Some of my favorite successes as a physical therapist have been helping patients who have battled constipation over a lifetime overcome this problem.
Thanks to dedicated gastroenterologists and colorectal surgeons who included us in their toolboxes for helping their patient population when appropriate, we were given this opportunity.
Through education in behavioral changes, healthy lifestyle choices, exercise, positioning, and manual therapy we’re able to guide patients on the road to “normal bowel movements”.
Treatment starts as always with a thorough history of the problem including what makes it better or worse and what’s been tried already. A thorough medical and activity history is taken. And a verbal review of food and fluid intake followed by some homework for a food and fluid diary to be done by the next visit.
A look at a patient’s posture and movement comes next as sitting with slumped posture compresses all the vital organs of digestion, “cramping their style” and inhibiting their function.
Palpation of the colon and some “visceral mobilization” which feels like a belly massage with some simple movements of the pelvis and legs can often elicit some gurgling and signs of movement in the right direction.
This treatment can be taught to the patient as a home program and together with some inversion, propping the buttocks higher than the head, and side-lying positions we can get the help of gravity to get things moving.
Biofeedback assessment of the pelvic floor can help to assess whether there is an outlet problem due to high tension in the pelvic muscles and external sphincter.
A review of the importance of fluids and oils in the diet to help lubricate the passage of an “easy” bowel movement, along with the addition of fiber such as salads, fruits, and vegetables and the avoidance of a heavy carb diet. I often give the image of a bagel stuck in the colon as an example vs yogurt sliding through the colon.
Supplements such as magnesium and Vitamin C can also act as stool softeners and are discussed as healthy options. An appointment with a dietician can help sought through an elimination diet which can seem too daunting to tackle on your own and can help avoid the feeling that you have to give up everything you love to eat.
Walking 30 minutes a day and a few simple exercises to “get things moving” helps combat all the sitting in today’s world which contribute to slow-moving digestion.
The “icing on the cake”, so they say is relaxation, as tension can definitely play a part in constipation. I mean who doesn’t get constipated after a travel day!
I recommend a 25-minute relaxation program called “Physiological Quieting” created by the pelvic physical therapist guru Janet Hulme which she provides for free with a Prime Membership on Amazon. Do this before bedtime for a wonderful deep sleep and an “easy bowel movement” in the morning.
The pelvic physical therapists at Maiden Lane Medical can help design the right program for you and help get you back on track! Maiden Lane also has a wonderful dietician to help too.