Breathing Excercise for Constiatipation---Question for Christine

Body: 

Hi Christine,
My therapist had me practice this exercise to help with constipation and Im wondering what you and others thought about it. She is trying to get my sphincter to bulge out which doesnt make sense for me wouldnt it make the prolpase worse?

But here is what she wants me to do. Take a deep breath in where the abdomen is puhed out then tighten the abdominals slowly exhaling but keeping the abdomen tight. And saying something like Ehhhh out loud to make sure that there is exhale as you bear down to have the bowel movement. She says its to prevent straining when having a movement. But Im not sure.Has anyone ever been told to do this and has it worked for them? Christine what do you think? I know when I try this I dont seem to be able to have much movement and not sure if Im ending up straining.

Hi lillyflower

I can see what the therapist is trying to do. I think it could be useful. I sometimes have difficulty passing bowel motions but mostly it just happens, as long as I can respond quickly to the urge before it goes away. Search for "Lopo" or "animal kingdom", where we explored how animals empty the bowel, and work out what muscles to use, and how to get the rectum in a straight line.

It is bracing firm and letting go, rather than pushing down and forcing it out. Kind of like squeezing the bottom of the toothpaste tube once, then waiting while the toothpaste responds to the changing pressure in the tube, and finally squeezes out all by itself.

Louise

Thanks Louise. It feels so strange for me to do it. I barely have any muscle strength. Its like I forgot how to go to the bathroom after I had that colonic injury. Its so strange. The only way I can go is if I have the urge by taking high dose Vitamin C and Magnesium Oxide and that doesnt always work for me. Im also afraid of getting a lazy colon.
LillyFlower

This does make sense - if one interprets the concept correctly.

The only way I believe this could be beneficial is if you continue to hold your belly out on the exhale. This isn't clear because you use the word "tight", which often means pulled-in. If the rectus muscles are being held out in a balloon, then the pelvic floor muscles should stretch to their full dimensions. Perhaps the vocalization helps to relax the pf muscles, but I do not know of such a connection. Of course "trying to get your sphincter to bulge out" sounds harmful, but I think the goal is to get the pf to open and relax, as this is the only way we can have a bm. Right afterward the pf contracts in order to squeeze any remaining poop out of the rectal vault - pretty amazing autonomic movement.

The main issue is that you do not strain against the toilet seat at all, which does not seem to be in her instructions. These pressures are bearing strongly down and when they're stopped at your hips against the firm toilet seat, the forces blow back up and are a leading factor in the development of prolapse. You can easily get into a natural position for moving your bowels by simply leaning forward like you are tying your shoe laces and getting your weight off the seat. Lean your torso all the way out and onto a stool or little table for "Lopo", our very own Louise's answer to a perfectly anatomical and relaxing way to go.

:) Christine

THanks for your reply Christine :) The therapist wanted to actually tighten my belly muscles on the exhale. That is what confused me so much. And made it difficult for me. Im still lost as to why tighten upon exhale. The vocalization was to make sure I wasnt holding my breath. Regarding bulging of the sphincter I think that she was trying to get my pf to relax as you said. But it does feel like it make the prolapse feel worse. I think I rather do Louise's postioning. Is it safer than the squatting position?

Louise, I have a question about your position. When I lean my torso can I lean it on my knee? Im having a hard time visualizing the postion. How high is the stool and what is it for? Can I hang my hand down as if trying to tie my shoes? Does the butt hover over the toilet seat or am I still sitting just leaned forward? And saggy back IM not sure if that means arched back? I apologize for the confusion. I have chronic fatigue and soemtiems hard to understand and slow to catch on

THanks so much for your help,
flowerlilly

Yes, then if tightening means contracting the stomach muscles, I can make no sense of the exercise. Both the pelvic floor and stomach (rectus) muscles contract together - when one contracts it is very difficult to keep the other from doing so. But the pf needs to relax to have a bm. It always amazes me that these therapists can simply discount anatomical reality. whatever...

Here's what I've been doing, and it helps:

(First of all I amended my diet, and that's made a difference.)

The instant I feel the urge, I head to the potty. Otherwise the feeling might go away and not return for a loooong time, and then I'm in deep trouble.

I sit down and pull up in to WW Position as much as possible, leaning slightly forward. I wait. If nothing happens, I do some deep breathing for a minute. I feel like inhaling deep into my low abdomen helps squeeze things out. I inhale and hold it for 10 seconds or so. If nothing happens, I lean to the right a little. Then I lean to the left. I might twist to the right....always keeping upright and leaning forward at the hips. Sometimes I might drape my body down as if I'm tying my shoes...if I get tired of waiting. Then I'll sit up and try some more. Sometimes it takes a long, long time for my bowels to finally move.

Ribbit, I did the same thing. When the recto first presented itself I had difficulty having a BM -- I would do some deep breathing and it gets things going.

Hi Flowerlilly

I sometimes rest my hands on my knees with my butt out, and kind of rise up off the seat then almost sit down, and do it again a couple of times. It is quite hard on the thigh muscles, but is just like a plie. This keeps my abdominals kind of braced, but not pulled in, and uses all the little muscles inside my pelvis to straighten out the rectum. Often it doesn't produce a motion at the time, but it produces a really easy motion just after the next meal. It is a re-alignment thing, I think. My Western body has not squatted since birth, so I cannot do it properly. Full squatting just blows my perineum out. My belly seems to get in the way. If you have been squatting from birth, then squatting might be better. That, I have found out is because lifetime squatters have differently shaped facets on the bones of their feet, moulded since childhood by resting and eliminating in a squat (presumably to keep your bottom out of the mud/dust, where chairs are not everyday furniture. The shape of these bones is set once we hit adulthood.

I also find that an energetic walk will help get my intestines back into alignment. the body is simply amazing how it can restore its own integrity using its own structure and metabolism, if we let it.

Louise

Thanks Loiuse :) So if IM understanding properly you lean forward use your thighs to lift your butt and then sit back down leaning forward? It does help me to lean forward. I've noticed that the rectum doesnt completely empty at time and please forgive me if this is TMI but the stool is stuck half way in and half way out. I then squeeze my sphincter muscles and Im not sure if that is a good thing or bad thing to do. THen some of it finally comes out but some stays in. Is it safe to squeeze the sphincters like that? I start panicking when it gets stuck half way out.

Yes I have the same feeling about the perineum bulging out when squatting.

Thanks for your patience in explaining the LoPo for me because its hard for me to catch on to things.

Yes, sometimes it does get stuck halfway out. Tilting the pelvis forwards and lifting the tailbone closes the pelvic floor muscles by stretching them tight so they come together in the middle, and literally squashes the sphincter closed. This is kind of like second stage labour. I only have to try and close the sphincter if the stool is dry. Yes, it is frustrating, and it is difficult to wipe clean afterwards but later in the day I find that I can pass some more, OK. I have had major stress this last week, and I did have two days when I felt really plugged up for two days. Then it took about six toilet visits during each day, with a small poo at each one, to clear the backlog. I didn't drink enough, had lots of adrenalin in my body, and I think I just dried out. But I knew it would pass, and it did. I am fine now.

Yes, you use your thigh muscles to lift your bottom off the seat!

cheers

Louise

Well let me tell ya gals! All I have to say is buy some slippery elm, apple pectic, ground flax and lots of water and I would almost bet $1000 you will hardly make it to the bathroom.LOL I did not make it twice this morning and is good but also bad. Got to cut back and adjust accordingly.
I have never gone to doctors just naturapaths, actually medical intuitives.
He told me about the slippery elm 10 years ago and apple pectin. If anyone is interested, look up slippery elm and see the benefits to the colon and other benefits. Be careful, I have had to throw a lot of underwear away lately trying to adjust. Lol All purchases only from the health food store.
Love You All Lots and Lots

That advice sounds....well....*heavenly*. LOL

I will ruffle through my boxes of herbs and see if I have slippery elm. I feel certain I do. I think I even have pectin!

What amounts worked for you? Did you make a slippery elm mush and drink it, or did you make tea, or what?

Hi Ribbit

An easy way to get pectin is to eat slightly green/underripe fruit. All fruit that you can make jam with easily has pectin in it. Granny Smith apples that are still green, rather than turning to goldy green are particularly good. I love them in my muesli, chopped up.That's what "an apple a day keeps the doctor away" is all about. :-) You might get a slight tummy ache but that probably means you ate too much underripe fruit. Pectin is a type of protein that binds lots of water to it. That's why it makes jam set. It also preserves the water in your stool, to keep it soft.

My muesli is 1/2 cup of rolled oats with boiling water poured over them, handful of almonds, 2 tablespoons freshlyl ground flax, some pumpkin and sunflower seeds, a big dollop of Greek yoghurt, a big granny smith apple, either grated or chopped up with skin on, and a slosh of milk to make it moister. I sometimes add a banana or some chopped dates, or raisins for sweetness, and maybe some walnuts. It takes a while to eat, but it does make me sit down for breakfast. Keeps me going until late lunchtime. :-)

Louise

Louise

Hey Friend,

I eat 2 or maybe three friuts in the morning, chew 5 alphalfa tablets (cleans the blood and whole body, detoxifys the body) Total of 20 a day. This is not for constipation, just health. I will be going on Schuesslers Cell Salts to strengthen tissue.

I use 1 tbs of slippery elm and 1 tbs. of ground flax mixed into a large glass of water or juice, not a hot drink. I drink one glass around 10 am or so and another later in the afternoon but need to cut back. Just start with one glass maybe in the afternoon. I follow the directions on the apple pectin bottle. I take 2 caps maybe 2 or three times a day. These are all natural products. Check out the health benefits on the computer. Any questions, let me know. Also for bread I always eat the sprouted grain or eziekiel bread from the health food store. Drink lots of water.
Love Ya

You can buy the apple pectin you need from the health food stores. Works great. Psyllium Husks never worked well for me so stuck with the pectin from 10 years ago.

I have plain pectin I bought a while back to make jelly, and....well, being ADD, I never got around to it. Story of my life.

So while I have all this pectin sitting around, I may as well use it.

But how? How much? Just sprinkle it on some water? I don't want to accidentally make myself more constipated.

Just like gelatin. If you don't add enough water you get a rock like substance. Add plenty of water and you get nice jelly jelly. That's why I would rather eat apples. I have ADD too. I would just lose the pectin in my fridge. At least apples are hard to hide in a fridge, and they clean your teeth on the way through, and there are thousands of ways you can eat them.

Pectin capsules are probably made out of apples anyway. :-)

Louise

Never know where to insert some comments but this was as good a place as any, the poo issues.

I found a beautifully wrapped box with bow and all on my table. How thoughtful this man was after all these years. Could it be my new processor or blender I thought with excitement? Heck no it was the best gift of all. LOL 3 bottles of apple pectic from the healthfood store(I was Out) and an added bonus of a bag of golden flax!! I call that love!!!!

that is love.

My mother's day gift from hubby was wonderful. It was a charter membership in the Whole Woman village. I am so happy!

Ah, Heavenly! He is a keeper, isn't he? A very thoughtful gift.

L

Ok I had my worst ordeal since this prolapse situtaion. I need advice for furture times. Please forgive me with the TMI. I had to go but it was half in and half out of the anus. I could not push it out. It would not retract in. I tried to wipe but it was too hard. I take MgO but sometimes still doesnt work. I was panicking becuase I was worried hat with it sticking out of the anus I would strecth the sphincter and hurt it. So out of panic I tried to push and i forced it. For 2 hours I tried . I'd get up walk around a little and to back. I didnt know what to do. I drank prune juice, took Natural Calm, High dose vitamin C. NOrmally these things work but not htis time. So I know I should not have pushed but I tried splinting. I felt the bulge vaginally so no doubt that i have a rectocele but splinting didnt work for me. I wasnt sure what to do when splinting. I pushed against it but I wasnt sure what to do. I tried to massage the colon. I did the LoPo nothing worked. I finally gave up and it did retract in becuase I couldnt go but now I feel like really wierd in the sphincter area like it was stretched and Im feelign leaking. What should I have done in this siutation? I knw I shoudnlt have tried so hard to push it out but is it safe for the sphicnter if the stool is sticiking out of it or can it harm it?

Thanks so much in advance for your advice

Well not to fear!! We all "rock and roll" at one time or another. I am , in fact, rock and rolling this morning too. I knew with what I ate and did not eat and do yesterday I would be in trouble. Now listen up. The stress is worse than the actual problem. It has taken a while for me to figure this out. Now calm down. Maybe lie down, relax, meditate and deep breathe a bit. Do you have an enema bottle? Also sometimes I have just had to wait till morning. I know, we all do, that panic when things aren't going well FOR THE MOMENT. It is OK!! Take a really good look at your diet and try other measures. I have to agree with all, diet is key. I did not do what I usually do yesterday, was too busy and I knew better. What are you taking to help with this issue? We really care but you .Remember we are all in this together!!!! XXOO

Dear Heavenly. Thank you for your support. Today Im more passively soiling my panties becaused I streched out my sphincter and Im feeling pain from all that pushing. In hindsight I should not have forced it. But I was scar3ed that by leaving the stool stuck partially out it would damage the sphincter muscles. In a situation where its stuck partiatlly outisde what do you do for that? Just walk around with it for a while and hten try again? I wasnt sure what to do in that situation as it didnt retract back into the rectum. It was sort of stuck.

P.S.
You are so lucky to have a supportive husband. My guy is no longer my guy because I have this problem. He has abadoned me because of this :(

Flowerlily, if your guy dumped you because of this, he wasn't worth having. Someone who truly loves you won't be bothered by your health issues. My husband has been so understanding. I'm very thankful for him.

I have had that problem before. Half in, half out, with a fussing baby and arguing children and nobody to step in and help. My advice is to not let it get to that point in the first place. I have to eat a lot of food. Lots of mashed winter squash. Lots of lentils. Lots of watery, mushy food. For some reason it just doesn't do the job to eat normal food and drink a bunch of water. I have to eat watery, mushy food. I can't eat meat. I can eat fish and occasionally a little turkey, but that's it.

Also, when I feel any urge at all, I immediately go sit down. Even if I only get out one little blip of poo, that's one little blip less to clog up later. ;)

Dear Ribbit,

My heart is broken but I dont think any guy would want to be with me already in this condition. When I try to meet soemone and let them know my condition they are not intersted.

Im so happy your husband is so undestanding, Ribbit :)

Ribbit when mine was half in half out, it caused the area in my sphincter to become numb and also in the vaginal area. I think it might have caused some nerve damage. I wonder if I just left it hanging in and out instead of trying to strain it for 2 long hours I could have averted this further nerve damage. I actually cant feel. Im worried I would never about not being able to get an orgasm either since all sensation is gone.

Thanks for sharing what you eat. I think you are right. NOt good to eat normal food. Even gluten free bread causes me problems. When I eat watery spinach and rice it seems to help me.

Much Love,
Flower

Give it time. You don't need relationship problems on top of this. I know Christine says prolapse doesn't get in the way of sex, but mine does somewhat. I understand what you're saying. The nerves don't work the way they used to. The signals that "this is supposed to feel good" don't get to my brain. It's just......Nothing. I think there was once that it actually worked, but it took a lot of doing.

hi flowerlilly
my dd used to struggle with chronic constipation. she had some episodes of 'half in half out' and it was so pathetic (she was about 6 years old at the time). the worst episode occured while we were on vacation and there was only one thing to do, short of taking her to the ER. I got me some latex gloves and astroglide and got that stool out of her. it was like a piece of wood, so dry! and liquid poo was dribbling out around it. really that was rock bottom for her (no puns intended)
at that point, we did a major diet overhaul (she's got sensory issues and was basically eating only white bread and cheese) and I gave her the anxiety/constipation pep talk.
that was the last of her constipation. she had chronic yeast infections too and that too stopped.

about the nerve damage, when I first found my prolapse I went 'dead' in the area too. sex felt like ...nothing. dh said it was all in my head and I decided to believe him and magically, after alot of introspection and self-talk, sex was good again! not saying its all in your head, but that some of it can be overcome by your brain talking to your body rather than assuming it has to happen the other way around.

hopefully you'll find your way out of this place soon

I'm NOT the relationship guru, but I wouldn't tell a new guy about this. let him figure it out for himself or not. dh swears he cant tell (I still think he's lying but whatever).
doubtful that every guy is hung to perfection either. and *if* Mr. Newguy told you his balls were saggy, would you really care? It'd be a strange conversation, I'd imagine, but wouldn't prompt me to end a relationship.

i agree with gmom, i wouldn't mention this. they don't need to know. let them get to know you, and unless you are having sex standing up, they'll never notice. but, if you aren't in the space for a relationship, then don't worry. it will come.

re food, sound like you have major allergies at the moment. have you ever thought of seeing someone like a naturopath / homeopath to try to get your system back up and strong? sometimes there are schools you can go to that are cheaper if that is a problem. also homeopathy can help with depression, anxiety etc, and with food sensitivities.

if you have problems again with the toilet, i'd just get up, walk around, and wait. and try not to panic--that stops everything.
pulses and a good walk definitely help. if you are eating spinach and rice doesn't sound like you are getting a lot of fibre, so that won't help. can you stomach something like red lentils? you also need to make sure you are getting enough nutrients to heal.
i'm not surprised about bread annoying you--lots of g/free breads have chemicals, and there is yeast. i'm on an anti candida diet right now, mostly veg, bit of protein, bit of grains, bit of fruit. i feel much better for it. i'm drinking a spoonful of cider vinegar + lemon + water very day to try to get my PH back to normal, to see if this can help other issues. but my body as a whole is defininately feeling stronger.

take care of you!
btw, how is the posture going and have you tried any exercises as yet?

Kiki

Good point, GranolaMom. :)