Role of Physiotherapy in Constipation
What is Constipation?
Constipation is not a disease; it’s a symptom that can result from a disorder of gut-brain interaction or a functional gastrointestinal disorder.
Symptoms
- Difficulty in passing stool (straining)
- Infrequent bowel movements (less than 3 times a week)
- Hard stools
- Reliance on laxatives
Risk Factors
- High BMI
- Low consumption of fruits and vegetables
- Family history of constipation
- Anxiety and depression
- Increased age
- Poor posture
Who is Affected by Constipation?
- 27.2% of the population is mostly affected
- Women more than men
- Post-operative hip fracture patients
- People with joint hypermobility
- People with neurological conditions
- People with back and neck pain
- Up to 30% of children
- Up to 36% of female athletes
- Up to 38% of pregnant women
Important Guidelines
Chew Food Properly: It’s recommended to chew at least 20 times per bite.
Defecation Posture: Use a squatting posture, similar to using an Indian toilet. It should not be painful.
Relaxation of Puborectalis Muscle:For any orthopedic problems, modifications may be needed.
Diet & Lifestyle Changes
Hydration: Drink 0.502 ml or 14.7 ml of water/fluid per pound of body weight for geriatrics and pediatrics.
Physical Activity: Encourage activities like swimming, cycling, and walking (at least 150 minutes per week for adults).
Foods to Avoid: Bananas, rice, apples with skin, toast, cheese, and peanut butter.
Foods to have: Fruits, fish oil, kiwi, Kombucha, etc.
Physiotherapy Recommendations
For Severe Cases: Biofeedback training using surface electrodes or internal anal probes:
- One electrode on the abdomen
- One electrode on the pelvic floor
Exercises to Improve Posture and Blood Flow:
- Lower trunk rotation
- Single knee to chest
- Side Lying thoracic rotation
- Prone on elbows
Diaphragmatic Breathing: Promotes parasympathetic activation and enhances vagal activity. Practice while on the toilet during defecation.
Motor Control Training of Pelvic Floor through exercise called Elevator Exercise:
- Close the door (shut the anus)
- Elevator goes up (pull the muscle up towards the head)
- Elevator goes down (release the muscle away from the head)
- Elevator opens (anus relaxes)
Colon Massage: A technique used to stimulate vagus, sacral, and other related nerves.
Additional Treatments:
- Interferential Therapy (IFT)
- Neuromuscular Reeducation Stimulation (NMES)
For More Interesting Blogs on Physiotherapy visit our blog page.
Dr. Sumit Gupta(PT)
Chief Consultant Physiotherapist
(Sports, Shoulder & Spine Specialist)