Are You Pooping Correctly?

3 must-use techniques to avoid hernias, hemorrhoids, and pelvic organ prolapses

Why You’ll Thank Yourself Later For Healthy Pooping Now

Pooping is something that we all do every day (hopefully!), yet no one ever really teaches us how to do it properly. When we are on the toilet, we get the stool out any way that we can, oftentimes rushing, pushing or straining. These common habits can lead to issues such as: 

• hemorrhoids-swollen veins in the lower part of the rectum and anus

• hernias-abnormal exit of tissue/organ, such as the bowel, through the wall of the cavity where it normally resides

• pelvic organ prolapses -when the bladder, uterus or rectum droop/ descend into the vaginal canal or rectum

• fissures/fistulas-small tears or holes in the tissue that lines the anus or rectum

 Sound scary? What if I told you there was a way to poop that could not only be more efficient but healthier for your body and avoid these pitfalls? There is! Just follow these 3 techniques. 

1) Squatty Potty Posture

Have you ever thought about how you would naturally position yourself to poop if you weren’t given a porcelain chair to sit on? Have you ever been camping and had to go #2? Our bodies are designed to poop in a full squat position. 

When we are in a full squat position, something very important happens: our puborectalis relaxes. The puborectalis is a pelvic floor muscle that goes from the pubic bone and wraps around the rectum like a sling. It holds the rectum at an angle while we are standing and sitting, which is great because it allows us to avoid leakage of stool and gas. However, the only time puborectalis relaxes completely and releases its pull on the rectum is when we are in a full squat. When we sit on a toilet we are having to push past the angle to evacuate the stool. This requires us to increase our intra-abdominal pressure by pushing/ straining.

Don’t worry, I know it’s not realistic to ask you to go outside and dig a hole in the ground each time nature calls. Instead, we can create a natural squatting position in our modern toilet clad world! 

Step 1) Elevate your feet on something so that your knees are higher than your hips- this could be yoga blocks, text books, or a squatty potty as long as it is stable and you can relax your legs. 

Step 2) Lean forward slightly keeping a flat back and rest our elbows on your knees.

Congratulations! You’ve just relaxed your puborectalis and I think you’ll find yourself able to empty stool much easier!

2) Avoid Breath Holding/Pushing/Straining

I ask every single pelvic floor patient that I see if they push/strain with bowel movements. Sadly, the answer is oftentimes yes. When we push/strain with bowel movements, it increases the pressure within our abdomen and pelvis. While it might be effective at getting stool out, it’s also putting all of that pressure on all of your organs and tissues as well. 

If you are in a good squatting posture and still feeling like you are having to push/strain, try making noises instead. Deep guttural noises like “Muuuuhhhh” or “Mooooo” can be very helpful. These noises keep you breathing which avoids increased intra-abdominal pressure and they also help relax the muscles of the pelvic floor or if there is someone else within earshot and you don’t want to make noise, just promise me not to hold your breath! If you are still having trouble, there might be a stool consistency issue. Where do your bowel movements fall on the bristol stool chart?

3) Pelvic Floor Relaxation/Lengthening

During bowel movements the pelvic floor muscles should be completely relaxed or lengthened. Lengthening is called many things such as a reverse kegel, bulging, going to the basement, opening etc. If your pelvic floor is not able to come down into this expanded/relaxed position, it can make it more difficult for you to empty stool.

If you are in the correct posture, you are breathing, you have good stool consistency and you still are not able to empty stool or feel like you need to push/strain, reach out to a pelvic physical therapist for an assessment of your pelvic floor!