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A Quick Guide to Constipation Relief in IBS

If you’re one of the many individuals dealing with Irritable Bowel Syndrome (IBS), you’re likely familiar with the frustrating battle against constipation. This guide aims to provide you with practical tips and techniques to help relieve constipation quickly and effectively. With a focus on toilet positioning, dietary advice, supplements, medications, and behavioural adjustments, I will equip you with the knowledge to improve your constipation.

Understanding the Pooping Process

Pooping is a natural bodily function, much like walking. While it’s something everyone can do, for some, it requires more effort and concentration. Your ability to poop efficiently isn’t just about muscle coordination; it’s also influenced by habits learned since toilet training. If you’re struggling with full evacuation (when you know there’s more up there), following these steps can help ensure the appropriate coordination of your pooping muscles.

Mastering the Correct Toilet Position

Did you know the human body was designed to poop in a squatting position? Modern toilets don’t always facilitate this, but with a few adjustments, you can mimic the squatting position for better bowel movements.

  1. Knees Higher than Hips: When sitting on the toilet, ensure your knees are slightly higher than your hips. You can use an old shoebox or invest in a footstep like a Squatty Potty to place beneath your feet. This position helps align your colon more naturally, reducing the strain needed to pass stool.

  2. Lean Forward: Lean forward and prop your elbows on top of your knees. This position helps straighten your rectum, making it easier for stool to pass.

  3. Spine Straight and Relaxed: Ensure your spine is straight. Bulge out your tummy (everything below the belly button), and relax your shoulders. This helps relax the muscles involved in pooping.

  4. Breathing and Bearing Down: Move your hands around the sides of your waist and cough to feel your waist widen. These are the muscles to use when pooping. Make yourself as wide as possible by broadening the waist and bulging out the lower tummy. Bear down to create pressure and propulsion for 2-3 seconds as if trying to force out gas. Relax and repeat a few times to complete emptying.

Many people strain from their chest which is counterproductive. This can cause tightening of your outer pooping sphincter and pelvic floor muscles, blocking the 'exit' pathway. Instead, use your abdominal muscles to bear down, as described above.

How to Be a Good Pooper

Developing good pooping habits can make a significant difference in managing constipation.

  1. Don’t Rush: Take your time in the bathroom. Rushing can increase stress and make it harder for your body to relax and evacuate stool.

  2. Listen to Your Body: Go to the bathroom when you feel the urge. Ignoring the urge to poop can lead to constipation. Establish a routine by going at the same time each day, such as after a meal when your digestive system is naturally more active.

  3. Stay Consistent: Try to establish a regular bathroom routine. Going at the same time each day can train your body to expect to poop at that time. Morning is often the best time as your body’s natural rhythms are most conducive to bowel movements.

  4. Create a Relaxing Environment: Sometimes, the bathroom environment can impact your ability to relax and poop. Make sure it’s a comfortable and stress-free space.

Supplements & Medication for Relieving Constipation

Sometimes, dietary changes and positioning aren’t enough, and you might need additional support from supplements and medication.

  • Fibre Supplements: Products like psyllium husk (Metamucil) can help add bulk to your stool, making it easier to pass. Fibre supplements can be particularly helpful if your diet is lacking in natural fibre sources.

  • Osmotic Laxatives: Laxatives such as polyethylene glycol (Miralax) work by drawing water into your bowels, softening stool and making it easier to pass. These are often recommended for short-term use.

  • Stimulant Laxatives: These include bisacodyl (Dulcolax) and senna (Senokot), which stimulate the bowel muscles to move stool along. They can be effective but should be used sparingly to avoid dependency.

  • Probiotics: Supplements containing Bifidobacterium and Lactobacillus strains can improve gut health and bowel movements. Probiotics can help balance your gut microbiota, which is crucial for regular bowel function.

  • Magnesium Citrate: Magnesium can help relax muscle spasms and act as an osmotic laxative. Start with 400mg per night for three nights. If needed, increase to 600 mg per night for three nights, until you reach 800mg per night. This can help draw fluid into the bowel, easing constipation.

  • Partially Hydrolysed Guar Gum (PHGG): This prebiotic fibre is beneficial for IBS, diarrhoea, and constipation. It is water-soluble, taste-free, and low-FODMAP. Start with 5g per day, increasing to 10g per day if required. Mix into water, tea, coffee, or yoghurt. PHGG promotes a healthy microbiome and reduces IBS symptoms, with up to 10g per day helping to treat constipation.

  • N-acetylcysteine (NAC): If magnesium isn’t enough, NAC can be helpful for constipation of all causes. Take 600 mg twice daily as it works differently from magnesium, providing complementary relief.

Always consult your healthcare provider before starting any new supplement or medication to ensure it’s appropriate for your situation. Long-term use of some laxatives can lead to dependency and decreased bowel function.

Dietary Adjustments for Constipation Relief

What you eat plays a significant role in managing constipation. Here are some dietary tips to keep things moving smoothly:

  1. Increase Fiber Intake: Aim for 25-30 grams of dietary fibre per day. Fibre helps add bulk to your stool, making it easier to pass. Good sources of fibre include whole grains, fruits, vegetables, and legumes. For example, oatmeal, apples, carrots, and lentils are excellent fibre-rich options.

  2. Add Two Green Kiwi Fruits Daily: Studies have shown that green kiwis can help improve bowel movements due to their high fibre content and natural enzymes. Incorporating kiwis into your diet can be a tasty and effective way to combat constipation.

  3. Stay Hydrated: Ensure you’re drinking enough fluids each day—approximately 30mL per kg of body weight. Proper hydration helps keep stool soft and easier to pass. Aim for water, herbal teas, and clear broths over-caffeinated or sugary beverages, which can sometimes exacerbate constipation.

  4. Avoid FODMAPs: Fructans and GOS can exacerbate IBS symptoms. Foods high in these should be limited or avoided if they trigger your symptoms. Common high-FODMAP foods include garlic, onions, and certain grains like wheat.

  5. Regular Physical Activity: Exercise helps stimulate intestinal activity. Aim for at least 30 minutes of moderate exercise most days of the week. Activities like walking, jogging, or yoga can be particularly beneficial.

Behavioural Tips for Effective Bowel Movements

In addition to dietary and positional adjustments, certain behavioural tips can also help you become a more effective pooper:

  1. Mindfulness and Relaxation: Stress can impact your digestive system. Practicing mindfulness and relaxation techniques such as deep breathing, meditation, or yoga can help reduce stress and promote better bowel movements.

  2. Avoid Excessive Straining: Straining can lead to issues like haemorrhoids. Focus on gently bearing down with your abdominal muscles rather than straining with your chest.

  3. Consider Biofeedback: If you have chronic constipation or pelvic floor dysfunction, biofeedback therapy can help you learn how to relax and coordinate your pelvic floor muscles during bowel movements.

What to Avoid & Include for Relief

  • Avoid High-FODMAP Foods: These include certain fruits, vegetables, and grains that can trigger IBS symptoms. Working with a dietitian to identify and avoid specific FODMAP triggers can be helpful.

  • Stay Active: Engage in regular physical activity to help stimulate bowel movements. Incorporating activities like brisk walking, cycling, or swimming can significantly improve bowel regularity.

  • Hydrate Well: Drink enough fluids to help soften stool. Water is best, but other hydrating fluids like herbal teas or diluted fruit juices can also be beneficial.

  • Eat Fibre-Rich Foods: Include whole grains, fruits, vegetables, and legumes in your diet. Foods like chia seeds, and flaxseeds are particularly high in fibre and can help promote regular bowel movement.

  • Incorporate Green Kiwi: Adding two green kiwis to your daily diet can help with constipation. Kiwis contain both soluble and insoluble fibre, which can improve stool consistency and frequency.

Final Thoughts

Managing constipation with IBS requires a combination of dietary changes, proper pooping techniques, and sometimes, the assistance of supplements or medication. By following these tips and understanding how your body works, you can achieve better digestive health and relief from constipation. Remember, always consult with your healthcare provider before making significant changes to your routine or starting new treatments.

By incorporating these strategies into your daily life, you can become a more efficient pooper and enjoy the benefits of a healthier digestive system. With patience and consistency, you’ll find that managing IBS-related constipation becomes more manageable, allowing you to focus on enjoying life without the discomfort and frustration of irregular bowel movements.

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