Constipation: It Stinks! By Heather Muir, RMT
Poop, crap, feces, stool, doodoo, turd, excrement, dump, toilet bowl stew, or colon cannonballs. Whatever you call it, chances are you can't talk about going number two without either blushing or snickering. It seems our culture is completely against talking about our bowel movements. It is either considered "gross" or "little boy humour." Yet, constipation appears to be more common than we let on. According to the American Society of Colon and Rectal Surgeons, approximately 80% of people suffer from constipation at some point in their lives.
Regularity is typically judged on an individual basis. For some in the Western culture, regularity means a comfortable bowel movement daily, down to as little as three times per week. Constipation is diagnosed with less than three bowel movements a week, or if there is a considerable amount of straining.
Some of the most common symptoms of constipation are:
straining, pain, or discomfort with bowel movements
Infrequent bowel movements
Hard stools (aka "rabbit" or "pellet" stools)
Abdominal pain, cramps or discomfort
Low back pain or discomfort
Bloating and/or flatulence
Bad taste in the mouth, bad breath, nausea, lack of appetite
Headache, irritability, and malaise
Just ask any new mother with a constipated child, and she would likely agree with many of these.
There was a very interesting study done in 1922 by a Dr. Donaldson.
"Five healthy men were required to eat normally but refrain from defacating for 90 hours. All complained of symptoms associated with auto intoxication such as foul breath, irritability, depression, and headache. All experienced immediate relief following an enema."
In the past, "autointoxication" had been named as the cause of many illnesses and issues. It was originally considered to be due to the toxic effect of focal matter being retained in the colon. the aforementioned study, in fact, contradicts the toxicity theory. It actually suggests that the symptoms are actually a result of distension (stretching) and mechanical irritation of the colon and rectum.
The digestive system is controlled by a vast network of nerves. One nervous system that plays a major roll in either helping or hindering the digestive process is the Autonomic Nervous System. As part of this, the Parasympathetic Nervous System (PNS) helps to support the digestive process, while the Sympathetic Nervous System (SNS) actually inhibits it.
The PNS is signalled by relaxation, peace and calm, whereas the SNS is signalled by stress or anxiety, and can also be referred to as fight or flight. As you can see, stress or anxiety would have a negative impact on your digestion.
In order to mix and move food, the Enteric Nervous System (ENS) signals muscular movements. One movement helps to mix the food, which is important for the absorption of nutrients and water. Another movement helps to move food through the digestive tract. On average, it takes 24 to 48 hours to move food through the entire digestive system. This is called transit time.
If you can imagine the movements and their purposes, you can start to see how things can go wrong. If you increase the mixing movements, you start to absorb more water. This leads to large, bulky stools that are difficult to pass. If the moving movements increase, you end up with less formed, more liquid stools.
What causes Constipation?
Poor diet, low in fibre, water or low food intake
Postural imbalances (leading to the inability of the abdomen, diaphragm, low back and gluteal muscles to contract)
Poor muscle control or muscle tone
Depression, eating disorders, fear or anxiety
Post surgical effects
Other GI or underlying conditions
Pregnancy and early postpartum
What can I do about it?
Firstly, you should talk to a naturopath or nutritionist for diet counselling. Increasing your water and fibre intake should also help move things along. Try to avoid taking laxatives, as prolonged use can lead to dependency and only worsen the issue in the long run.
Massage has also been proven to help considerably with constipation. Remember the nervous systems that help or hinder digestion? Massage encourages the PNS, which is the system that helps digestion. In turn, it quietens the SNS, which hinders digestion.
Massage has also been proven to decrease cortisol levels, which has been dubbed the stress hormone, and is used to measure the activity of the SNS (the digestive hinderance). In 2005, a study was done that showed cortisol (stress hormone) decreased, and serotonin and dopamine (happiness and reward hormones) increased following Massage Therapy. Having this effect on hormones, even general massage can have a positive effect on digestion.
There are also specific techniques that all RMTs learn to encourage the physical act of digestion. Your RMT can also assess any postural or muscular imbalances that may be contributing to constipation.
What can I do at home?
The use of hydrotherapy (using the temperature that water carries to stimulate your own circulation) is highly effective in this instance. To aid digestion, use a cool, wet cloth on your abdomen. Wash your stomach by beginning at the right hip, moving up to the ribs on your right side, over to the left ribs, and down to the left hip. Repeat this action, stopping to wet and cool the cloth as needed. This acts to stimulate the muscles that mix and propel food along the large intestines.
Another thing that had been suggested is that squatting with your hips flexed is the optimal position for voiding, as it aids the abdominal muscles in contracting, and helps to relax the pelvic floor. Because of the design of our Western toilets, getting to this position is nearly impossible unless you're a gymnast. Some sources suggest placing a stool (pun not intended) in front of the toilet. Placing your feet on it will flex your hips and put you in a position similar to squatting, making bearing down easier.
Last, but certainly not least, adopting a diet low in fats and high in fibre, as well as increasing your water intake will help to prevent any constipation.
Rattray F, Ludwig L. Clinical Massage Therapy: Understanding, Assessing and Treating over 70 Conditions. Elora, ON: Talus Incorporated; 2000
2012 American Society of Colon & Rectal Surgeons
T Field, M Hernandez-Reif, M Diego, S Schanberg, C Kuhn: Cortisol Decreases, Serotonin and Dopamine Increase following Massage Therapy. Touch Research Institutes: University of Miami School of Medicine, Miami, FL. International Journal of Neuroscience Vol. 115: Issue 10. Pg. 1397-1413
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