Giusi M. Tsaousis, PT, DPT, PCES, NCPT, SFMA

Constipation. We use this term so freely, but medically speaking, constipation is having less than 3 bowel movements (BM) per week. Yes, you read that statement correctly! If you are one of those people who are not medically diagnosed with constipation but feel “backed up” from time to time or somewhere in between then you might find these tips very helpful.

1. Get on a schedule 

• In order to have regular BM’s, eating your meals regularly can help. Our bowels like routine. Three meals per day is usually recommended and since schedules differ from person to person, do your best to schedule your meals accordingly. The key is to try to eat all three meals at the same time every day. Did I mention that your bowels like routine?!

2. Give yourself time 

• Being mindful of your daily urges can help you prepare for success. If you know that you usually get the urge for a BM after your morning coffee, leave yourself enough time to do the deed. It may be difficult to have a successful BM while you are rushing out of the house! Try setting your alarm for 30 minutes earlier to give you enough time BUT do not snooze!

3. Chew your food

• Studies have shown that we should chew our food at least 10-30 times (depending on the consistency of the food. More for steak, less for mashed potatoes) for proper digestion. That may seem like a lot and most of us do not follow these guidelines or even think about how many times we have chewed each bite. Start with chewing your food at least 10 times and work your way up to as close to 30 times as possible. Also, if you love consuming food in the form of a smoothie, think about replacing it with a meal you can chew. The act of chewing initiates digestion and promotes peristalsis aka movement of the things in our intestines. It’s a bit more complicated than that, but this is a simplification for the purpose of this blog post. 

4. Fiber

• According to the Mayo Clinic women should try to eat at least 21 to 25 grams of fiber a day, while men should aim for 30 to 38 grams a day. You should try to get fiber from food rather than a supplement if possible. Not sure what 25 grams of fiber looks like? Check out this Fiber Chart to help you calculate your current daily intake. Research has shown that eating a variety of foods containing 30 different plants per week can lead to better gut health. You may think this sounds like an impossible task, “30 plants?! What am I a rabbit?” but keep in mind that many foods you already eat are checking off those plant boxes. Fruits, herbs and nuts are all considered plants and can be included in that number. Even coffee (hallelujah!) is considered a plant!

5. Massage

• The “ILU” massage is a technique can help to get things moving. To perform the massage you always end on the left side of your body. You would start on your left, just under the rib cage, and walk your fingers down towards your hip. That’s the “I. To perform the L you start under the rib cage on your right side and walk your fingers across to the top of the I (just under the left ribs) and then complete the I. The U is starting from your right hip, walking up to your right ribs and then completing the L. See my Instagram post for a visual. The direction is important since you are essentially trying to move your stool along its track for successful emptying. Do this a few times a day and it should help get things going. 

6. Positioning and breathing 

• When sitting on the toilet, either lean forward or place a stool under your feet. This position allows for easier passing of the stool. Breathing aides in the relaxation of your pelvic floor muscles and the anal sphincter. I like to tell my patients, “Exhale your poop.” This is much more effective than bearing down and holding your breath. Holding your breath will build pressure and stress your pelvic floor muscles. If you do this infrequently, it’s not a big deal but if you make this a habit, the continued stress may lead to pelvic floor dysfunction. Check out my Instagram Post for a visual on this technique and always remember to smell the flowers and blow out the candles!