Constipated? Skip the Gimmicks, Go Back to the Basics

Obstructed defecation can cause constipation

Constipated? Skip the Gimmicks, Go Back to the Basics

Lots of people who experience occasional trouble with constipation simply take a laxative and end up being fine. But a more complex problem arises if you have something we call obstructed defecation, where people just can’t poop.

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There are several common causes of this condition, starting with any structural deformities due to age, heredity or injury. It might also indicate problems with your digestive tract, that you may have an impacted stool, or that there may be neurological issues involved.

What are the symptoms?

The following are several typical signs that you may have a problem with obstructed defecation:

  • You pass hard stools on a regular basis
  • You experience excessive or prolonged straining while passing stools
  • You require routine use of laxatives or enemas to relieve the constipation

What are the first steps to take?

While there are some gimmicks on the market to help people with this issue, we find that the safest and most reliable way to address it initially is to ensure that you take a few simple steps:

1. Increase the fiber in your diet. The goal is to eat 25 to 35 grams of fiber each day. The lack of fiber in the American diet is perhaps the major problem that leads to issues with constipation.

One of the challenges is that not all natural sources are equal in the amounts of fiber they contain, so you don’t always get a consistent amount of fiber intake every day, depending on what you eat. One day a bowl of oatmeal may do it. Another day a serving of broccoli may not.

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Of course, each person’s needs are different, too, so you have to find what works best for your body.

Additionally, some people may benefit from taking a fiber supplement. We recommend using a psyllium powder, rather than some of the other pills available on the market. Make sure that you take it with a tall glass of water.

2. Drink plenty of water each day. The preferred recommendation is eight 8-ounce glasses each day or approximately half a gallon total from all liquids you drink, from your morning coffee to the milk in your cereal.

3. Get a proper amount of exercise, even just walking regularly. Most doctors recommend 30 minutes of exercise per day on most days of the week.

Additional problems for women who have given birth

Women who have had two or more children are also at a greater risk of having problems with obstructed defecation. This is particularly true if they have experienced an injury during childbirth known as rectocele that damages the fascia or the internal tissue that separates the vaginal wall and anus that can lead to pelvic floor dysfunction.

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For most patients, we start with dietary changes, position changes and even physical therapy, but there is also a surgical procedure that could help some women with this issue, while others don’t seem to benefit. If you have this condition, you need to discuss it with a specialist.

A device that may help you

Would putting your feet up on a Squatty Potty® stool used to elevate your feet help? Possibly. It works for some people, not for everyone. Studies have shown that sitting on a toilet is not the optimum position to void. That would be squatting, which is not always an easy solution.

Basically, if you are having difficulty going to the bathroom or you are experiencing a change in your bowel habits, particularly a decrease in the size of your stools, you need to see your physician to schedule an exam or even a colonoscopy to make sure that everything is okay.

Squatty Potty®  is a registered trademark of Squatty Potty LLC.

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Meagan Costedio, MD

Meagan Costedio, MD, is a surgeon in the Department of Colorectal Surgery whose interests include minimally invasive techniques.
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