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Visiting the bathroom is part of the daily human experience.
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But occasionally, constipation strikes,
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a condition that causes a backup in your digestive system.
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The food you eat can take several days to exit your body.
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And for many, constipation can become chronic,
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meaning regularly passing lumpy hard stools accompanied by straining.
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What's behind this unsettling phenomenon?
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Constipation arises in the colon, also known as the large intestine.
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This muscular organ is split into four sections:
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the ascending,
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transverse,
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descending,
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and sigmoid colon,
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which connects with the rectum and anus.
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The small intestine delivers stool
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consisting of ingested food, bile, and digestive juices
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to the large intestine.
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As this stool moves through the colon,
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the organ siphons off most of the water it contains,
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transforming it from liquid to solid.
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The longer this transmission takes,
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the more reabsorption occurs, resulting in increasingly solid stool.
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Once it reaches the sigmoid colon,
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a final bout of reabsorption occurs before it enters the rectum,
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distending its walls and telling the internal anal sphincter to relax.
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This is the point where you can usually decide whether to physically expel
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or retain the stool.
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That's regulated by the pelvic floor muscles,
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particularly the puborectalis
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and external anal sphincter.
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The puborectalis forms a sling-like formation around the rectum
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called the anorectal angle.
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And when you voluntarily relax your external anal sphincter,
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the stool is finally expelled.
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When you're constipated, however,
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a desire to visit the bathroom isn't enough to coax your body into action.
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Usually there's two factors behind this problem:
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the stool's slow movement through the colon
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and/or pelvic floor dysfunction.
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In the first, stool moves excessively slowly through the intestines,
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causing over-absorption of liquid, which makes the stool dry and hard.
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With pelvic floor dysfunction,
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stool becomes difficult to eliminate from the rectum
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because of tightened pelvic floor muscles, or due to a pelvic organ prolapse,
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usually through childbirth or aging.
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Both of these problems make the anorectal angle more acute
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and it becomes difficult to expel waste.
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To identify constipation precisely,
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researchers have developed metrics, such as the Bristol Stool Chart.
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Most people who look at that chart
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will be able to tell they've experienced constipation before.
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When you're on the toilet, you should ideally be in a squatting position.
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With your buttocks firmly on the toilet seat,
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you can elevate your feet on a stool
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and lean forwards with a straight back,
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which straightens the anorectal angle and eases the passage of waste.
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Going a day without a bowel movement isn't necessarily cause for alarm.
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But if you are experiencing chronic constipation,
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simple dietary and lifestyle changes,
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like fibrous vegetables,
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regular exercise,
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abdominal massage,
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and 6 to 8 cups of water per day
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may help restore your daily trip to the toilet.