Medically reviewed by Onikepe Adegbola, MD, PhD
Constipation is characterized by infrequent or unpleasant bowel movements that last several weeks or more. Constipation is defined as a lack of more than three bowel motions per week. Chronic constipation can cause patients to have to strain excessively to expel gas and pass feces. Treatment for chronic constipation is influenced by its underlying cause.
As per a study titled “Epidemiology and burden of chronic constipation” published in the Canadian Journal of Gastroenterology & Hepatology, between 2% and 27% of the population suffers from chronic constipation.
Causes Of Constipation
The most common causes of constipation are:
- Dietary changes (such as reduced fluid consumption, a low-fiber diet, and/or items that cause constipation)
- Medications that cause a slowed bowel movement
- Irritable bowel syndrome(IBS) with constipation as the primary symptom
- Overuse of laxatives
- Inability to relax the anal sphincter voluntarily. This causes a condition called reflex (spastic) bowel condition.
A sphincter is a ring-shaped muscle that helps open or close passages in the body by tightening or relaxing.
Sphincter Muscle Constipation
The voluntary external anal sphincter is a thick, crimson muscle coiled around the internal anal sphincter. The external anal sphincter is the one you squeeze when you need to go to the restroom but don’t have access to one. You can control it because it is a voluntary muscle like the ones in your arms and legs. When straining to perform a bowel movement, some persons have problems relaxing the sphincter muscle or even clamping the sphincter more tightly shut. Constipation symptoms appear as a result.
Sphincter Muscle Relaxation Techniques
You can utilize a variety of strategies to relax your sphincter.
1. Simple relaxation of the sphincter: Concentrate on your sphincter muscles while deep inhaling.
Inhale deeply and slowly for 4 seconds, then slowly exhale for another 4 seconds. Concentrate on how your sphincter muscles feel when you do this. Allow your sphincter to relax in tandem with the rest of your body’s muscles.
- To get your muscles to relax, repeat this exercise as many times as necessary. Aim to perform this at least 15 times, but there are no negative consequences if you do it for longer.
- Before you begin deep breathing, you might find it simpler to concentrate on your sphincter muscle by intentionally tightening and relaxing it a few times.
- To tighten the sphincter muscle around the anus, pretend you’re trying to keep yourself from passing wind or holding a bowel movement to find your sphincter muscles.
2. Relax and unwind by meditating to relieve stress and muscle strain.
While comfortably seated, close your eyes and take slow, deep breaths through your nose. To quiet your mind and relax your muscles, concentrate on your breathing pattern. Your sphincter muscles should relax as a result of this meditative technique.
- Meditation should be done in a calm, distraction-free area for best results. It will be easier for you to clear your mind and release the tension in your body as a result of this.
- Don’t quit if meditation doesn’t work the first time you try it. You may have to practice it several times.
3. Massage your lower abdomen
Lie down on your stomach and apply mild pressure right below your ribs with the tips of your fingers. Stroke the left side of your abdomen to your hips. Then, moving down your side, use your right hand to massage around the bottom of your ribcage to the left side of your body. Finally, begin massaging your lower right side around your hip and work your way up to your ribcage. To finish the massage, repeat the other strokes.
You can repeat the massage as frequently as you need.
4. Sit with your feet propped up
To relax your muscles, sit with your feet propped up. It will be easier for your sphincter muscles to relax if your pelvic muscles are also relaxed when you’re trying to have a bowel movement. Prop your feet on a little footstool while sitting on the toilet, so that your knees are bent and higher than your hips.
- Sitting in this position not only relaxes your sphincter muscles but also relieves constipation by reducing constriction in your large intestine and rectum.
- To keep an even more effective toilet position, lean forward with your hands on your thighs.
- When using the restroom, sit on the toilet to ensure that your pelvic muscles are correctly engaged and relaxed.
5. If nothing else works, use your finger to relax your sphincter.
Apply lubricant to your index finger before inserting it into the anus. Circularly move your finger around till your sphincter muscles relax. This procedure may take a few minutes, but it shouldn’t be too painful if you use a lubricant.
Seeking Medical Help
- Consult your doctor to figure out what’s causing your sphincter muscles to be so tight.
If you have a stiff sphincter or have been constipated for more than 2 weeks, you should consult a physician because it could be a sign of a significant medical problem. Your doctor should be able to explain why this is happening and what measures you should take to have it resolved.
- If you can’t relax your sphincter spontaneously, take a muscle relaxant.
Use a relaxant that specifically relaxes your sphincter muscles for the best effects (instead of other muscles in your body). Before you choose this treatment technique, talk to your doctor about taking muscle relaxants.
- Learn biofeedback techniques from a pelvic floor therapist.
Biofeedback is a technique that involves increasing your visual and physical awareness of your body’s activities. It’s most commonly used to strengthen the rectal sphincter, but it can also be used to relax it. It takes roughly three visits with a professional to notice a difference in your symptoms. As per a study titled “Biofeedback is superior to laxatives for normal transit constipation due to pelvic floor dyssynergia,” published in ‘Gastroenterology,’ biofeedback sessions were more effective than laxatives in the management of constipation.
- If your doctor recommends it, consider surgery to treat your sphincter.
An inability to regulate one’s sphincter muscles may necessitate surgery in some rare circumstances. Working with your doctor, rule out all other treatment options first, as this is the most extreme option.
Constipation is a common problem that affects people as they age, take certain medicines, or eat a low-fiber diet. For sphincter muscle-related constipation, you need to follow some basic treatment options to get relief. They can be simple relaxation techniques, meditation, gentle massage on your lower abdomen, squatting positions, and applying a lubricant to relax the sphincter. If all these do not seem to work, you should promptly see your doctor, who will ascertain the case and let you know the next possible step.
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