What is Constipation?

Constipation is a bowel condition that is estimated to affect approximately 20% of people. Typical symptoms include less than three bowel movements a week, where the consistency of the stool is dry and hard making it difficult to pass. The sensation of incomplete emptying can be a common complaint for those with constipation.

What causes constipation?

Constipation occurs when our waste moves through our digestive tract too slowly or the stool cannot be eliminated effectively from the rectum. When this happens stool becomes more solid, dryer and even harder to pass. 

The pelvic floor and constipation. 

Today let's talk about the pelvic floor and the important role it plays in helping you to eliminate a stool. For many this happens naturally and there is no need to think about it. But if you have dyssynergy of your PFMs (puborectalis - PR)  they become uncoordinated making it difficult to have a bowel movement.  

Why is coordination of the Pelvic Floor Muscles so important for a bowel movement?

It is increasingly recognized that pelvic floor dysfunction can cause difficulty with bowel movement and constipation. 

The puborectalis (PR) muscle originates from the pubic bone and wraps around the bowel, by doing so it creates a kink in the bowl. This kink works as part of our continence system. When the timing is right and you're getting ready to expel a bowel movement the PR muscles should relax in a coordinated manner, this straightens the back passage and with a strong propulsion through the rectum should allow for easy expulsion of the stool. 

Up to 50% of those who are chronically constipated have dyssergy of their PR. This means that either the PR is unable to relax or it reflexly contracts rather than relaxes with a bowel movement. This results in constipation. 

How do I treat constipation?

Our Osteopaths will work alongside your current health care providers to produce an individualized treatment plan, they use a variety of techniques to help your pelvic floor muscles relax and with biofeedback techniques teach you how to effectively bear down. 

Osteopaths work with your breath and facial system to help relieve any tension within the abdominal region restricting movement of your bowel. Then, through education, work with you to create a healthy bowel routine, defecation training, ensure good toilet habits using correct posture/stool and breathing strategies while having a bowel movement.

Tips to Improve Constipation at Home

1. Stop and chew your food. No rushing. 

2. Drink adequate water

3. Eat a variety of fibrous foods.

4. Exercise regularly

5. Abdominal massage

6. Spend time outside each day

7. Use a stool when sitting down for a bowel movement.

8. Relax the rectum when sitting on the toilet, allow your perineum to bulge. 

9. Keep your mouth and jaw relaxed.

10. Use low toned sounds - oooooo cha.

11. Never delay a bowel movement.

12. Relaxed breathing 

13. Don’t strain - use correct breathing strategies. 

14. Avoid negative self talk when toileting. 

KATE'S TOP TIPS FOR GUT HEALTH

People all over the country are going cray cray buying toilet paper like it’s going out of fashion, some even with rooms full of the stuff! This is leaving those not invested in the hysteria, starting to run low. Really low.

It got me thinking about our use of toilet paper, and if we all had good quality stool, we could all save loads of toilet paper and a stack of money. 

Are you guilty of wiping, wiping, then more wiping, and then just a bit more wiping just to be sure? … If you are doing this after every bowel movement, you are definitely using lots of this highly sought after material... aka toilet paper. Does this sound familiar? When you have a good quality poop (and your pelvic floor muscles that form the sphincter are strong) you should only need to wipe once. Yes. You heard it here peeps!

Did you know that optimum gut health should always be a priority, it reduces inflammation and stress as well as improving the immune system (and who doesn’t want an optimal immune system right about now?) Studies have also shown that good gut health has been associated with improved mood and lowered anxiety and that is a bonus for everyone! Your gut’s relationship to the pelvic floor muscles is also vital, as constipation and straining can cause weakness in the pelvic floor, which may, in turn, affect many aspects of your life. In the past, all of this may not have been enough incentive to get your gut health on track, but maybe the fear of running out of toilet paper, is the push (get it?) that you need! 

It’s time to get your gut health on point. 

Here are my tips for improving your gut health

1. Mindful eating/ chewing - Food is essential to nourish our body so that it is able to function optimally and survive. Our relationship with food can also affect our digestion, especially if it involves anxiety. If this is the case, mindfulness meditation and seeking professional help is essential. Being mindful when eating is of great importance; this may be hard for those who are usually running out the door with a muffin in one hand and a coffee in the other but it is a simple thing to do for great benefit. It is important to make time to relax and sit down for mealtimes, and did I mention without the phone/TV! And chew, chew and chew some more. If you are using a knife and fork, once food is in your mouth, put your cutlery down. And chew. Chewing breaks the food up and gets our stomach juices flowing, which further helps with the digestion of our food. This process also makes it easier for digested food to pass through the intestines with minimal irritation to the gut lining and then allows for the effective absorption of all the essential goodness we receive from our food. 

2. Use a squatty potty. There is a very good reason why toddlers (pre toilet training) squat when doing a poop. Squatting helps to relax our pelvic floor muscles which takes out a kink in our rectum and straightens the last part of our back passage, which then allows for ease of movement of the waste product. It's that simple people. If you don’t have a squatty potty, a cardboard box will do the job.

3. Move, move and move some more. Apart from releasing endorphins that make us feel good, movement causes peristaltic movement in our large intestine. This is a natural contraction of the wall of the intestines to help move stool through the bowel. I think we have all been a witness to this at some point. Have you ever got up for an early morning run and 2km in you are busting for a poop?

4. Diaphragmatic breathing helps our pelvic floor go through its full range of motion of lengthening and shortening, so when it comes to the action of pooping, you are not fighting against a shortened muscle. The act of relaxed diaphragmatic breathing also dampens the sympathetic nervous system that promotes stress and encourages our parasympathetics which leads to rest and digestion.

5. Remove inflammatory foods from your diet. Foods such as gluten, dairy, and refined sugars have all been shown to promote inflammation of the gut. If the idea of this is stressing you out, try eliminating one at a time. For more information check out this blog.

6. Eat less processed and packaged foods including bread, pasta, biscuits, chips, and cheese. This is a hard one, but a good one when it comes to gut health.  

7. Eat more good fats to support the lubrication of the intestines. Good fats include grass-fed butter, ghee, pumpkin and hemp seeds, avocado, salmon, coconut oil, olive oil, avocado oil, macadamia oil, and omega 3 fatty acids.

8. Eat whole foods. Choose organic foods in their original state when possible, with the aim of 5 servings of vegetables a day. Spinach, honey, pear, prune, peach, apple, apricot, berries, carrot, cauliflower, beet all help to lubricate the intestines. If you need help with movement through your bowels; cabbage, sprouts, peas, coconut, sweet potato, asparagus, papaya, fig, rice bran, oat bran, chia seed, psyllium seed, marshmallow root, licorice root all promote bowel movement. 

9. Fluid intake. We usually lose, through urine and sweat, around 2 liters of water a day and what comes out must be replenished. From eating fruit and vegetables we get approximately one liter of fluid. The remainder should vary depending on the weather, activity levels and how much you sweat, you should generally be aiming for 1.5 litres a day. Remember, if you are thirsty, you are already dehydrated. If your urine is dark yellow you are dehydrated. Ideally, you want your urine to be a pale lemon color. 

10. Mindfulness - having a mindful practice has been known to lower stress which in turn has a positive impact on digestion. 

11. Osteopathy - research has shown that visceral manipulation to the intestines can improve constipation. Woohooo! And the good news is, it’s easy to do on yourself. As Osteopaths we believe structure and function are interrelated and by releasing the fascia and ligaments supporting the organs we can have a positive effect on the symptoms associated with gastrointestinal dysfunction. Chloe, Elizabeth and myself (Kate) have a passion for this area of osteopathy, and we have all done extensive training in this field. 

12. Probiotics - find a high count multi-strain probiotic and take the required amount daily. A high quality probiotic introduces friendly bacteria into the gut, with the aim to increase gut motility, aid digestion and absorption of nutrients. A set of mighty impressive skills right there! Different brands of probiotics have different cultures so it’s a great idea to rotate every couple months to introduce different strains of these friendly little guys. 

The information in this blog is meant as general information and is in no way meant to replace medical advice. If you have any concerns regarding your gastrointestinal system you should consult your general practitioner. 

Chloe's Health Tip ~ Beef Bone Broth

One super easy way to make your soup extra nourishing is to make it with bone broth. Bone broth may not sound very appealing, but it can actually taste really yummy, and better still, it is great for your body – in particular, your gut!

Bone broth is very nutrient dense – containing numerous minerals and amino acids, necessary for good health. As well as being good for digestion and gut health, bone broth is also said to be beneficial for the health of our skin, muscles, eyes, bones, joints and immune function…hence many old tales telling us to eat chicken soup to cure a cold!

Bone broth is really easy and cheap to make. Here’s how I make mine, using a slow cooker.

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Beef Bone Broth

• Place about 1kg beef marrow bones in the slow cooker. (Cannings Butchers sell some really good quality, cheap marrow bones – get them to cut them up for you if they’re not already, otherwise you won’t fit the bones in the pot!)

• Fill the slow cooker with water, then add a splash of apple cider vinegar (this is essential to draw the minerals out of the bones)

• Leave the slow cooker on low for about 24 hours and VOILA! – you’ve got yourself some bone broth!

* You can also add some vegetables and herbs to the slow cooker if you like – I tend to just season mine with salt & pepper when I am about to eat it.

• Just remove the bones and strain the broth before you fill your jars or containers. Store in the fridge or the freezer for future use. When cold, the broth may have a jelly-like consistency, this is due to the gelatin, from the bones, in the broth (which is really good for the gut).

Bone broth isn’t just for soups. You can use it in any recipe that calls for stock to be added or just drink it on its own!

Enjoy! You can thank me later.