How to relieve constipation

Summary

Life Kit: How to Relieve Constipation

Podcast Information:

• Title: Life Kit
• Host: Marielle Segarra
• Description: Life Kit from NPR offers expert advice on various aspects of being human, from sleep and money management to parenting and more. Hosted by Marielle Segarra, the podcast aims to help listeners navigate everyday challenges with practical tips and insights.

Episode: How to Relieve Constipation
Release Date: April 8, 2025

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Introduction to the Topic

Marielle Segarra opens the episode by addressing a common yet often uncomfortable issue: constipation. She empathizes with listeners who may be experiencing severe constipation, setting a supportive tone for the discussion.

Quote:
"Have you ever been really, really constipated? Like you haven't pooped for a few days or a week and your abdomen is getting fuller and you sit on the toilet but nothing comes out?"
— Marielle Segarra [01:17]

To kickstart the conversation, Dr. Kumkum Patel, a gastroenterologist, provides a motivational pep talk aimed at easing the anxiety associated with constipation.

Quote:
"You got this. Imagine that the poop is traveling and it's just waiting. You're gonna open those gates and allow for that poop to naturally flow out because it's ready and you're ready and you no longer want it in there."
— Dr. Kumkum Patel [01:44]

Understanding Constipation

Marielle delves into the basics of constipation, distinguishing between normal and chronic conditions. She references medical guidelines to help listeners identify if they might be experiencing chronic constipation.

Frequency Guidelines:
Dr. Lynn Chang, a gastroenterology professor at UCLA's David Geffen School of Medicine, defines chronic constipation as having fewer than three bowel movements per week.

Quote:
"One is less than three bowel movements per week."
— Dr. Lynn Chang [05:41]

Immediate Steps to Relieve Constipation

Avoid Prolonged Sitting on the Toilet

Dr. Chang advises listeners not to sit on the toilet for more than five minutes at a time to prevent complications such as hemorrhoids and pelvic floor dysfunction.

Quote:
"If you have been sitting on the toilet for longer than five minutes, it's time to get up."
— Dr. Lynn Chang [05:44]

Hydration

Dr. Patel emphasizes the importance of drinking warm liquids to stimulate intestinal muscle contractions, aiding in the movement of stool.

Quote:
"Get a glass of water, warm water perhaps, because warm liquids tend to stimulate the contraction of the intestinal wall muscles."
— Dr. Kumkum Patel [06:28]

Physical Interventions

Toilet Posture

Marielle introduces the concept of using a toilet stool, such as the Squatty Potty, to improve posture during bowel movements. This simple tool can straighten the pathway for stool, making elimination easier.

Quote:
"When you lift up your legs closer to your chest, you're actually easing up the angle at which your poop can come out. It's straightening it out."
— Dr. Kumkum Patel [07:26]

For those without access to a toilet stool, creative alternatives like using a step stool or resting elbows on knees are suggested to achieve a similar posture.

Pelvic Floor Exercises and Stretches

Kelly Peterson, a physical therapist specializing in the pelvic floor, recommends specific stretches to alleviate pelvic floor tension, a common cause of constipation.

Quote:
"You have to be flexible enough to be able to do this. You basically are, you know, keeping your feet wide and sitting your bottom down and you bring your arms in between."
— Dr. Lynn Chang [08:37]

Abdominal Massage

Another technique discussed is abdominal massage, also known as the "I love you stretch." This involves tracing the letters I, L, and U around the belly to stimulate the intestines.

Quote:
"Sometimes it's called the I love you stretch because your hand will look like it's spelling out the letter I, L, and U."
— Dr. Kumkum Patel [08:37]

Managing Urges and Preventing Damage

Marielle addresses the challenge of managing the urge to poop while avoiding prolonged toilet sitting. Dr. Chang advises listening to genuine bodily signals rather than abdominal discomfort to prevent straining.

Quote:
"When you feel the urge in your rectum, then you want to go to the toilet, not just because you feel uncomfortable in the abdomen."
— Dr. Lynn Chang [09:50]

Prolonged sitting can lead to hemorrhoids, pelvic floor dysfunction, or rectal prolapse, making it crucial to heed these guidelines.

Medical Interventions

Laxatives

When physical interventions are insufficient, laxatives become an option. Dr. Patel explains the difference between osmotic and stimulant laxatives.

Quote:
"Osmotic laxatives pull water in and make it smoother for that poop to slide out."
— Dr. Kumkum Patel [11:07]

Osmotic laxatives like Miralax are gentler and take longer to work, while stimulant laxatives such as Senokot and Ex-Lax act faster but can cause cramps or diarrhea.

Suppositories and Enemas

For severe cases, suppositories and enemas are recommended. Suppositories help evacuate stool from the rectum, while enemas stimulate the bowels more forcefully.

Quote:
"You might consider an enema which will go even higher up in your digestive tract to your colon."
— Dr. Lynn Chang [13:09]

However, frequent use of enemas is discouraged to prevent dependency.

Relaxation and Stress Management

Stress is a significant factor contributing to constipation. Dr. Patel explains how the body's fight-or-flight response can hinder bowel movements.

Quote:
"When we're under stress, we release hormones that put our body into fight or flight mode... I don't really have time to poop."
— Dr. Kumkum Patel [14:19]

To combat this, relaxation techniques such as the 4-7-8 breathing method, warm baths, and exercise are recommended to reduce stress hormones and facilitate bowel movements.

Breathing Technique:

Quote:
"So basically, you take in a deep breath over the count of four, hold for seven, and exhale for eight."
— Dr. Kumkum Patel [14:45]

Long-Term Solutions

Dietary Changes

Increasing water and fiber intake is essential for preventing chronic constipation. Dr. Chang highlights various fiber-rich foods and advises incorporating them gradually to avoid gas and bloating.

Quote:
"If you're not used to eating a lot of fiber and you start eating more, usually you're going to get gas and bloating and even some cramps."
— Dr. Lynn Chang [16:07]

Fiber-rich foods include whole grains, beans, vegetables like broccoli and kale, fruits such as raspberries and apples with the skin on, and surprisingly, avocados, which contain up to 10 grams of fiber each.

Investigating Underlying Causes

If constipation persists despite dietary changes, it may be necessary to consult a healthcare provider. Chronic constipation can result from medications, hormonal changes, or underlying health issues that require specialized treatments like pelvic floor therapy or, in extreme cases, surgery.

Quote:
"Chronic constipation can also be caused by hormonal changes like the ones that happen when you're pregnant... It can help to see a doctor because they can help you figure out the cause."
— Marielle Segarra [16:44]

Recap of the Episode

Marielle summarizes the key takeaways to help listeners effectively manage constipation:

1. Identify Constipation: Pooping fewer than three times a week indicates constipation.
2. Limit Toilet Time: Avoid sitting for more than five minutes to prevent complications.
3. Change Posture: Use a toilet stool or adjust your position to ease bowel movements.
4. Use Laxatives Wisely: Start with osmotic laxatives and consult a doctor if needed.
5. Relax and Manage Stress: Implement relaxation techniques to reduce stress-related constipation.
6. Dietary Adjustments: Increase water and fiber intake gradually.
7. Seek Medical Advice: Consult a healthcare provider for persistent issues.

Quote:
"Always remember, as Dr. Patel said earlier, you got this."
— Marielle Segarra [17:57]

Conclusion and Final Thoughts

The episode closes with a final motivational reminder from Dr. Patel, reinforcing the listener's ability to overcome constipation with the right strategies.

Quote:
"You're going to open those gates and allow for that poop to naturally flow out because it's ready and you're ready."
— Dr. Kumkum Patel [18:00]

Marielle encourages listeners to explore other Life Kit episodes for further health and wellness tips, reinforcing the podcast's mission to provide practical advice for everyday human challenges.

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This episode of Life Kit provides a comprehensive guide to understanding and managing constipation through a combination of immediate interventions, lifestyle changes, and medical advice. By addressing both the physical and psychological aspects of constipation, Marielle Segarra and her expert guests offer valuable insights to help listeners find relief and maintain digestive health.

Transcript

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[Mariel Segarra]

You're listening to Life Kit from npr. Hey everybody, it's Marielle. Question have you ever been really, really constipated? Like you haven't pooped for a few days or a week and your abdomen is getting fuller and you sit on the toilet but nothing comes out? Are you sitting on the toilet right now? All right, just in case, we're gonna start with a little pep talk.

[Dr. Kumkum Patel]

Okay? Here we go. You got this. Imagine that the poop is traveling and it's just waiting. You're gonna open those gates and allow for that poop to naturally flow out because it's ready and you're ready and you no longer want it in there?

[Mariel Segarra]

That's Dr. Kumkum Patel. She's a gastroenterologist at Providence, St. Joseph and St. Jude Heritage Medical Group in California. Anyway, where were we?

[Dr. Kumkum Patel]

So, gently imagine it leaving your body. Now gently push over a deep breath in and push all the way out. Relax your bottom and let it come out.

[Mariel Segarra]

Now, I hope that worked for you. And you know, it might have, because relaxation is one of the things that can help you poop. But slightly, sometimes it takes more than that, especially if you've got chronic constipation, which can happen because of diet, medication, hormonal changes, and lots of other things so on this episode of Life Kit, we are going to give you a step by step guide for that SOS moment when you're really constipated. And we will also help you make changes to avoid situations like that in the future. A quick note here we are talking about poop in this episode. If that makes you uncomfortable, there are points where you might decide to tune out but also try to listen. Pooping is a natural thing and these tips can really help, especially in a pinch.

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[Mariel Segarra]

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[Dr. Kumkum Patel]

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[Mariel Segarra]

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[Mariel Segarra]

Okay, so let's start with a common question. How often should we be pooping? Experts say there's a range that's considered normal. Like some of us will poop several times a day and others every few days. But there are medical guidelines for what's considered chronic constipation.

[Dr. Lynn Chang]

One is less than three bowel movements per week.

[Mariel Segarra]

Dr. Lynn Chang is a gastroenterology professor at UCLA's David Geffen School of Medicine. She says there are other signs, too, like if you have to strain at least 25% of the time. But for the moment, we're not going to distinguish between whether your constipation is chronic or more of a one time or occasional thing. If you've pooped fewer than three times in the past week, you're probably constipated right now and you're probably wondering what to do. First of all, if you have been sitting on the toilet for longer than five minutes, Dr. Chang says it's time to get up. Because when you sit and strain for too long, you can get things like hemorrhoids next. And you may have already thought of this one, but just in case, drink some liquids. Here's Dr. Patel again.

[Dr. Kumkum Patel]

Get a glass of water, warm water perhaps, because warm liquids tend to stimulate the contraction of the intestinal wall muscles. Okay, so if you want coffee, if you want warm water, take one of those things, okay? Start drinking it because it's going to stimulate the actual peristalsis. That's the movement of the muscles in the colon to start moving again.

[Mariel Segarra]

From here. There are different paths forward, depending on your preferences and also on how long it's been since you pooped. If you feel like time is on your side and you have the patience to wait, you can try a physical intervention. That's takeaway one. And when I say physical, I mean without using medication. Dr. Patel says you can start by getting a toilet stool, often known by the brand name squatty potty. You can get one for about 20 or 25 bucks. And you can use these whether you're constipated or not. They basically allow you to squat over the toilet. And that works because when you lift.

[Dr. Kumkum Patel]

Up your legs closer to your chest, you're actually easing up the angle at which your poop can come out. It's straightening it out. So your poop now has a straight and narrow pathway to come straight out instead of having to go through an angle.

[Mariel Segarra]

If you don't want to buy a toilet stool or you're just not at home, you can get creative. Kelly Peterson is a doctor of physical therapy who specializes in the pelvic floor. Can you use a step stool or a trash can or something to get your feet higher?

[Dr. Kumkum Patel]

Can you rest your elbows on your.

[Mariel Segarra]

Knees and lean forward or fold all the way forward? Now, if your constipation is not that severe, a squatty potty or a Change in position might be all that you need. Another approach is to stretch your pelvic floor, and that's because pelvic floor dysfunction is one possible cause of constipation. For instance, if your pelvic floor muscles are in spasm, that could be making it harder for you to poop. Kelly has a few go to stretches. One is known in yoga as child's pose. Another is called happy baby. Basically, it's like a squat on your back, and a third is just a regular deep squat. You have to be flexible enough to be able to do this. You basically are, you know, keeping your.

[Dr. Lynn Chang]

Feet wide and sitting your bottom down.

[Mariel Segarra]

And you bring your arms in between. Another physical intervention for constipation that you may have seen online is abdominal massage. Sometimes it's called the I love you stretch because your hand will look like it's spelling out the letter I, L and U. You'll lay on your back, and then starting on either side of your stomach, trace the letter I, then L and then a U or half circle around your belly button. And Dr. Patel says you just want to use firm pressure with your hands.

[Dr. Kumkum Patel]

I mean, I've seen videos where someone was taking one of those theraguns and, you know, applying it to their abdomen. And I don't know if that's a little too intense or not, because that stuff is super powerful. I don't know if I'd go straight to the theragun.

[Mariel Segarra]

If you start to feel an urge, hooray, get yourself to the bathroom. Let's take a moment, by the way, and talk about urges. We're not supposed to sit on the toilet for more than five minutes, but that's really hard when you're constipated because often your abdomen will feel so full and uncomfortable. And you think, if I just poop, I will feel so much better. But Dr. Chang says that does not mean the poop is ready to come out.

[Dr. Lynn Chang]

So I usually tell my patients, when you feel the urge in your rectum, then you want to go to the toilet, not just because you feel uncomfortable in the abdomen. Maybe it's getting prepared to have a bowel movement, but it's not the right time to sit on the toilet.

[Mariel Segarra]

You want to limit your time on the toilet because when you sit and strain and try to push the poop out, you can do damage. For instance, you might get external hemorrhoids, which are swollen veins in your rectum that can be painful and itchy and cause bleeding. You might also develop pelvic floor dysfunction, where Your muscles get weaker and it gets even harder to poop. Or you could even get a rectal prolapse where your rectum slips down inside your anus and you don't want to.

[Dr. Lynn Chang]

Get to that point.

[Mariel Segarra]

So Dr. Chang says if you're sitting on the toilet, try pushing a couple.

[Dr. Lynn Chang]

Times, and if it's unsuccessful, then you should really get up from the toilet, you know, move around, do something else, and then go to the bathroom again later on.

[Mariel Segarra]

Okay, so let's say you don't have the patience for all of this or you've been constipated for more than a few days. In that case, Dr. Chang says you may need medication that's takeaway. 2. One option is a laxative, and there are different kinds. Dr. Patel says a gentler approach, and the one you probably want to start with is called an osmotic laxative, which.

[Dr. Kumkum Patel]

Means that it pulls water in and makes it smoother for that poop to slide out. Okay.

[Mariel Segarra]

Miralax is one of the most popular brands, but there are generics, too. These can take two or three days to work, but if they don't, or if you don't have the time to.

[Dr. Kumkum Patel]

Wait, get yourself a stimulant laxative, which means that you're going to actually stimulate your bowels to start contracting and squeezing to actually be able to push that poop out.

[Mariel Segarra]

Senokot and Ex Lax are two popular brands. And Dr. Patel says stimulant laxatives tend to work within six to 12 hours. Now, let's be clear. The kind of pooping you're gonna do after a stimulant laxative is probably not gonna feel good. It might give you cramps or diarrhea.

[Dr. Kumkum Patel]

Because it's actually causing spasms and contractions of your intestines. So, yeah, it's irritating the hell out of the wall of the intestine. And that's why it's causing the poop to move through, because the poop's like, okay, no, no, this is bad. The intensers are like, no, no, let's get rid of everything in here.

[Mariel Segarra]

But this can be a short term fix. One thing to keep in mind with laxatives, they can be super helpful in a pinch. But some of them, particularly stimulant laxatives, can cause other problems. Like you might build a tolerance to them and need higher doses with time. And if laxatives give you severe diarrhea and you're using them over a long period, you could end up with electrolyte imbalances. So basically, if you find yourself using laxatives regularly, talk to a doctor. Dr. Chang says sometimes an oral laxative alone isn't going to work because your rectum might be blocked off at this point.

[Dr. Lynn Chang]

Sometimes what you're getting is loose stool that just gets around the hard stool, but you're not really removing the hard stool in the rectum.

[Mariel Segarra]

So in these cases, she recommends a suppository which is like a medication bullet that dissolves.

[Dr. Lynn Chang]

It's very short, it's like an inch and you put in the rectum and what that will do, it'll also have a laxative effect and it'll stimulate just the rectum. The stool that's in the rectum will be evacuated.

[Mariel Segarra]

If that's not working, you might consider an enema which will go even higher up in your digestive tract to your colon. You can buy an enema kit over the counter. Sometimes they'll come in a bag, sometimes in a bottle, and they'll have a tapered tip. You put that in your rectum and.

[Dr. Lynn Chang]

Squeeze and it stimulates the bowel and you hold it for as long as you can. And when you have the urge to go, then you evacuate.

[Mariel Segarra]

Dr. Chang does not recommend that people use enemas regularly because sometimes patients start to feel like they need them to poop. So think of enemas as another helpful tool when you're really stuck. Okay, so the next thing we're gonna suggest may not solve your constipation on its own, but it can help takeaway. 3. Try to relax. And I know, easier said than done when it feels like your abdomen is going to explode. But try, because one of the many causes of constipation is stress. Dr. Patel says when we're under stress, we release hormones that put our body into fight or flight mode. Researchers have different theories on why this results in constipation. One is that your body's basically like, I'm running away from a tiger right now. I don't really have time to poop.

[Dr. Kumkum Patel]

And so it kind of holds it all in until you're relaxed enough to poop it out.

[Mariel Segarra]

Dr. Patel says you may experience stress related constipation when you travel, maybe because you're getting on a flight or you're in an unfamiliar place, or you're just changing your everyday routine.

[Dr. Kumkum Patel]

And that produces a stress response in a lot of people.

[Mariel Segarra]

One way to relax is with breathing exercises. And here's one Dr. Patel suggests called the 4, 7, 8 technique.

[Dr. Kumkum Patel]

So basically, you take in a deep breath over the count of four hold for seven and exhale for eight. That actually helps a lot by calming the nerves down. And by calming the nerves down, you can get yourself out of that fight or flight mode.

[Mariel Segarra]

You can also try a warm bath or exercise, which has been shown to lower levels of the body's stress hormones. Okay, so hopefully we've helped you solve your short term problem. But if you find that you're chronically constipated, there are a few other things you want to do. First of all, and this is takeaway four, make some dietary changes. Drink more water and eat more fiber. Different types of fiber can bulk up your stool and also help it move faster through your digestive system. The World Health Organization recommends that adults get 25 grams of fiber a day by eating a healthy diet. Some foods that pack a lot of fiber, whole grains and bran cereals. No surprise there. Beans, veggies like peas, broccol, kale. Also fruits, especially raspberries. Apples with the skin on. And this one surprised me. Avocados. 10 grams of fiber each. Dr. Chang says. One thing to look out for. If you don't currently eat foods with a lot of fiber, you should start incorporating it gradually.

[Dr. Lynn Chang]

Because if you're not used to eating a lot of fiber and you start eating more fiber, usually you're going to get gas and bloating and even some cramps.

[Mariel Segarra]

But also if you are regularly constipated and these dietary changes aren't working. Takeaway 5. It's time to investigate further. Chronic constipation can be caused by a lot of things. It can be a side effect of medications or of supplements like calcium and iron.

[Dr. Kumkum Patel]

Sometimes it may need to be changed to a different form of medication. If it's really that terrible. Other times there may be a way to overcome it. But sometimes you may need a prescription medication.

[Mariel Segarra]

Chronic constipation can also be caused by hormonal changes like the ones that happen when you're pregnant. Or maybe it's happening because you travel a lot or you're under a lot of stress at work. Figure out what your triggers are. You might also have an underlying issue that calls for other treatment, like pelvic floor, physical therapy, or in some cases, surgery. It can help to see a doctor because they can help you figure out the cause, adjust your medications if needed, or prescribe medications that you can't get over the counter. Alright, it's time for a recap. If you poop fewer than three times a week, you are probably constipated. Don't sit on the toilet for longer than five minutes at a time and try not to strain. If you change your posture, maybe with the help of a toilet stool, that can help you poop more easily. If you're going to take a laxative and you have time to wait, try the osmotic kind first. They're usually gentler than stimulant laxatives, but if it's been a while or you're really uncomfortable, go for the stimulant kind. If you find that you're constipated all the time, drink more water, eat more fiber, and consider making an appointment with your medical provider to investigate the cause. Lastly, always remember, as Dr. Patel said earlier, you got this.

[Dr. Kumkum Patel]

You're going to open those gates and allow for that poop to naturally flow out because it's ready and you're ready.

[Mariel Segarra]

For more Life Kit Check out our other episodes. We have one on how to manage IBS and another on how to talk about STIs. You can find [e-mail] LifeKit and if you love Life Kit and you just cannot get enough, subscribe to our [e-mail] LifeKitnewsletter Also, we'd love to hear from you, so if you have episode ideas or feedback you want to share, email [e-mail] this episode of Life Kit was produced by Claire Marie Schneider with fact checking help from Sacile Davis Vasquez. Our Visuals editor is Beck Harlan and our digital editor is Malika Garib. Megan Keane is our Supervising editor and Beth Donovan is our Executive Producer. Our production team also includes Andy Tagle, Margaret Serino, Sam Yella, Horse Kessler, and Sylvie Douglas. Engineering support comes from Patrick Murray. I'm Mariel Segarra. Thanks for listening. Why'd you have to go and make me so constipated? Okay, here we go.

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