Let’s Talk About Constipation

This article is written by our Resident Women’s Health Physiotherapist Libby Borman. Libby is an experienced physio with a wide range of knowledge. She is passionate about women’s health and specialises in helping women with bladder or bowel problems, and pelvic or sexual intercourse related pain.

Last week I caught up with Libby over lunch and we spoke about a common problem many Mums experience, but don’t really wanna talk about – Constipation. Fair to say it’s not your typical lunch time topic of conversation, and probably why I recall a couple of weird looks coming from the table next to us. Anyhoo – Libby was full of great information. Check it out.


What is constipation?

Constipation is a common digestive problem that affects people of all ages and can be caused by a number of factors, including diet, lifestyle, and medical conditions. Someone is constipated if they have a combination of:

    • Dry hard poos
    • Need to strain to empty
    • Need to strain to finish
    • Feelings of incomplete bowel emptying
    • Bowels open less than 3x week 

NB: Bowel habits vary in everyone. Normal can range from doing a poo 3x day or only 3x week.


Why is constipation an issue?

If you have ongoing issues with constipation please seek help from your GP, local pelvic health physio or a good pharmacist. Blocked up bowels can make you feel quite gross reduce appetite, give belly aches and lead to anal pain from haemorrhoids or fissures. Regular straining to poo can weaken your pelvic floor, which can lead to other issues like prolapse and bladder leakage. 


What causes constipation?

  • Not eating enough fibre
  • Not drinking enough water
  • Not getting enough physical activity
  • Ignoring the urge to pass a stool when you need to
  • Being stressed or having a change in environment
  • Pregnancy
  • Using laxatives too much
  • Certain mediations such as some pain killers and iron tablets
  • Certain medical conditions (ie. thyroid problems)
  • Having problems with your digestive tract (ie. coeliac disease)


A note about Fibre 

Constipation is not just to do with how much fibre you eat but Fibre intake is important! Have a look at how many fruits and vegetables are in your diet, and if you can choose higher fibre cereal and bread. If it’s difficult to increase fibre intake with your diet, a fibre supplement may be useful (think metamucil or benefibre). You do need to be careful about rapidly increase fibre in your diet as it can plug up your system more. And, because our poo is made up of 70% water, you need to monitor how much fluid you consume/drink in a day – if its less than 1.5L combined, aim to increase it!


Other things to be aware of

  • Being able to relax your pelvic floor and anal muscles properly is important! When you are trying to poo, let your tummy relax/bulge out and try let your anus and PFM relax. No straining – because when your abdominal muscles tighten, your anus often reflexively closes. Hard to get something out through a smaller hole.
  • Check your toilet posture. Feet should be supported to help you relax, and most people find that if their knees are higher than their hips, and they lean forward, that they can poo more easily. Most kids benefit from a step under feet. 
  • Our body has some natural reflexes that help us empty our waste. When we wake up, when we think about food, and when we eat, stimulates our gut to move things along. A good time to try go, is 20-30 minutes after waking up, eating or having a hot drink.
  • Busy people often miss the urge to go. Which then means that you may not get another opportunity til the following day. Which allows more time for the body to absorb water from the poo, making it drier and harder. So, if you get an urge to go, try prioritise going in the next 15 minutes. And if that urge to go is always when you are at the gym or on the bus heading to work, you may need to rethink your morning schedule to create an opportunity to empty.


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