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What to Do When You Can’t Poop Right
by Tara Galles, MS, OTR
Can’t go? Or perhaps going is detonating a bombshell? Irregular bowel functioning is a serious health issue that becomes all consuming, not to mention painful. By the time patients make it to one of our clinics, they have usually seen multiple specialists and have every over-the-counter digestive health supplement in their drug cabinet. It’s important to understand that bowel issues are both a chemical and mechanical function of the body. So, a well-functioning digestive system is like a well running car: you can put the premium fuels and chemicals in to make it go, but if you don’t start the engine and drive it regularly, it won’t drive.
Here are several reasons your digestive engine may not be running smoothly and what you can do about it.
Can’t go? Or perhaps going is detonating a bombshell? Irregular bowel functioning is a serious health issue that becomes all consuming, not to mention painful. By the time patients make it to one of our clinics, they have usually seen multiple specialists and have every over-the-counter digestive health supplement in their drug cabinet. It’s important to understand that bowel issues are both a chemical and mechanical function of the body. So, a well-functioning digestive system is like a well running car: you can put the premium fuels and chemicals in to make it go, but if you don’t start the engine and drive it regularly, it won’t drive.
Here are several reasons your digestive engine may not be running smoothly and what you can do about it.
DEHYDRATION
Water is the lube that keeps your digestive tract moving. Running on coffee, soda, tea, juice, energy drinks, alcohol, or even kombucha doesn’t provide adequate hydration. The stimulants in these drinks can also be an irritant to the digestive tract, inhibiting normal function. Daily guidelines for water intake are approximately 2.5-3.5 liters per day, depending on your weight and physical activity. Just because you feel sufficiently hydrated, doesn’t mean your digestive tract is. Drink plenty of water!
GASTROINTESTINAL MOTILITY
Gastrointestinal motility describes the propulsive movement the digestive system. Your gastrointestinal system is made of muscles. Just like any muscle of the body, these can become weak, painful, and restricted. General exercise can help normalize motility as well as balancing dietary fibers (see below). Myofascial restrictions of the abdominopelvic cavity will cause gastrointestinal motility issues. This is often caused by scar tissue from abdominal surgery or immobility from prolonged bloating. When this is the case, motility will not typically improve without manual therapy to normalize the tissues.
OVERSTRETCHED RECTUM
When you have an overstretched rectum, the muscles of the rectum and intestines have become stretched and weakened. Often, this allows watery stool from farther up the digestive tract to move around the impacted stool and leak out. There will often be pellet like poop mixed in when the rectum is overstretched. Pelvic floor therapy can help strengthen the rectum for more normal function.
FIBER IMBALANCE
Balancing fiber types is essential for normal bowel function. Soluble fiber acts as a bulking glue to form the stool. Insoluble fiber stimulates the intestinal wall for motility. If your poop is too moist or too hard, modifying your fiber intake may help.
PELVIC FLOOR MUSCLE DISCOORDINATION
Pelvic floor discoordination is the inability to correctly relax and coordinate your pelvic floor muscles to have a bowel movement. Often, this is because the pelvic floor muscles become hypertonic or tight and have a difficult time coordinating to release a bowel movement. There are over 10 pelvic floor muscles that need to coordinate to have a successful bowel movement, so pelvic floor muscle discoordination isn’t an open and shut deal (pun intended).
Nerve injury as well as hip and back pain can also impair the pelvic floor function needed to have a bowel movement. If you can’t poop, therapeutic exercise (not just doing “Kegels”) and neuroeducation can help you develop coordination of the pelvic floor, so pooping is not such a problem.
IRRITABLE BOWEL SYNDROME (IBS)
Irritable Bowel Syndrome (IBS) is the name for a cluster of symptoms that can, but not always, include abdominal pain and cramping, diarrhea, or constipation. The pain produced by IBS can also be from abdominal muscle or pelvic floor trigger points. Orthopedic rib, shoulder, and/or back pain is frequently observed as secondary pain from IBS. Normally, it is caused by immobility or pressure from the intestines, liver, or stomach.
The intestines hook directly into the spine through the mesentery and is often very immobile in people with IBS. This also impairs enteric nervous system function, centered in the gut, which leads to anxiety and depression. Manual therapy techniques can help relieve muscular and fascial cramping and pain and facilitate normal digestive movement. It can also help elevate your serotonin production.
SMALL INTESTINES BACTERIAL OVERGROWTH (SIBO)
SIBO is the overgrowth of bacteria, which is often caused by the impedance of forward motion in the digestive track. Scar tissue from abdominal surgery can cause adhesions similar to a “kink in a hose.” Another root cause of SIBO is the malfunction of the ileocecal valve and/or pyloric sphincter. Manual therapy techniques combined with therapeutic abdominal exercises can release adhesions which are causing kinks or malfunctions and facilitate proper digestive movement. We also teach patients how to promote healthy digestive bacterial growth.
ACCIDENTAL BOWEL LEAKAGE
Accidental bowel leakage is typically caused by injury to or dysfunction of the anal sphincter. The anal sphincter is a small but complex muscle group strong enough to seal in fecal matter yet sensitive enough to open differentiating between solid, liquid, and gas. Anal sphincter injury can be from a perineal tear during childbirth, nerve damage, scarring from surgery or radiation, or a stretch injury. Dysfunction of the anal sphincter can be from constipation that overstretched the rectum, internal hemorrhoids, prolapse of the rectum, or other causes. Pelvic floor therapists can guide you to Take CONTROL! of anal sphincter function to prevent accidental bowel leakage.
When you can’t poop right, it can be all consuming. ‘Normal’ frequency of bowel movements number anywhere from three times a day to three times a week. They are supposed to resemble a long banana shape.
If you are having abnormal or painful bowel movements, decide to Take CONTROL! Talk to your doctor about pelvic floor therapy. An evaluation will help you better understand why you can’t poop right, and how you can resolve the core issues. Call 765.319.8420 to make your appointment today!
Tara Galles, MS, OTR
Tara Galles, MS, OTR, is owner of You’re in CONTROL! With over 20 years of clinical experience she compassionately moves each woman to take CONTROL! of their body and rehabilitates them to feel like a natural woman again. As a mother of four children she also understands what it’s like to be a pelvic rehab patient. You may contact Tara about your pelvic issue at (765) 319-8420, or make an appointment using the button at the top of the page.