[Photo credit: PracticalCures.com]
Constipation is a common condition that affects up to 42 million Americans which is usually caused by:
- Dysfunction with the nerves, muscles, or hormones in the body
- Pelvic floor dysfunction leading to an outlet dysfunction
- Delayed transit through the colon
- Lifestyle and dietary habits
Specific factors such as medications, lack of physical activity, dehydration, lack of fiber in the diet, pregnancy, aging, travel, laxative overuse, diseases, and IBS form the majority of reasons a person develops constipation.
Constipation is currently diagnosed through a cluster of symptoms, which include hard stools that are difficult to pass, straining for 25% of defecation, a sensation of incomplete evacuation for at least 25% of bowel movements, and fewer than 3 bowel movements per week. If your constipation results from a dysfunction of the nerves, muscles, or hormones in the body, you will need to consult your doctor and may need to seek out a physical therapist specializing in pelvic floor dysfunction; they can also assist you in making the necessary changes if your constipation results from lifestyle and dietary habits.
However, here are some simple lifestyle changes to help manage constipation:
1.) Diet modifications
Certain types of foods can increase constipation (processed foods, cheese, white rice, red meat, bananas, dairy products).
Increasing fiber intake is important for the health of the digestive system and can help alleviate constipation. There are two types of fiber: soluble and insoluble. Soluble fiber helps to soften and bulk stool, while insoluble helps to promote movement through the colon.
- Soluble fiber examples: fruits, vegetables, legumes, nuts, seeds, oats.
- Insoluble fiber examples: whole grains, brown rice, oat and corn bran, some vegetables and root vegetable skins.
2.) Anxiety and stress management
Stress is a common cause of constipation. Increased anxiety and stress triggers the sympathetic nervous system (our “fight or flight” response) and deactivates the parasympathetic nervous system (the “rest and digest” system). This not only decreases the activity of the digestive system, slowing transit through the colon, but also decreases the body’s ability to relax the muscles of the pelvic floor to allow for defecation.
3.) Daily aerobic exercise
Moderate levels of aerobic exercise increases blood flow to the digestive system and improves function. Any form of exercise is beneficial, and can be as little as a 10-20 minute walk.
4.) Toilet posture/positioning
Proper toilet posture can help assist in relaxation of pelvic floor muscles to allow for improved ease of bowel movement and decreased straining. Modern toilets typically create a sitting posture that does not allow the anorectal angle to straighten, which may increase difficulty with voiding.
For improved ease of bowel movement, the best toileting position is one that mimics a squatting posture. Placing the feet on a stool to increase the amount of hip flexion while sitting is a simple solution to create a better toilet posture.
5.) Drink water, plenty of it
Dehydration is a common cause of chronic constipation. Decreased fluid intake can lead to firmer, harder stools that are more difficult to pass. Current recommendations for fluid intake vary depending on activity level, health status, and the environment. Generally, a good rule is to aim for around 2 liters of water intake per day.
Sleep deprivation can slow the intestinal slowdown and decrease bowel regularity. Sleep recommendations vary based on individual needs, however most resources continue to suggest aiming for 7-9 hours per night.