Constipated?

There are 3 different classifications of constipation -

• Functional constipation

• Opioid induced constipation

• Irritable bowel syndrome

Functional constipation is described as at least 2 or more of the following:

• Straining during bowel movements

• Type 1-2 stools on the Bristol Stool chart

• Sensation of incomplete emptying after a bowel movement

• Sensation of a blockage in the rectal area

• Requirement of manual maneuvers to pass bowel

• Less than 3 spontaneous bowel movements a week

• No abdominal pain

• Loose stools are rarely present

Opioid induced constipation is described as:

• NEW or WORSENING symptoms of constipation when initiating, changing, or increasing opioid therapy with 2 or more of the following:

  • Straining during bowel movements

  • Type 1-2 stools on the Bristol Stool chart

  • Sensation of incomplete emptying after a bowel movement

  • Sensation of a blockage in the rectal area

  • Requirement of manual maneuvers to pass bowel

  • Less than 3 spontaneous bowel movements a week

  • No abdominal pain

  • Loose stools are rarely present

Irritable bowel syndrome is described as:

• Recurrent abdominal pain at least 1 day a week in the last 3 months with 2 or more of the following:

• Pain is related to bowel movements

• Experiencing a change in frequency of stool

• Experiencing a change in appearance of stool

If you are experiencing constipation and are not sure what your next steps should be, here are a few things to try:

• Increase the angle of your hips while having a bowel movement

• Try to get your knees above your hips. Do this with the use of a squatty potty, a small stool you have at home, or even some books you may have lying around. By increasing the angle of your hips, it decreases the tension in the pelvic floor and allows stool to pass easier

• Avoid straining while having a bowel movement, instead try relaxing your pelvic floor muscles

• Try taking big belly breaths with :04 inhale and :04 exhale

• Straining makes it more difficult to pass stool as it closes the anal sphincter while big belly breathing will allow the sphincter to relax and pass stool

• If you are having difficulty knowing if you are straining or not, pelvic floor physical therapy at Loon State may be a good next step

• Exercise

• General guidelines for exercise are 150 minutes of moderate intensity exercise a week with strength training 2x per week

• Increasing blood flow can help increase movement of our bowels

• If you are unsure where to start with an exercise program, we can assist you with starting at Loon State PT

• Drink more water

• We should be aiming for 1/2 of our body weight in ounces a day

• If our bowels are dehydrated they have more difficulty passing and can become uncomfortable to pass, therefore keeping fluid in our system can help

If you have further questions or want to learn more, we are here to help at Loon State Physical Therapy. We have three convenient locations in Lake Elmo, Edina/Linden Hills, and Minnetonka/Hopkins.

-Lexi Noel PT, DPT