I’m my house, with two small children, poop is a regular topic of discussion. Poop jokes, poopy diapers, conversations about how frequently each child pooped. Needless to say we are not shy about discussing our poop.
However, if that is not your reality (and lucky you) you may not be paying close attention to a vital marker of health. Your bowel movements can tell you a lot about what is going on in your body but most people don’t pay much attention or know what to expect as normal.
What is normal?
This can be tricky because generally it differs for everyone. A normal frequency might be anything from two to three bowel movements a day to one every two to three days. In general though, a normal bowel movement is well-formed, passes easily without pain and is neither loose or cracked.
If your unsure if your bowel is normal, taking a peek inside the toilet bowl can be helpful. In clinic we use the Bristol Stool chart (1) to help identify healthy or problematic stool. If you are using this as a reference, number 4 is your ideal poop.
What contributes to poor poop?
Again this is highly individual, but some things to consider if you are either constipated or have loose stool include:
Adequate Hydration
Pelvic Floor Muscle Tone
Dietary Habits
Gut Health
Digestive Health
How Can We Help Get You Regular?
Digestion and constipation are things we discuss frequently as pelvic therapists. Retaining stool, or chronic constipation, can stretch out your rectum and make it exceedingly difficult to empty your bowels. Loose stool or irritable bowel may indicate an underlying condition. Both can contribute to pelvic floor dysfunction.
So what do we recommend to our clients?
Hydration
Adequate water intake is essential to good digestion.(2) Take a look at the colour of your urine, if it is dark or has a strange odour, it might be an indication you are dehydrated. Try to hydrate throughout the day so that your urine is a light straw colour or almost clear. A bladder diary can help measure if you are taking in adequate fluids. It is important to remember that drinks such as coffee, caffeinated tea or alcoholic beverages don’t count because they act as a diuretic eliminating water from your body.
Fibre
With more and more hype around low carbohydrate diets, more of our clients are showing signs of constipation. Why? Often they have cut out fruit, a great source of both water and dietary fibre. We often have clients fill out a fibre diary to determine if they are getting enough fibre from their food. When this is not the case, a fibre supplement can be very helpful in restoring proper stool consistency. (3)
Gut Health
This is a whole blog on it’s own, but more and more research on health is being devoted to establishing healthy gut flora. Essentially we want to make sure our gut has enough healthy bacteria to assist in digestion, maintain good immunity and properly absorb the nutrients in our food. Several things can affect your gut flora including antibiotic use, oral contraceptives and even the bacteria we were exposed to at birth. A high quality (read: not the drug store brands) probiotic can be an important step in balancing the bacteria in your gut. (4) But beware, not every probiotic is a good choice depending on your individual symptoms. Ask your health practitioner to help you choose a probiotic that best meets your specific needs.
Pelvic Floor Tone
In many cases, digestion can be fine, but your pelvic floor can be the issue. If you are someone with high tone in the muscles of your pelvic floor, you may not be relaxing enough to pass stool freely. This can contribute to constipation and hemorrhoids. This culprit requires an internal exam with your local pelvic physiotherapist but can be easily resolved with stretching, relaxation techniques and breathing. Sorry folks, this also means sitting your butt down on public toilets. The hover we all do for hygienic reasons clenches your pelvic floor muscles making it more challenging to poop
Toilet Posture
Is this really a thing? You bet. It may surprise you to know that we were never meant to sit on a toilet. Toilets are a modern convenience that actually increase the angle of our rectum making it more difficult to pass stool. To pass your poop more freely, you are going to want to squat more like our ancestral caveman relatives. To achieve this in a modern-day bathroom, raise your feet onto a footstool to decrease the angle. Commercial products like the Squatty Potty are great but a good old Ikea step stool will also do the trick. In a pinch (pun intended), lay a waste basket on it’s side and use it as a step stool.
Move
Exercise and daily movement is a great way to keep you regular. The movement helps to encourage digestive peristalsis, the movement of your food through your intestines, and keep you regular. Movement in the bathroom can also help. Instead of straining try some gentle twisting in combination with breathing to relax the muscles and encourage passage of stool.
If your bowels continue to be an issue after trying the above suggestions, it might be time to visit your healthcare provider. We have lots of techniques that encourage healthy toileting. These may include pelvic floor treatments, abdominal massage, nutritional and supplement review, acupuncture and others.
Don’t let this become a persistent problem! Poop or get off the pot….and give us a call today.
References:
Lewis SJ, Heaton KW (1997) Stool form scale as a useful guide to intestinal transit time. Scandinavian Journal of Gastroenterology 32: 920–4
Chung BS, Parekh U, Sellin JH (1999) Effect of increased fluid intake on stool output in normal healthy volunteers. J Clin Gasterenterol 28: 29-31.
Kamarul Zaman M, Chin KF, Rai V & Majid HA (2015) Fibre and prebiotic supplementation in enteral nutrition: A systematic review and meta-analysis. World J Gasterentol 17: 5372-81.
Dimidi E, Cox C, Scott SM & Whelan K (2018) Probiotic use is common in constipation, but only a minority of general and specialist doctors recommend them and consider there to be an evidence base. Nutrition 61: 157-163.
+Melanie Stevens Sutherland, Clinic Director & Senior Orthopaedic and Pelvic Floor Physiotherapist
Melanie is a graduate of McMaster University and brings 20+ years of experience as a senior physiotherapist to Body Co. She has enjoyed a long tenure working with active populations at prestigious sport medicine clinics. Past clients include Provincial, National and Olympic level athletes as well as members of the National Football League, the Canadian Football League, the Ontario Hockey League, the American Hockey League, the National Lacrosse League and Major League Soccer.
Following the birth of her own children, Melanie developed a strong interest in women’s health. She has taken specialized courses in pelvic floor physiotherapy and women’s nutrition. She is passionate about helping women find strength and confidence in their post-natal bodies following pregnancy and delivery.
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