AUGUST 2024
If you’ve ever felt like you’re not as “regular” as you should be, you’re definitely not alone. Constipation is one of those things no one likes to talk about, but it’s more common than you might think—especially in my line of work as a pelvic floor physical therapist. Whether it’s a kiddo struggling with potty training or an adult dealing with digestive issues, understanding constipation is key to feeling your best. So, let’s dive in, shall we?
What Exactly is Constipation?
First things first—what even is constipation? We’re talking about infrequent bowel movements, hard stools, and that dreaded straining on the toilet. According the Rome Criteria (think of it as a handy checklist for doctors and therapists like me), constipation is when you have fewer than three bowel movements per week, experience straining, OR feeling like you haven’t fully emptied your bowels. The consistency of your stool also plays a part. Have you seen the Bristol Stool Scale? (another handy list doctors use to rate the consistency of your stool). But you can also be constipated if you have excessive stool backed up in your colon that is not coming out even if you are pooping daily with soft poops. So, it’s not always an easy diagnosis.
Here are some interesting statistics for you – 16% of adults would be defined as constipated (33% of those over 65 years old!). Women are more likely to be constipated than men. It is estimated that up to 30% of children are constipated and constipation is the leading cause of bedwetting. Approximately 5% of all pediatrician visits are related to constipation.
Signs of constipation are varied but include bloating, excess gassiness, belly aches, indigestion, loss of appetite and irritability. Constipation in kids can look like bed wetting, poop smears in underwear or poop accidents, difficulty concentrating, extra large poops that clog the toilet, extreme bladder or bowel urgency, Recurrent UTIs, itchy bottoms or difficulty toilet training. Constipation can also be related to gut disorders, poor nutrient absorption, and reflux.
Now, everyone’s “normal” is a bit different, but if you or your child are experiencing any of these signs, it might be time to pay attention.
What Causes Constipation?
For the Little Ones:
Diet: Kids can be picky eaters for a number of reasons, and if they’re not getting enough fluids or fiber, their bowels can slow down.
Emotions: Potty training, stress at school or home, or fear of toilets or painful poops—these can all throw off their routine.
Activity Levels: Let’s face it, kids today might not be as active as we were back in the day, and that can make a difference.
Schedule Changes: travel and new routines are often a challenge for kids who are just learning to use the toilet.
Toilet Training: Potty training too early, before the child is showing signs of readiness, can lead to excessive holding and stool back up.
For the Adults:
Diet and Dehydration: If you’re not getting enough fiber or water, your bowels can get sluggish.
Sedentary Lifestyle: Sitting all day? Your bowels might be, too.
Medications and Health Issues: Some meds and conditions like IBS or pregnancy can slow things down.
Stress and Tension: if life is causing tension in your neck, your jaw or your back, it may also be causing tension in your pelvic floor which can slow down your gut function over time.
Why Treating Constipation is a Big Deal
So, why should you care? Because untreated constipation can lead to some pretty uncomfortable issues—think hemorrhoids, anal fissures, or even more serious stuff like fecal impaction. Chronic constipation can really mess with your quality of life, absorption of nutrients, your immune system and your mental health, so it’s not something to brush off.
Early treatment, especially when symptoms first start cropping up, can save you (or your child) a lot of trouble down the line. And let me tell you, a little prevention goes a long way.
How to Get Things Moving
Diet and Lifestyle Changes:
Upping your fiber intake and drinking plenty of water can make a world of difference for most people. There are a few people who feel worse with fiber – we can help them as well!
Regular exercise is your friend—it helps keep everything moving. Bending, twisting, walking – it all helps!
Medical Interventions:
Sometimes, a little help from over-the-counter remedies like laxatives can be just what you need. But, if you’re meeting the Rome Criteria definition of constipation or things aren’t improving, it’s time to see a healthcare provider.
Physical Therapy Interventions: No one thinks of PT as a first line defense for constipation, but there are a lot of ways PTs can guide you to better bowel health!
· Abdominal bowel massage
· Breath work – to encourage better digestion and emptying
· Core strength – a strong abdominal wall helps to keep the food moving down and not out
· Defecation dynamics – education on posture on toilet, timing of bowel movements
· PF training – to help relax muscles that may be slowing down the gut motility, to improve muscle awareness to be able sense urge early and facilitate emptying.
Wrapping It Up
Constipation is no fun, but it’s also nothing to be embarrassed about. As a pelvic floor PT, I’ve seen firsthand how addressing it early can make a huge difference in how you feel day-to-day. If you or your child are dealing with constipation, don’t wait—start making changes today, and don’t hesitate to reach out for professional help if needed.
Here’s to smoother days ahead!
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