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Opening the Dialogue About Pooping, Hemorrhoids, and the Pelvic Floor

columbus dr. emma hemorrhoids pelvic floor physical therapy postpartum pregnancy sexual health May 25, 2023

Hemorrhoids are swollen veins in the anus. They can be external and visible or internal and not visible. Externally they appear like skin tags. They can be itchy or painful and sometimes bleed. When not irritated, you may not even notice them.


How do I get hemorrhoids?

Hemorrhoids are usually a sign of consistent straining and pressure. This can be present due to poor pooping or postural habits. In the third trimester of pregnancy they occur in around 30-40% of pregnancies usually due to the increase in blood flow in the pelvis, and the increased pressure due to a growing baby and constipation. 


How do I keep my poop healthy?

General recommendations consist of:

- 25-30g of fiber per day. Fiber is important to help bulk up the stool and move stool. Even if you are struggling with constipation, assess your fiber intake. If you realize you are low on fiber or only getting fiber from one source, consider slowly adding fiber in a variety of ways in order to decrease the likelihood of intestinal gas and abdominal bloating. 

- Drink 8-12 glasses of water per day. Fiber works best if we are hydrated. Fiber soaks up the water and creates bulky and moveable stools.



How should I poop to protect my pelvic floor?

  • First, we need to consider how to set ourselves up for success. The main trick we can use for this is to elevate your knees above your hips. This helps to improve what is known as the anorectal angle. Basically, it makes sure there are no kinks in the path out of the anus. Check out this video for the set up!
  • Second, we need to consider how to release tension in our pelvic floors. Too often we are forcing and bearing down into our pelvic floors instead of letting go of tension. We should inhale and drop our rectum down, blooming it open. Exhale, like you are blowing a candle while you maintain a dropped rectum. Check out this video for some other breath techniques!
  • Third, we need to consider a schedule. Consistency is key, so I would pick a time during the day you know you can give yourself 5-10 mins to sit on the toilet. Considerations for helping make your bowels more consistent is to have a stimulant. Stimulants could be eating, drinking hot water, drinking hot tea, drinking coffee, etc. Around 20-40 mins after consuming food, the gastrocolic reflex is stimulated, which basically means once the stomach is stretched there is improved colon motility.



How can a pelvic health physical therapist help?

As a pelvic health physical therapist I can talk to you about strategies, look at the ability of your pelvic floor to coordinate and lengthen, discuss downtraining techniques to help your pelvic floor and body relax, and talk to you about how to improve your poops! If you are in the Columbus area, give us a call or click the link below to see how we can help.


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