Constipation Definition/ Signs & Symptoms
Constipation is a condition in which a person has difficulty passing stools or passes stools infrequently. It is often characterized by hard, dry stools that are difficult to pass, and can also include symptoms such as:
- Straining and discomfort during bowel movement
- Bloating, feeling of fullness, flatulence
- Lumpy/ hard/ dry stool
- Difficulty passing stools
- Abdominal pain, cramping
- Sensation of incomplete evacuation, anorectal blockage/obstruction
- Hemorrhoids due to straining
- fewer than 3 movements per week
- Chronic constipation symptoms – pain, distension, cramps and nausea
- Bad taste in mouth AND headache ( due to toxins building up)
Digestion:
- Digestion is controlled by the Autonomic Nervous System (ANS) – PNS , SNS.
The autonomic nervous system (ANS) is part of the peripheral nervous system and includes the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS) - The Sympathetic Nervous System (SNS) has inhibiting effect on digestion
- Transit time – time it takes for fecal matter to move through large intestine – usually 24-48 hours from ingestion to defecation
- Hard, difficult to pass stool is result of increased transit time – more time for water to be absorbed
Normal Digestion:
- Food moves through the colon, absorbing water as it forms waste products “stool”
- Smooth muscles contracts causing peristalsis, pushing stool towards the rectum
- Water has been absorbed by the large intestine so stool will be solid by the time it reaches the rectum
Causes of Constipation
- hard and dry stools occur when colon absorbs too much water or if the colon’s contractions are slow or sluggish
Contributing factors:
- Dietary changes/ imbalances insufficient fluid intake
- Emotional turmoil/ life changes chronic sympathetic system
- Lack of exercise
- Ignoring the urge to pass stool
- Pregnancy
- Surgery
- Conditions: Stroke, Parkinson’s, Multiple Sclerosis, paraplegia, quadriplegia
- Medications:
- Pain meds (Demerol, morphine)
- Anti-Parkinson’s
- Antacids with aluminum and Ca+
- Antispasmodics
- Anticonvulsants
- Antidepressants iron supplements
- Blood pressure (Ca+ channel blockers)
- Diverticulosis (pouch that forms in colon)
- Diverticulitis (inflammation from feces stuck within the pouch)
- Scars/ Adhesions (fascial sheath gets tighter and impedes the flow)
- Stricture: narrowing within colon
- Polyps: wart/ growth inside colon, similar to inverted skin tag. (polyps may be pre-cursor to cancer)
Constipation Massage Therapy Treatment
Massage can help alleviate constipation by promoting relaxation (encourages parasympathetic response) and increasing blood flow to the intestines, which can help to stimulate the muscles in the gut and promote bowel movements.
Constipation Massage:
- PRONE
- Entire back massage, focus on lumbar, sacral and gluteal regions
- SUPINE
- Therapist on the client’s right side, client’s hip and knees are flexed, techniques are clockwise ( same direction as peristalsis). Peristalsis is a series of wave-like muscle contractions that move food through the digestive tract
- Treatment begins with palmar kneading from the lower abdomen to the xyphoid process, hen, across the lower border of ribs, down the back to the lower spine, and then forward over iliac crest. Repeat a few times
- General effleurage in a clockwise direction on the abdominal area with overhand palmar kneading ( full sun half moon)
- Follow up with specific work to the diaphragm, abdomen, psoas
Colon work
-
- Reinforced finger kneading, techniques applied from distal colon to proximal [ descending colon (L) -> transverse colon –> ascending colon( R) ], but always in clockwise direction of kneading
- This is repeated a few times with increased pressure.
- Now apply same techniques from ascending to descending (R to L). Again, repeat a few times
- Overhand palmar kneading ( full sun half moon) and effleurage in clockwise direction is repeated
- Place hands on both sides of hips and gently rock back and forth
Contraindications:
- No hot hydro with cardiovascular problems
- No hot hydro with inflammatory bowel disease
- No abdominal massage with diarrhea
Constipation Self Care
- Cool hydro over abdomen can stimulate peristalsis
- General exercise program
- Diaphragmatic breathing
- Eat well-balanced diet: high-fiber with fruits and veggies [Daily: 5-10 servings of fruits/ veggies; 2-5 servings of grains/ legumes]
- Drink plenty of water
- Exercise
- Undisturbed toilet breaks
- Bulk-forming laxatives, Stool softeners, Lubricants
- Referral to nutritionist/ naturopath for diet recommendations
Fiber: A mineral that the body cannot digest
Soluble fiber: beans, legumes, whole grains; don’t shock the body with them or you will get blocked/ slow the peristalsis.
Insoluble Fiber: celery, vegetables, fruits and nuts (cellulose)
*** significant or prolonged change in bowel movement = go see doctor
