Constipation and prolapse is often the result of a cycle of straining, incomplete emptying and progressive worsening of prolapse symptoms.
These simple steps for diet, timing and bowel emptying technique can help you to break the cycle of constipation and prolapse worsening.
Read on now to learn:
- Symptoms of constipation and prolapse; and
- 10 expert tips for better bowel movements.
Constipation and Prolapse Symptoms
Constipation with a prolapse may be characterized by:
- Hard and/or lumpy pellet-like stool consistency;
- Long-term straining to empty the bowel;
- Sense of incomplete bowel emptying;
- Sense of rectal blockage and/or obstruction;
- Needing to manually support (using fingers) to empty; and
- Emptying the bowels less than 3 times per week.
10 Expert Tips for Better Bowel Movements
1. Correct Stool Consistency
Managing your stool consistency is the first and vital step for improving bowel movements with a prolapse. If your stool if too hard, it will be very difficult to pass. Good stool consistency requires adequate fibre intake (30 grams/day). Some women with constipation and prolapse make the mistake of consuming too much fibre. Too much fibre can overload the gut, a little like blocking the pipes causing constipation to worsen.
Foods that soften the stool include: fresh fruit with skins on, garlic, red capsicum, nuts, popcorn, greens (broccoli, spinach, green beans and cabbage) and spicy foods. Caffeine is a bowel stimulant and prune juice contains naturally occurring laxative.
Fibre supplements can improve stool consistency if your fibre intake is inadequate. Speak with your pharmacist or doctor about stool softeners if you are unable to achieve the correct stool consistency through diet alone.
2. Adequate Fluid Intake
Ensure that your fluid consumption is adequate. Fluid consumption of 2 litres per day is usually recommended for most individuals. Be mindful of the fact that insoluble fibre (in skins and grains) and some of the bulk forming laxatives commonly available (e.g. Metamucil and psyllium husks) require adequate fluid intake to avoid these obstructing the bowel and worsening constipation and prolapse problems. Fluid intake can be increased simply by including soups, jelly and fruits high in water content into your diet.
3. Eat Breakfast
Eating stimulates bowel motility. Skipping breakfast is a missed opportunity to stimulate your bowels at the start of the day. Some women find that a warm drink and walking around helps to promote the urge to empty their bowels.
4. Obey the Urge to Empty
When you first sense the urge to empty your bowels, do so at the earliest convenient time. Never defer the urge to empty your bowels. Some women with constipation and prolapse lose the ability to sense when they need to empty owing to stretching of the rectum. When this happens routine emptying is most important to avoid overstretching the rectum and losing rectal sensation.
5. Take Sufficient Time
Allow sufficient time to empty your bowels, try not to rush. Sometimes the simple action of taking 5-6 slow deep breaths can help to relax the pelvic floor and facilitate bowel emptying. If you find that after a minute or two of relaxed breathing and sitting on the toilet that your bowels don’t move then get up and return to your daily activities. Plan your return when you next feel the urge to empty. Sitting on the toilet for long periods of time durations without an urge increases the likelihood of straining the pelvic floor.
6. Correct Bowel Movement Position
Position for bowel movements with a prolapse:
- Sit on the toilet seat, never hover above the seat;
- Knees should be higher than hips (use a wide stool or a toilet roll under each foot);
- Lean forwards at your hips; and
- Maintain the normal inward curve in your back.
7. Correct Bowel Movement Technique
Technique for bowel movements with a prolapse:
- Make your waist wide and bulge your abdomen forwards (i.e. barrel shape);
- Hold the breath you have, don’t take a new breath. This technique relaxes and opens the anal sphincter to allow the bowel movement to pass as shown in How to Empty Your Bowels online video; then
- Lift and squeeze your pelvic floor muscles when finished.
8. Pelvic Floor Exercises
Perform regular daily pelvic floor exercises to improve pelvic floor support. During bowel emptying the pelvic floor muscles provide a firm platform of support for the passage of the stool from the body. Strengthening your pelvic floor muscles can improve the firmness of the pelvic floor and enhance bowel emptying. This is particularly important for women who have a long history of straining as their pelvic floor supports are likely to be stretched and weakened.
Manual support can also assist emptying with a prolapse. Some women find that simple hand pressure against the perineum (between the vagina and anus) can provide pelvic support where it is naturally lacking. This technique does not harm the pelvic floor and can be most useful to avoid straining.
9. Pelvic Floor Relaxation
Inadequate pelvic floor relaxation and release with bowel emptying is one major cause of constipation and prolapse. The action of straining and drawing the abdomen inwards strongly increases downward pressure on the pelvic floor and actually increases tightening of pelvic floor muscles and closing of the anus. This is the direct opposite to the desired effect of releasing the anal sphincter. Pelvic floor release is promoted by bulging the low abdomen forwards and with relaxed deep breathing.
10. General Exercise
General exercise helps to stimulate bowel motility. Research has demonstrated that moderate intensity exercise such as cycling increases the movement of wastes through the gut regardless of fluid and dietary input. Try to include regular low impact exercise such as walking or cycling as part of your daily routine. Be mindful of avoiding exercises with the potential to overload and strain the pelvic floor.
If you consistently incorporate these 10 simple steps for better bowel movements into your everyday life, you be more likely to avoid worsening of your constipation and prolapse problems. You may even find that your bowel movements actually improve despite your prolapse!
“Constipation and Prolapse” is by Michelle Kenway, Pelvic Floor Physiotherapist. Michelle is the author of the internationally acclaimed exercise guide for women Inside Out – the essential women’s guide to pelvic support
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