Is It Really Constipation?

By Dr. Zarina Vitebsky, DPT, MSPT, PRPC, TPS, LPF, DN on 1/16/2023


Healthy poop depends on a number of things. How long it takes you to poop, how often you poop and what your poop looks like are all relevant. Here we walk through the different shapes and colors, along with some tips for healthy digestion.

Poops that are hard and difficult to pass (Types 1 and 2) indicate constipation. Drinking more water and eating high-fiber foods can ease constipation. Foods high in fiber include beans, nuts, vegetables and fruits.

Poops that are well-formed and easy to pass (Types 3 and 4) are the ideal kinds of poop. 

Poops that are entirely liquid or have too much liquid (Types 5, 6 and 7) indicate diarrhea or urgency. Sometimes diarrhea is caused by temporary illness and should pass in a few days. You can follow the BRAT (bananas, rice, applesauce and toast) diet to reduce further GI upset. 

There are people who take a very less amount of fiber, and then there are those who intake too much. This can happen if you abruptly start consuming fiber. Excessive fiber can result in various issues such as:

  • abdominal pain

  • bloating

  • diarrhea

  • short-term weight gain

  • constipation

  • reduced blood sugar levels

The two main types of fiber that play a vital role in digestion are:

  • Insoluble fiber: It helps the food to pass in a quick manner through the intestines and stomach. Moreover, it makes your stool bulky. It also plays an essential part in balancing your intestine’s pH.

  • Soluble fiber: It is responsible for giving your food a gel-like form. This puts a brake on digestion and is the reason why you feel full (a vital part of weight management). It can also alleviate the chances of heart disease and puts your blood sugar to a healthy level.

Consuming the right amount of fiber is very important. You can assume that ingesting more than necessary is always better than having too little (but you should always be careful). Slowly add fiber to your diet, and don’t rush.

Remember to think of fiber as bulk that attracts water in the GI tract. If you don’t have enough fluid in your system or you haven’t taken in adequate fluids, dehydration of the GI tract can occur, leading to hardening and difficulty passing the stools. This is especially common when the fiber is primarily soluble fiber like that found in oatmeal, beans, apples, strawberries, or blueberries.

Opposing symptoms, like diarrhea and loose stools, can occur when this bulk is made up of the insoluble fiber found in wheat, corn bran, leafy vegetables, broccoli, and tomatoes. Although adding insoluble fiber to your diet can be a good treatment for constipation, too much consumption of this type of fiber can lead to diarrhea and loose stools—especially if you up your intake all of a sudden, which will push the contents of your GI tract through more quickly.

Signs and symptoms of chronic constipation:

  • Passing fewer than three stools a week

  • Having lumpy or hard stools

  • Straining to have bowel movements

  • Feeling as though there’s a blockage in your rectum that prevents bowel movements

  • Feeling as though you can’t completely empty the stool from your rectum

  • Needing help to empty your rectum, such as using your hands to press on your abdomen and using a finger to remove stool from your rectum or splinting

  • Increased bloating and gas formation

  • Difficulty with the muscles involved in elimination

Problems with the pelvic muscles involved in having a bowel movement may cause chronic constipation. These problems may include:

  • Inability to relax the pelvic muscles to allow for a bowel movement (anismus)

  • Pelvic muscles don’t coordinate relaxation and contraction correctly (dyssynergia)

  • Weakened pelvic muscles

  • Pudendal nerve involvement causing muscles to act inappropriately

From clinical experience, visceral manipulation is a useful intervention in the treatment of constipation. This innovative gentle manual therapeutic technique assesses organ motion and aids in correcting abnormal movement patterns of the affected organs, in relationship to their attachments to the surrounding fascia. Visceral manipulation is a type of massage therapy. At Pelvic Health Physical Therapy, we use gentle manipulations with the goal of improving mobility in your abdominal area. We use visceral manipulation modalities to treat digestive issues like bloating, cramping, and constipation. These treatments can also reduce stress and improve back pain.

Please email us at or call us at 908-443-9880 to discuss what we can do to help you manage your symptoms.

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