.
Your individual routine may be affected by travel, the food you eat and the amount of liquid you consume, as well as stress. Constipation can also be one of the side effects of chemotherapy.
If we look at the anatomy involved, you have two sphincters, one at the top and one at the bottom of the rectum. The top internal sphincter sits between the colon and rectum, and is controlled by the brain and spinal cord. The bottom external sphincter, the anus, is voluntarily controlled.
If you don’t want to go to the toilet for whatever reason, the anus can contract and push your stools up into the rectum again and stop your urge to poo. It’s not healthy to do this, as all the unwanted waste that you need to get rid of will be reabsorbed into your system, e.g. unhealthy hormones. You shouldn’t voluntarily hold your faeces in for more than three hours.
If your stools are made up of separate hard lumps, you are very constipated. If your faeces are lumpy and sausage-like, you are slightly constipated.
Ideally, normal stools should be sausage-like with cracks on the surface, or smooth, soft and sausage- or snake-like, and should be passed with no effort.
Before flushing the toilet, it’s important to look and see what your stools look like so that you can assess if you need to modify your bowel habits as well as other factors affecting the passing of stools.
- It’s advised to drink six to eight glasses of water daily (30ml water to 1kg of body weight).
- Include 25 – 35 grams of fibre in your daily diet. If you are not eating this quantity of fibre yet, increase it slowly so as not to overwhelm an already stressed system.
- Keep stress levels to a minimum.
- Identify and eliminate irritants, like spices, processed and refined foods.
- Avoid smoking and caffeine.
- Include exercise in your daily routine.
- Add a couple of spoonfuls of flaxseed to your diet and lots of leafy greens.
- Drink a warm beverage first thing in the morning to stimulate your system.
- Probiotics and prebiotics may be helpful.
- Ensure that you always eat slowly, digest your food properly and enjoy the food.
Good toileting behaviour
This is vital. Should anxiety be a factor for your constipation, you must devote unpressurised, dedicated and quiet time to toileting.
It’s important that you practice mindfulness and relaxation so that the anal sphincter, together with the pelvic floor, is free of any tension to gently pass your stool.
When sitting on the toilet, don’t slouch but rather extend your spine, leaning slightly forwards. Elevate your feet on shallow blocks or books so that your knees are higher than your hips. Keep your knees together and your feet apart, to adequately open your anus.
Be mindful that your pelvic floor is completely relaxed. Take a deep breath in and then gently blow through pursed lips and at the same time gently bear down to push.
Always remember the importance of meticulous gut health aiming towards a better general health.
MEET OUR EXPERT – Sue Serebro
Sue Serebro is a qualified physiotherapist and certified lymphoedema therapist. She obtained three international certifications in Australia, America and locally. Her passion remains the rehabilitation of patients who have been diagnosed with breast cancer and menopause.