Bowel Health: Why are our Guts are like Puppies

Bowel Health:  Why are our Guts are like Puppies

Lizanne Pastore PT, MA, COMT

                OK.  I know not many people feel comfortable talking about poop, unless it’s the “butt” of a joke.  But many people have trouble with their bowels.  In my pelvic floor physical therapy practice, it is rare for me to meet a patient with normal, healthy bowel habits.  The majority of my patients struggle with constipation, irritable bowel syndrome (IBS,) or have determined that they are “intolerant” or “sensitive” to certain foods such as gluten, dairy, sugar, dyes, or something else.  Yes, this “food sensitivity” is a growing trend, but not like a fashion trend that comes and goes.  These sensitivities seem to be getting more common and serious.   There is speculation in the medical community as to what causes this sensitivity, but the bottom line is we just aren’t certain.  The issue is complicated and multifactorial.

Let’s start with some basics.  Those “in the know” about poop describe 7 basic types of stool,  ( hyperlink:  from very watery to very hard.  These same folks want us to have bowel movements at the least 3 times a week and at the most 3 times a day.   In assessing whether you are “normal” or not, determine first if you fall into this range, and second what you have been doing over your life and if it has changed.  If you used to have a daily morning BM but now you only go every 2 or 3 days, or find that the consistency has changed, then this is not normal for you.

Try keeping a daily food and drink log and document when you defecate and urinate.  See if you can find trends or patterns.  You can also describe the quality of your stool; ideally we want soft, easy to pass stool.  Straining—that is bearing down hard with a closed glottis (think “grunting”)—is not safe and should be discouraged.  I ask my patients to experiment with their posture on the toilet.  Try the following:

1.  Don’t rush, allow yourself time.

2.  Try placing your feet up on a footstool (5 to 7+” in height).  You can use books, folded towels, or a “squatty potty” (hyperlink Lean forward so your elbows rest on your knees and keep a neutral spine.  This opens up the ano-rectal angle—it sort of ‘unkinks’ your rectum—allowing stool to pass more easily.

3.  Never grunt or strain, instead exhale gently as if blowing a feather and consciously relax your pelvic muscles.

Tips for improving quality of stool and colon “transit” include eating healthful foods, such as several servings of vegetables, fruits, and whole grains each day.  (Always check with your doctor or health provider before changing your diet significantly, especially if you have any health concerns.)  There are 3 main kinds of fiber—soluble, insoluble, and “resistant starches.”  Soluble fiber dissolves in water and helps lower cholesterol and blood sugar levels.  Insoluble fiber does not dissolve in water and helps to bulk stool.  Resistant starches are resistant to break-down in the digestive tract and so do not produce as much gas (flatus.)  It’s important to introduce fiber slowly, starting with a small amount of one kind at a time and assessing it’s effectiveness over a week or so, adding more if needed.  Always drink plenty of fluid when adding fiber, we recommend 30 ml of water per kilogram of body weight (eg.  A 135-pound person weighs 61 kilograms.  And 30 ml is equal to about 1 oz, so this person would need about 61 oz of water per day.)  Alcohol and caffeine dehydrate the stool and should be avoided, especially if constipated.

Bowels love routine, so eat similar sorts of foods at about the same times of the day, and try to wake up and go to bed at similar times.  Exercise aids colonic transit, so even daily brisk walks are helpful for digestion, although wait a bit if you’ve just eaten.  There are simple colon massages that help with transit too.  Finally, a good night’s sleep is just about the most important thing you can do for your gut.  We digest food when we are in our restful mode, and most of us have our BM’s in the mornings after a good sleep.  My mom used to tell us kids, “Rest and digest!”  (Maybe this is why I became involved in the pelvic floor!)

The bottom line is that our guts are like puppies and toddlers!  All need structure, routine, rest, exercise, healthy food and plenty of water.  Talk to your doctor or health provider if your bowel routine has significantly changed.