If you are one of the many women who struggle with constipation and wondering if your constipation symptoms are making your bladder worse? I have information for you…
As a pelvic health physical therapist (physio) it’s expected that I will discuss bladder habits with my clients, but these same ladies are often surprised when I ask questions about their bowel habits.
I get it, it can be difficult to see the link between the two because our medical system is divided by organ specialty. When you have a bladder problem you go to a Urologist or Urogynecologist, and when you have a bowel problem you go to a Gastroenterologist or GI doctor.
So it’s natural that you would not immediately see the link between the two. Recent research, however, has revealed very real links between the two and a need to re-think our perspective on the relationship between the two.
We know that there is cross-talk between our organs. Yep, they are talking to each other and when one is unhappy the other is unhappy as well.
It turns out that your bladder is sensitive, and it’s especially sensitive to pressure. When you’re constipated the added pressure of the backed-up stool in the abdomen makes your bladder uncomfortable.
It also decreases the amount your bladder can expand to hold more urine, and as a result, you end up with more bladder urgency.
The added pressure due to constipation often leads to increased urinary frequency, bladder urgency, and in some cases urinary leakage.
Yikes!
So what is constipation?
Constipation is characterized by fewer than three bowel movements per week, straining more than 25% of the time when on the toilet, a feeling of incomplete bowel emptying, and lumpy or hard stools that are difficult to eliminate.
If you’ve had any two of these symptoms in the past twelve months, you’ve likely experienced constipation.
It is the most common digestive complaint and it’s estimated to affect up to 27 to 34% of the population in the US. It’s most common in women and is very common during pregnancy and post-partum.
What are the most common causes of constipation?
- Hormonal changes; pregnancy, post-partum, perimenopause, menopause, hysterectomy
- Diabetes mellitus
- Thyroid dysfunction
- Medication side-effects; opiates, antidepressants, and anti-inflammatory medications such as Acetaminophen, Aspirin, and NSAIDs.
- Inadequate dietary fiber/poor diet
- Dehydration or poor fluid intake
- Lack of exercise
- Changes in sleep pattern
- Travel – changes in the time zone
Tips on how to prevent constipation!
As a pelvic health specialist, I often get questions about how to prevent constipation symptoms that are aggravating an existing bladder problem. My ladies are happy to know there are lifestyle modifications that can make their constipation symptoms much better. I’ve listed my top tips below…
Fiber, Fluid, Movement, and Posture
Increase your dietary fiber!
A diet high in fiber will go a long way towards solving your constipation problem. Aim for 25 to 38 grams of fiber per day, if you are unsure of how much fiber is in food check out this fiber resource here.
Go slow when adding fiber to your diet!
If you are used to eating processed foods and suddenly add fiber to your diet, you are likely to experience excess gas and bloating. Your gut microbiome (your beneficial gut bacteria) may not be geared up for dietary change. To prepare your gut and reduce the chances of discomfort, add fiber slowly over a series of weeks.
Dietary fiber is beneficial for your health, it helps relieve constipation, lowers your risk of diabetes, heart disease, and some types of cancer.
Fiber also helps with weight management because it increases satiety, that feeling of being ‘full’, and lowers the likelihood of food cravings.
There are two types of fiber; soluble and insoluble fiber in foods.
- Soluble fiber dissolves in water. When this type of fiber is going through your gut, it absorbs water and changes into a gel-like substance. This type of fiber is important because it lowers blood sugar levels by slowing digestion and allowing nutrients to be absorbed slowly into the bloodstream.
- Insoluble fiber does not dissolve in water. This type of fiber remains intact as it goes through the digestive tract. It acts as a sweeper, helping to move food through the intestines. It also controls the acidity of the intestines, allowing the microbes to operate optimally, thereby getting the most nutrients from our food. By regulating food movement, this type of fiber helps to promote regular bowel movements.
Soluble fiber foods include:
- Oats
- Nuts
- Peas
- Barley
- Seeds; sunflower seeds, flax seeds/meal
- Vegetables; brussels sprouts, broccoli, avocados
- Beans; black beans, kidney beans, lima beans
- Fruits; pears, nectarines, apricots, apples, guava
Insoluble fiber can be found in:
- Fruits
- Nuts
- Flax seeds or Flax meal
- Seeds
- Potatoes (with skins)
- Vegetables such as celery, green beans, broccoli, cauliflower, leafy greens, avocados
- popcorn
- Wheat bran
- Whole-grain foods such as brown rice, whole grain bread, whole grain pasta
Most foods have both types of fiber present, but some are especially high in one or the other. It’s important to get your fiber from a variety of sources to keep our gut microbiome healthy and happy.
What are strategies for increasing fiber?
- Take in small amounts of fiber throughout the day.
- Add fiber in slowly, so you don’t get as much gas/bloating
- Don’t overload on unprocessed fiber; aim for 25-38 grams per day
Avoid fiber sources that thicken your poop and slow your digestion; ripe banana, applesauce, marshmallow, mashed potato, white rice, white bread, cheese, peanut butter, peas, pasta (soluble fiber sources).
It’s also important to drink plenty of water, especially if you are eating a lot of foods with soluble fiber. The extra water will help the soluble fiber form a gel, which assists in digestion and prevents elimination from becoming too slow.
How much water should you be drinking?
As human beings, we are largely made up of water. As much as 75% of our body consists of water as the main element. We also know that attaining a water balance is an essential element for human health.
But exactly how much water should you be drinking has been debated and studied intensely. In 2005 the National Academies of Medicine published a consensus study report on ‘Adequate Intake’ of water.
This study found that women should consume 2.7 L/day of total water, which includes fluid and food sources of water. Of the 2.7 Liters, 80% should come from fluids and 20% from food sources. That works out to the following amounts:
Fluids – which include plain water, and liquid beverages
- 2.2 L/day or 74 fluid oz. or 9.25 cups
Food – which include soups, broth, watery fruits
- .5 L/day or 17 fluid oz. or 2 cups
Increasing our hydration by six cups per day can decrease the likelihood of developing bladder infections or recurrent UTIs. Another reason to monitor your fluid intake and make hydration a priority!
Want more information on water’s influence on UTIs? Check out my blog on the subject.
Movement matters!
When your body is moving on the outside, it means your body is moving on the inside and this includes your colon. So if you are feeling bloated or backed up, consider adding movement to your day.
Aerobic exercise such as a brisk walk has been shown to decrease the likelihood of constipation. Aim for 30 minutes of movement per day to help your gut move things through your system and decrease your constipation.
Yes, there is a posture for pooping!
Just as there is a posture for optimal bladder emptying, there is also a posture for pooping. As it happens they are similar. To optimize the likelihood of a satisfying poop, make sure you are positioning yourself correctly.
The top 5 positioning strategies are listed below.
- Sit with your legs supported fully. No dangling! If you need support place a small stool under your feet to bring the floor to you.
- Keeping your spine straight, lean your trunk forward, and rest your hands or forearms on your thighs.
- Ideally, your knees will be slightly higher than your hips.
- Relax your belly.
- Take deep belly breaths to let your pelvic floor muscles relax, allowing for better bowel emptying.
For more tips on optimizing emptying, check out my blog on the subject!
Still, feeling like your constipation symptoms are bothering your bladder?
It may be necessary to take a stimulant to get things moving. Taken occasionally over-the-counter stool softeners, magnesium supplements, and stimulant laxatives can be helpful to get things moving. We all need a little help from time to time!
Want all the constipation tips? Grab my Constipation Tips for a Happy Bladder printable.
What are your go-to solutions for constipation? Leave me a comment below!
Happy bladder wishes! 
~ Tami
Tami Lines is a licensed Physical Therapist with certifications in Pelvic Rehabilitation and Women’s Health Coaching. She is the founder of Pelvic-Health-Matters. Tami has over 15 years of experience with expertise in bladder Health, and pelvic floor muscle dysfunction for adolescent and adult women. She is also a mom of two wonderful young adults working their way through college.
References:
Neurogastroenterology and motility: the official journal of the European Gastrointestinal Motility Society [Neurogastroenterol Motil] 2020 May; Vol. 32 (5), pp. e13789. Date of Electronic Publication: 2020 Jan 06.
Institute of Medicine 2005. Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate. Washington, DC: The National Academies Press. https://doi.org/10.17226/10925.
Pediatr Gastroenterol Hepatol Nutr. Diets for Constipation. 2014 Dec; 17(4): 203–208
Published online 2014 Dec 31. DOI: 10.5223/pghn.2014.17.4.203
Am J Physiol Gastrointest Liver Physiol Cross-organ sensitization between the colon and bladder: to pee or not to pee? 314: G301–G308, 2018. First published November 16, 2017; doi:10.1152/ajpgi.00272.2017
