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A Guide to Healthy & Happy BowelsA normal and healthy bowel pattern is different for everyone. One person might have a bowel movement every three days, while another person might have more than three bowel movements every day. Both patterns are healthy and both are normal. You should never have pain with passing stools, feel like you have to push or strain to pass stools, feel like you are not in control of your bowels or have leakage as these can be signs of pelvic floor muscle weakness/dysfunction. A persistent change (as in continuing for more than 3 weeks) in your personal bowel habit may signify a serious medical condition and is worth contracting you primary care provider for a checkup. Conditions that can negatively affect stool movements:Muscle damage/ Weakness of sphincterCommon causes are nerve and muscle damage from child delivery (higher degree tears or use of forceps) or surgery (due to anal fissures, fistula or hemorrhoids), radiation treatment for cancer, medical diseases that affect the nerves (such as diabetes or MS), abuse trauma or spinal cord lesions.Inflammatory bowel disease: Irritable bowel syndrome & Crohn’s Disease are most commonDiarrheaDiarrhea is basically a condition of altered stool consistency. It can be affected by dietary imbalances, digestive tract diseases, acute illnesses, laxative use, medications, physiological issues (such as “short gut syndrome” or malabsorption syndromes), radiation enteritis or even stress/anxiety related.ConstipationConstipation is a condition in which there is difficulty in emptying the bowels, usually associated with hardened stool. It can be affected by dietary imbalances, digestive tract diseases, dehydration, medication induced (especially with psychotropic and antimotility drugs), fecal impaction and sphincter weakness. Collagen vascular disease: scleroderma, dermatomyositis and amyloidosisInadequate tissue capacity: Usually due to rectal ischemia, tumors/growth or excessively restrictive attireCognitive impairmentsFunction impairments that limit general ambulation or mobilityAgingFiberThere are two main types of fiber: soluble and insoluble. Both of these types can prevent and relive constipation and diarrhea by soothing and regulating the digestive tract, although some people may find one to be more easily digested. Let’s take a look at both types.Insoluble FiberFunction: moves bulk through the intestines, control and balances the pH (acidity) of your gutBenefits: promotes regulate bowel movement and prevents constipation, removes toxic waste in less time though colon and keeps optimal pH in colon which can be helpful in preventing colon cancer.Soluble FiberFunction: makes stool softer/less bulk, binds with fatty acids and prolongs stomach emptying time so sugar is released and absorbed more easilyBenefits: lowers total cholesterol and LDL (“bad) cholesterol which lowers risk of heart disease; also regulates blood sugar for people with diabetesFiber also stabilizes intestinal contractions resulting from the gastrocolic reflex, a natural stimulant for gut mobility we get when we eat. It normalizes the bowel function from either extreme diarrhea or constipation but may not help as much in those with IBS as it typically does not have much effect of abdominal bloating and discomfort. For most people, it’s best to get fiber from foods – Taking supplements won’t make up for poor eating habits.Foods to avoid:Good foods (insoluble fiber)Good foods (soluble fiber)Very spicyWhole wheat productsOat/Oat branMilk productsWheat oatDried beans and peasChocolateCorn branNuts and barleyArtificial sweetenersFlax seed and other seedsPrunesAlcoholVegetables such as green beans, cauliflower and potato skinsFruits such as oranges, pears, peaches and applesUnder/Over ripe fruitsFruit and root vegetable skinsFlax seed and other seedsAcidic foodsPopcornCarrotsCarbonated and caffeinated beveragesBrown RicePsyllium husk (Metamucil)If you are unsure that you are getting the right amount of fiber or eating the correct foods, a simple solution is to complete a food/drink log of all that you ingest throughout the day. This not only helps you see what you are taking in and when, but allows you to compare it to what is coming out with use of a bowel diary so you can better modify your treatment plan. Consistency in eating time can also affect your bowels, so try to keep a fairly regular schedule. Supplementing fiber in your dietGo slow. If you add a lot of fiber to your diet too quickly, it can cause some uncomfortable side effects, like bloating, cramping, and gas. Experts recommend you gradually build up how much you take. It also helps to take supplements with a large glass of water and stay hydrated throughout the day. Psyllium husk, a natural dietary fiber originating from?plantago ovata, has been the source of both soluble and insoluble fiber in Metamucil for 80 years and is a good option for many. Amount of fiber per day – how much is TOO much? Don’t overdo it. It’s possible to get too much fiber in your diet. Studies suggest that adding 50 or more grams per day may affect how your body absorbs nutrients. The national?fiber?recommendations are 30 to 38 grams a?day?for men and 25 grams a?day?for women?between 18 and 50 years old, and 21 grams a?day?if a woman is 51 and older. So be sure to think about how much fiber you get overall, from both diet and supplements, when figuring out how much you need.Several studies suggest you shouldn’t combine fiber with drugs that treat depression, diabetes, high cholesterol, thyroid disorders, seizures, and various heart ailments. Even common medications like aspirin, ibuprofen, and penicillin can be affected by an increase in fiber. Because fiber slows down digestion, it may decrease the rate at which some drugs are absorbed. Your best bet: Talk to your doctor about possible interactions between fiber supplements and any medicines you’re taking and take your fiber either 1 hour before or 2 hours after you take your medications or at night.Tip for Regulating Your BowelsChoose the best time of day to have a bowel movement. For most people this is a half hour to an hour after breakfast or lunch. These times are good because the body uses the gastrocolic reflex, a stimulation of bowel movement that occurs with eating, to help produce a bowel movementMake sure you have convenient access to a bathroom and do not feel rushedEat all your meals (breakfast, lunch and dinner) at a predictable time each day – your bowel functions best when food is introduced at the same regular intervalsEat the same amount of food at a given time each day. In other words, if you always eat a large breakfast a small lunch, then keep up that pattern daily – consistency with quantity is key. At every meal eat 2 servings of fruit or vegetables and at least one serving of a complex carbohydrate (such as a whole grain cereal, brown rice, bran or oatmeal).Drink plenty of water, at least 8 ounces with each meal and ideally 8 glasses a day.Until regular movements are establishes at your desired time, you may eat 2-3 dried prunes (or 1/3 cup prune juice) each night to help stimulate AM bowel movements.Exercise daily at a consistent time each day. Ideally doing a full body aerobic exercise – for example 15 to 30 minutes of brisk walking, swimming or cross training. If you are unsure how to start this, contact your physician or physical therapist for advice. Complete a bowel diary to help identify your normal potty patterns and consistencyBowel Diary4305300147320Name:Start Date:Instructions:When you have a dowel movement, please fill in the letter(s) corresponding to what happened in the appropriate day and time boxKey:N = Normal bowel movementI = Incontinence/Bowel accidentP = Pad or pants changeS = Straining to pass stoolF = Fingers needed to push stool out (splinting)SundayMondayTuesdayWednesdayThursdayFridaySaturdayGas Meds6:00 AM????????7:00 AM????????8:00 AM????????9:00 AM????????10:00 AM????????11:00 AM????????12:00 PM????????1:00 PM????????2:00 PM????????3:00 PM????????4:00 PM????????5:00 PM????????6:00 PM????????7:00 PM????????8:00 PM????????9:00 PM????????10:00 PM????????11:00 PM????????12:00 AM????????1:00 AM????????2:00 AM????????3:00 AM????????4:00 AM????????5:00 AM????????Type 1Separate hard lumps, like nutsType 2Sausage-shaped but lumpyType 3Like a sausage but with cracks on its surfaceType 4Like a sausage or snake, smooth and softType 5Soft blobs with clear cut edgesType 6Fluffy pieces with ragged edges, a mushy stoolType 7 Watery, no solid pieces, entirely liquidWhen you have a bowel movement, place the number that best characterizes your stool type in the appropriate place in the table.Hydration Station – How much water do we really need?Staying hydrated is not only essential for daily living but important for bowel mobility and softness. Water helps to move waste materials along, and is absorbed throughout the entire length of your colon. Dehydration?is one of the most common causes of chronic constipation. If you don’t have enough water in your body already -- if you're dehydrated -- the large intestine soaks up water from your food waste. This makes hard stools that are difficult to pass.When it comes to thirst, most experts say "let your body be your guide." In general you should drink half of your body weight in ounces per day. For example, if you weigh 120 pounds, you need to drink 60 ounces of fluid daily. Remember, this recommendation also includes the fluids in your food, so try to eat a good variety of water rich foods. Importantly, aim to drink two-thirds of all your fluids in the form of water. Tips to improve your water intake: Aim to drink a glass of suitable fluid every hourHave a bottle of water on your desk and with you all the time, in the car, on the train etc.Decrease the amount of tea, coffee and alcohol to not more than 3-4 cups per day.Drink when exercisingProper “Potty Mechanics”Did you know that there is a right and a wrong way to have a bowel movement? You should never have to strain, push or hold your breath to go to the bathroom! To practice proper ‘Potty Mechanics’ just follow the steps listed below to a strain and pain free bathroom experience:Sit forward on the toilet, ideally with a small stool or step under your feet to help bring the knees upRelax your pelvic floor muscles, noting how your stomach muscles relax and bulge or “pooch” forwardConcentrate on relaxing your anus, widening your “sit bones” and relaxing your stomach muscles – you can put one hand on your waist to help feel this movement is you are unable to visualizeKeep your jaw relaxed with your mouth open, brace, then breathe out or even grunt to prevent you from pushing while passing your stool outward.Pull up your anorectal muscles as you finish emptying to improve closing reflexBowel MassageThis is a technique that is safe for you to perform at home daily to help assist with bowel mobility and flow. For this massage, we will be following the path that fecal matter travels in your colon to assist it on its way out! You can choose to either lie down (preferred) but you can stand up if you prefer as well. Using lotion or oil may be more comfortable, but performing dry is fine too. ................
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