Constipation Conversation

If the New York Times is talking about it, then I certainly can as well.  In a recent article in the Well section of the New York Times (“Simple Remedies for Constipation,” February 8, 2016, link to article), Jane Brody discusses causes of constipation, a variety of simple yet effective remedies to treat constipation, and certain false “myths” about constipation.  She shares with the readers a decent amount of personal information – namely, she elaborates upon her personal struggle with disordered bowel movements at various stages of her life, and she shares with the reader the tricks and techniques which helped her along her journey.  I applaud her candidness and appreciate that she divulged what probably was not easy to share in order to benefit the greater public audience.

On that note, I feel inspired by Brody to share my own personal story.  While reading the article, I was especially struck by the following line, “Most of the time, relatively simple treatments prove adequate.” I could not agree more, and I speak from firsthand experience.  Once upon a time, I was a teenage girl who was somewhat of a “germaphobe”.  By that, I mean that I tried to avoid using the public bathrooms at all costs, both for voiding and defecating, and I waited until I returned home from school to use the facilities.  I left for school at approximately 7:30 AM and did not return home until 6:30 PM.  Unbeknownst to me, I was wreaking havoc on my pelvic floor muscles (which I did not even know existed at the time) by “holding it in” all day.  In addition, I strictly limited fluid consumption in order to preclude the necessity of voiding in the public bathrooms.  The decreased fluid resulted in extremely hard and large stools which I was unable to pass frequently and only with tremendous pain.  I recall crying to my mother after one particularly painful experience, “childbirth couldn’t possibly be more painful than what I just experienced.”

At the time, my pediatrician instructed me to take laxatives daily.  Not once in our conversation did he ask me what I was eating or drinking.  Something didn’t sit well with me about being dependent on laxatives as a teenager, and that didn’t seem like a viable plan moving forward.  Wasn’t my body supposed to work like everyone else’s? As far as I was aware, none of my friends required daily laxatives to pass bowel movements.  When I mentioned this to one particular friend, she asked me the million dollar question, “How much water are you drinking?”  She looked aghast when I shrugged and responded, “None.”  My friend kindly explained to me the importance of drinking water, and suggested I attempt drinking 8 cups of water per day.  Desperate as I was, I decided to follow her experiment.  Public bathrooms would simply have to become my friend at best, or tolerable at worst.  Success is the best form of positive reinforcement.  Within several days, I was passing pain-free bowel movements on a regular basis.

I was shocked twofold: 1. How such a simple solution could impact my health so significantly, and 2. How my physician never recommended this solution, and that I would still be taking laxatives had followed my physician orders.  The experience taught me to ask questions.  I say the following with all due respect to physicians and medical care providers:  You know your body best.  If a medication or intervention doesn’t make sense to you, you have every right to delve deeper into the matter and ask about alternatives.

In conclusion, I thank Brody for sharing and for inspiring me to do the same.  If our stories educate others and direct them to proper care, then they are well worth telling.  Furthermore, I thank Brody for discussing how breathing exercises, colon massage, and biofeedback, all which are components of pelvic floor physical therapy, can help individuals suffering with constipation.  My one critique of Brody’s article is that she never mentions pelvic floor physical therapy explicitly.  As I wrote in the comments section of the New York Times article, “As a pelvic floor physical therapist and certified biofeedback clinician at Revitalize Physical Therapy who encounters patients suffering from constipation on a regular basis, I want to emphasize how beneficial physical therapy is in the treatment of bowel dysfunction. Biofeedback is definitely helpful to many, however nothing can substitute for external and internal manual myofascial release and connective tissue mobilization. Trained pelvic floor physical therapists are experts of the musculoskeletal system, and they can assist with releasing tightness or tension in the pelvic floor muscles which may be interfering with proper defecation.”  Perhaps my experience years ago subconsciously inspired my decision to become a pelvic floor physical therapist and to help others experiencing what I endured.  If you or anyone you know stand to benefit from these types of services, please contact me.  I would love to have the opportunity to help you.