A well emptied bowel is important to promoting a well functioning bladder.
If you have a tendency towards constipation, it can be helpful to your bowel health, bladder health, and overall health to address this concern.
There are many potential contributing factors that may cause an individual to experience constipation such as medications, supplements, dietary patterns, presence of neurological disease/deficit to name a few. It is important to discuss and there are healthcare providers out there keen to help you find resolution.
Constipation may present as difficulty in relieving bowels, a sensation of incomplete emptying, infrequent hard bowel movements, or overflow bowel incontinence (where looser feces leaks around the larger mass of hardened stool).
Conservative Suggestions to Promote Regular Bowel Movements
- Hydrate yourself well.
Aim to drink 1.5-2L of mostly water a day.
This helps draw water into the bowel to move stool along.
Ideas to increase hydration:
Carry a water bottle with you so you can take sips throughout the day.
Anecdotally, some report finding drinking warm water, particularly in the morning before or with breakfast, helpful to stimulate peristalsis (the wave like contractions in the bowel)
Increase the flavour of your water with natural additions such as a slice or two of lemon, orange, cucumber, a few berries, or herbs such as a sprig of rosemary.
Consider the material of your water bottle or glass. Some individuals find drinking from glass or ceramic bottles more quenching and flavourful than from plastic. Find out what is to your liking and budget. - Check in on your daily fibre intake.
Visit Health link BC: Fibre and Your Health | HealthLink BC for recommendations on your suggested daily fibre intake, based on sex and age.
If you can, try recording your intake for a few days of your usual eating habits (consider downloading a free dietary app like MyFitnessPal | MyFitnessPal or, MyPlate Calorie Counter | livestrong to record). This can aid you in learning your baseline intake of fibre and whether you could add in a few more sources of fibre to get you into the ideal nutritional range.
Ideas to increase fibre:
Get your veggies and fruit in!
Sprinkle chia and/or flax into smoothies/on salads/on oats or granola.
Incorporate bran and/or a multigrain for a quicker high concentrated source.
Add in prunes or, dates to your breakfast. See above Health link BC document for more ideas of fibre sources. - Exercise and move your body daily.
Physical activity is an important factor in maintaining bowel regularity.
Physical activity increases abdominal muscle tone promoting more efficient elimination of stool. Also, physical activity helps to stimulate motility in the colon.
Daily movement of any kind helps to promote blood flow to bowel and stimulate peristalsis.
If able, try to incorporate any type of physical activity into your daily routine such as a short walk around the neighborhood, or gentle yoga stretching to promote regular bowel emptying.
Gentle yoga-like poses such as Lord of the Fishes pose (abdominal twists) may help promote digestion (see link The Best Twisting Pose for Cleansing and Energizing (yogajournal.com) for demonstration). - Optimize your environment.
Make your bathroom a relaxing environment to defecate it, our body can become tense the more we feel rushed or, stressed about having a bowel movement.
Consider playing some relaxing music or, spraying your bathroom with a relaxing natural aromatherapy.
It may be stressful when the urge to defecate arises when you are out and about. Try taking a moment to find your calm and take your time. We all poop! Try as much as you can to let go of external stressors/triggers outside your control like others waiting for the washroom after you or, the cleanliness of the bathroom. If someone is waiting, they will find an alternate place to go, otherwise, they will just wait. If the cleanliness of the environment is a bother to you; consider carrying travel disinfectant wipes and/or, hand sanitizer to reduce microbes and increase your peace of mind when out at about. If you let out a toot/make a loud noise with defecation, remember, this is normal and something common all bodies do. - Consider your positioning and adding in simple equipment.
Consider placing a stool in front of your toilet to help you get in an optimal pooping position. This slight adjustment in your positioning can improve the angle of the rectum within the pelvis which allows the poop to travel down with more ease.
There are specific stools available for purchase that are designed for this specific purpose (such as Squatty Potty – The #1 Way to #2! – SquattyPotty ).
There are also some folding stools available for purchase for a more discreet option that you can fold and tuck it away when not in use. However, any other stool you may already have around your home may work or, even a stack of large books may work (just ensure it is high enough to help you get your knees slightly above hips, see below).
Source: Easing the strain: put your feet up for constipation – Evidently Cochrane - Consider the technique of “opening your bowels”.
Bearing down/straining can contribute to hemorrhoids and is hard on your pelvic floor muscles over time.
Try to initiate the defecation using your abdominal muscles instead of straining forcefully with the muscles around the anus/the pelvic floor muscles. Instead, try to relax these pelvic floor muscles during defecation to help ‘open’ the rectum.
See this link for additional explanation: NHS (royalberkshire.nhs.uk)
Pharmacological and Medical Device Options
If you have optimized the above and are still challenged by constipation or bowel incontinence it may be worth discussing your symptoms further with your GP, specialist (if you have one), or, a Nurse Continence Advisor.
Medications may be helpful even temporarily to relieve longstanding constipation so a more conservative regime can be established. Gentler medications to start with generally include stool softeners such as trialing Docuate (or Colace) or, an osmotic laxative Restoralax (contains an ingredient called Polyethylene Glycol [PEG] which draws water into the bowel).
A stronger laxative may be suggested and helpful as a second line ideas for management of more stubborn constipation these may include but are not limited to Biscodyl or, Sennokot.
Supplementation with magnesium may also be of benefit and may be worth further discussion with your provider.
There are herbal remedies such as laxative teas that may be of benefit but, it would be advisable to discuss with a care provider before taking as they may interact with pharmacological management.
**However, if you think you may be dealing with impaction of stool, taking oral medications only may not be enough to clear the bowel contents and may lead to discomfort and other concerns such a blockage if the lower bowel is full of hard, impassable stool.
It may advise to use additional remedies to move along the stool from below such as suppositories, enemas, manual dis-impaction, or bowel irrigation systems such as Peristeen (see link for more information: https://www.coloplast.ca/global/dynamic-blocks/anal-irrigation-and-peristeen/ ).
Bowel irrigation systems may be particularly beneficial if you have a neurological cause for your constipation. Thus, it is advised to work with your health care providers when considering medicinal management of bowel function **
North Shore Urology 