So you haven't pooped in a few days. What's normal and what’s not.

Every body is different but what if that difference is actually a cause for concern? I bet you know someone who will go to the bathroom, like clockwork, at the same time every day. Maybe they even go twice or three times a day! You, on the other hand, can’t remember the last time you went. Maybe it was a few days ago, maybe last week. If this sounds like your story and you’ve been living this way for some time now, you are officially constipated. 

Constipation affects everyone sooner or later. It affects women more often than men, and the likelihood also increases with age and pregnancy. Did you know that constipation is the second most common complaint among pregnant women? Well, now you know. 

If you have any two of the following symptoms, consider yourself constipated:

  • Going more than three days without a bowel movement
  • Straining
  • Hard, dry stool
  • Feeling a sense of obstruction or incomplete evacuation
  • Needing a manipulation to facilitate evacuation

You may even feel pressure, pain, or swelling in your abdomen or rectum. Whatever symptoms you experience, it is not pleasant to deal with and the resulting complications are even worse. Complications from constipation can include fecal impaction, hemorrhoids, bleeding, anal fissures, incontinence, and a weakened pelvic floor. In order to avoid all of these horrible sounding things, it’s best to avoid constipation in the first place.

Sometimes, constipation can occur as a result of something else such as irritable bowel syndrome (IBS), the use of analgesics or other medications, pregnancy, colon cancer, hypothyroidism, or a neurological disorder like Parkinson’s disease or multiple sclerosis. Other times, diet and behavior can play a role. Whatever the reason, there are things that can be done to manage and even prevent constipation. 

To start, check your food and drink intake. Drinking adequate water, cutting back on caffeine, and eating a diet high in fiber can get things moving. Start by drinking at least two extra glasses of water a day. Also remember that food can be a source of water so try to eat foods that have both fiber and water, such as hot cereal or soup. Are probiotics and prebiotics included in your diet? If not, you might want to consider adding them. If you do decide to go the probiotics route, get a good quality form that requires refrigeration. 

Get moving! Aerobic exercise will move food through the digestive tract faster, thereby reducing how much water is absorbed by the intestines. The slower the movement, the more absorption, the harder the stool. Go for a 30-minute walk after your bowl of soup and side of greens.

When you gotta go, go! Your bladder is a storage vessel for urine. Your rectum, is NOT a storage vessel. In fact, there is no storage vessel. The longer you wait to go after you feel the urge, the longer your waste sits in your intestines, the more water is absorbed, the harder your stool…terrible things can happen after that. So, when nature calls, answer right away.

When you do go, sit the right way. Modern day toilets are too high for a proper poop. As a result, your knees are at the same level or below your hips. This is ideal for urination but not for a bowel movement. Since we can’t lower the toilet, raise your knees up by propping a stool, rolls of toilet paper, a garbage can, or whatever you have handy under your feet. This reduces the angle between your knees and your hips, elongating and relaxing the muscles around your anus. Relax them even further using noises such as “moo-ing” or “shhhh-ing” on an exhale. Yes, you will feel completely stupid but your anus and pelvic floor will thank you later. If you try and there’s no action, don’t push it, try again at another time when you feel the urge. In the meantime, have a glass of water or a smoothie. 

If you know you’re constipated or would like to prevent it, try the following tips and let me know how they work for you. Feel free to share your tips as well. I would love to pass on new tips and tricks to my patients. 

Love, peace, and good poops.

Your friend,

Dr. K