Season 4 Episode 5: Why Is My Poop Stuck?
What does it mean when you feel like your poop is stuck? Either you need to go, but it’s not coming out OR you are going, but it seems there is more that needs to come out. You might think that eating more fiber or drinking more water will do the trick, BUT in this episode, we discuss the three main reasons your poop might feel stuck … and what you can do about it!
If you need help walking through this, I’d love to help you! You can schedule a consultation here.
In this episode we cover:
What does it mean when your poop feels stuck?
Poor poop posture and how it can impact your poop feeling stuck
What to do if you’re holding tension in your pelvic floor
How poor coordination of muscles might cause your poop to feel stuck
The impact of your poop being too hard
Don’t forget to connect to others in The GUT Community, a Facebook group for those with IBS and digestive disorders to support one another and dive deeper into each episode together.
Let's talk about why your poop feels stuck!
So whenever you are dealing with stuck poop, let's first talk about what that even means. So that means that you feel like you need to go, but it's not coming out, or you are going, but it seems like there's just a little bit more to come out. That is the feeling we're talking about.
The short answer is that you have a stool evacuation problem. The long answer is that there's many reasons why you may feel like you need to poop more, or even just poop in general, but it's not coming out, that is related to stool evacuations. Once we figure out why you are not eliminating poop properly, or why you're feeling this way, then we're able to tailor a strategy and plan directly for you. And no, it's not just more fiber, more water, there's a lot more to it than that.
So the major reason why people feel like their poop is stuck and this can happen is poor poop posture, poor relaxation, or coordination of muscles, hard stool, or poorly formed stool. So let's talk about it.
Poor poop posture is related to the way that you are sitting on the toilet and how that helps support evacuation of stool……or maybe creates a barrier to properly evacuating stool.
If you're watching on YouTube, I'm gonna show you this little pillow of a colon and I want you to look at the end of the colon, you have a holding place for your stool called the rectum. So imagine it sticking out like a little pouch, kind of like a kidney, if you've seen a kidney or a stomach, a little pouch off to the side, that is where all of your stool kind of holds and stores until it's all packed in and ready to go for you to poop it out.
You have a really great muscle right at the base of your rectum called the puborectalis muscle, and that kinks off that little pouch so that you are not pooping all day, it's really important to keep it kinked off whenever you're the stool is forming and it's getting stored.
When you sit on the toilet properly you allow for this puborectalis muscle to unkink and release that kind of that curvature if you will to the rectum, which will allow it to lengthen and empty fully so all the stored stool comes out. Now the best way for that to happen is for you to be sitting where your knees are above your hips.
The more traditional westernize toilet does not really allow for this, where your knees are in line with your hips, or for some people like me who are shorter, your knees may even be below your hips as your sitting. Think about yourself if you're sitting in a chair right now, where are your knees in relation to your hips? If they're in line or lower, what that does is that actually does not allow that kink to unkink. The puborectalis muscle might still be holding tension right at the base of your rectum, which can be interfering with the release of your stool.
Now whenever you lift your knees above your hips, putting your feet on a stool of some sort, or like really traditional toilets, where it was a hole in the ground whenever you're squatted down and your knees are above your hips, what that does is creates the proper positioning for that muscle to unkink and for your rectum to release.
Not only that, relaxation on the toilet also matters. Whenever you are properly relaxing, all of the muscles around your anal sphincter or the pelvic floor muscles and your anal sphincter if you're not familiar, it is the opening to your butthole, so opening at the base of your anus, where you are releasing stool, so that sphincter is meant to relax and open for stool to come out and then contract and become more tense for stool to stay in.
In order for that to happen properly, you need this puborectalis to open but you also need relaxation and good coordination with these muscles around your sphincter so that it can relax. So relaxing your abdomen and relaxing your pelvic floor and using your diaphragmatic breathing to relax and open with your inhale and then rest and contract slightly with your exhale, that is going to help you indeed properly.
Now some people have a dysfunction or poor coordination of these muscles and they may need more specialized care from a pelvic floor physical therapist in order to correctly coordinate the muscle and the release. You can test this through an anorectal manometry exam, but a pelvic floor physical therapist can also do a physical exam within your anal sphincter to test that coordination and strength as well as tightness.
That is really cause number two of your poop being stuck, which is poor relaxation and coordination of muscles. So if you do have a very tight pelvic floor, then you are going to have a poor release to evacuate stool. One big sign of this is that you are releasing stool that's very skinny. So some people might say it looks like tadpole poops or very small finger like or pencil like like long strands, but really small, that's a sign that that sphincter is not opening properly and might be tight.
You can also test for this by taking your finger and literally placing it on your sphincter and just taking a few breaths and noticing the tension that's there and you may even feel this if you're someone who holds a lot of tension in your pelvic floor. If you're not familiar with what your pelvic floor is, watch this, a description of what your pelvic floor looks like and all the details so that you can get a better visual.
If you notice that you're holding tension there, then that can be a sign that you could have a really tight pelvic floor. A tight pelvic floor can also be a very weak pelvic floor, which is something where strengthening and relaxation will come into play. Now what you can do for this is stretches and diaphragmatic breathing, especially on the toilet and prior to getting on the toilet and I'll also link some stretches for you that you can try. But you can also massage pelvic floor muscles on the toilet versus pushing.
So what that means is if you know where your pelvic floor is, surrounding the anal sphincter, you can use the toilet bowl by creating clockwise and counterclockwise motions around the toilet, rolling back and forth kind of doing some pelvic tilt, but massaging those muscles on the toilet can sometimes help them open and release to have a more complete bowel movement and things are stuck. And then again, a pelvic floor physical therapist can give you even more specialty instructions and care for this based on what's really happening for you.
Now another part of this is poor coordination of the muscles. So it is possible for the muscles to actually not be working properly, which can lead to the body pulling up like into the body versus pushing down and releasing out. And that is a problem because your poop is supposed to go out, not come back in and up. And so if this is happening, then this is something that needs to be addressed and you kind of have to retrain the body brain connection to those muscles to get things working properly.
This can be due to poor habits, which would be like straining or bearing down, so if you have been dealing with the two issues we're about to talk about, which is poor form of stool and even hard stool, and you're straining and pushing and that's been a habitual thing that you've you've been doing that can lead to this poor coordination. It can also be due to pelvic floor dysfunction, which can be caused by a lot of different things.
So as I mentioned earlier, an anorectal manometry exam can be really helpful to just get a test of how those muscles are coordinating and then a pelvic floor PT would also be a valuable asset to test what's going on and also treat it, and then biofeedback therapy is an evidence based treatment for pelvic floor dysfunction, that can be really helpful.
Some other things that can be helpful with coordination of muscles, and proper release is Pilates, any kind of alignment based exercise like that is actually working the pelvic floor and the diaphragmatic breath, yoga is the same way. And even just general stretching, especially stretching of those muscles can be beneficial.
So the third main cause that I want to hit on is hard stool. And this is what we most often see or what I would consider to be the most obvious if you will answer for stool that is not evacuating properly. When stool is very hard, think about that rectum and that holding place in your colon. If stool is getting very hard, it can ball up and you may have passed stool like this before where it's like a very big ball and that can be extremely painful. This is not only going to be painful, but the larger and harder that this is that's more work for that anal sphincter to do to open up. Sometimes this can even get so far backed up that it can cause a perforation to the bowels. It can also cause even more backup and what we call overflow diarrhea where liquid stool is trying to pass through and moves around all of that hard stool.
Now reasons why this stool can get really hard is poor hydration, so poor water intake is one of the common reasons, poor evacuation over time, so if you're not releasing that stool, it balls up because it's storing too much. So if you're not eliminating which might due to some of these other issues we talked about, could also be due to ignoring the urge to go or just having bad toileting habits.
Another reason is water reabsorption and this can happen from slowed motility or that chronic backup. So in your colon, what happens as food or the particles, they're not really food anymore, but particles move through your colon, and they form stool, your bacteria in your colon are fermenting fibers which are non digestible, so they make it they're non digested, your microbes will ferment those fibers and produce gas and some beneficial byproducts that we want.
What's also happening is our body is reabsorbing water from the fluids and everything that has come in. So that's where we actually hydrate our bodies. And so if things are moving too slowly, the colon is going to continue reabsorbing water and that can make soul even harder. So not only is it slow, but now it's becoming harder. And the same is true is stool is just sticking around and backed up in the rectum, then your body's going to keep reabsorbing that water, which is going to cause more hard stool.
So the first tip for this is to increase water intake, which is again, obvious, that's where more water more fiber comes into play. And my tip for that is to increase it a little at a time and slowly over time, so that your body can adjust for that.
Another thing would be increasing softening fibers or softening foods like chia seeds, psyllium, and kiwi, those can all be helpful to help kind of soften and gel up the stool so it can move more consistently.
Now if you do need some more next level support, that's where osmotic laxatives can really come into play like MiraLAX, because those pull water in and so they work specifically to soften and also flush the bowels in order to get things passed, so that's why those might be beneficial for some.
Now the last reason for poop feeling stuck is poorly formed stool, which is kind of like the hard stool but a little bit differently. So whenever stool is not formed properly, so it's not that type four on the Bristol stool chart that we want, what happens is that it's not going to pass completely.
So not only do we want to avoid hard stool, but we also want to avoid too soft or poorly formed stool, because it's not going to be formed together to like really pull everything out that needs to. You might have some stuff stuck around which is going to lead to more bloating discomfort, meaning gas production.
Like I had mentioned with your backup, if you do have watery stool, this can be a sign of hard backup stool and what we call overflow diarrhea. So this isn't always just stool formation, that could be a sign that you need to work on the hard stool first, but if you are dealing with looser stool with urgency, that's a sign that your gut is actually moving way too quickly. The solution for that is to check for food intolerances or any malabsorption issues that might be going on, stress and stressors in the body, as well as the overall health of the gut. Is to get in a really vulnerable state with maybe increased permeability or some major issues going on, is there an infection present, we need to address that because if the gut is moving too quickly, it's going to be really hard to just form the stool that we need to and that urgency is going to be a big sign of that, especially right after meals or all day.
Now if it's just loose stool without a lot of urgency, so you're kind of hitting this the end of the Bristol stool chart here, then what we may see is that you need more fiber, and we need bulk forming fibers. So oats, legumes, different vegetables can be helpful for this, psyllium is also a great fiber supplement that can be very helpful for this, flax seed, some chia seeds, that can be helpful to help take that looser stool form it together, so it passes more completely, it's also easier to pass for you.
As I mentioned at the start, there are a lot of reasons why your poop may feel stuck and if you have experienced that before, know that you are not alone. What I do want to encourage you with, is to take note of some of these different characteristics that you might be experiencing so you can start piecing together what may be going on with your trusted healthcare professional.
One thing I would urge you not to do is use any type of outside manipulation tool to clear the stool that feels stuck, meaning your hands, any type of items to kind of dig that stool out. If you're doing that, that is going to create risk for other things. Now, don't feel shamed about it, it happens, communicate that that that is happening and that is what you are needing to do because that will help your providers help you get to the root of what's going on.
If you are needing a provider to help with this and if you're needing that level of assessment to really figure out what's happening in your body, then my team might be a good fit for you because this is what we do best. So if you are interested, schedule a consult call.
I hope that was helpful, please let me know by commenting on Instagram, if you don't feel comfortable sharing all about your poop through an Instagram story, you could just message me and I'm happy to chat with you and also help you feel like you're not alone and just hear you for the first time and then scheduling a consult call will be a way for us to talk more about that. See you in the next episode!