Let's Talk About Poop, Baby

In this episode we'll talk through all the "fun" changes that happen in our digestive function with hormone changes during perimenopause and menopause:

• The "normal" amount of bowel movements per day, and when to worry
• Factors influence bowel regularity
• Medications that can cause constipation
• Aging isn't just on the outside, we also experience aging in our internal organs
• How our lifetime habits that we learn as children can impact bowel function in adulthood
• Taking time to poop is also self care!!!
• Techniques to help our bowels function optimally and change leaned patterns
• The connection between pelvic bowl/floor health and bowel movements
• Best ways to prepare your digestive system to have bowel movements with ease

Chapters

00:00 Introduction to Pelvic Health and Bowel Health
01:40 Understanding Bowel Health and Hormonal Impact
05:17 Normal Bowel Frequency and Dietary Considerations
08:49 The Connection Between Constipation and Bladder Health
12:38 Childhood Constipation and Its Long-Term Effects
16:16 Self-Care and the Importance of Regular Bowel Movements
19:23 Understanding Rectal Health and Complications
21:36 Breathing Techniques for Pelvic Health
25:06 Understanding Bowel Movements and Pelvic Floor Dynamics
29:08 Dietary Impacts on Bowel Health
35:24 Optimal Bowel Movement Practices
40:56 The Interconnection of Bowel and Urinary Health

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Transcript

SPEAKER_03 0:01

Real women. Real talk.

SPEAKER_02 0:04

Real messy.

SPEAKER_03 0:06

This is Messy Midlife. Hi everybody and welcome back to Messy Midlife. Hi, ladies. Hello. Cindy, welcome back again to continue our conversation that we're gonna end up having a lot of episodes on all the stuff related to our pelvic floor, our pelvic bowl, and all of the stuff as that really start to show up in midlife for sure, whether we like it or not. And so we needed to have you come back so we could talk about bowel health because that's another big thing that changes. And all of these things are so overlapping. And then so all the stuff that we talk about today impacts the stuff that we talked about in the last episode, and it will impact the stuff that we're gonna talk about in a future episode as well, right?

SPEAKER_04 0:54

Absolutely. It's all connected. I literally named my company Comprehensive Therapy Services because it's it's all encompassing, it's all connected. It uh yeah, it's all the organs talk to each other, you know, there's lots of chatter.

SPEAKER_03 1:14

But it's it's to the degree that when I first came to your practice, I was referred for urinary incontinence uh postpartum, and I was also dealing with really bad sciatic pain. And you and your team real recognized that the two were connected in a lot of ways, and we ended up having to focus so much on the sciatic pain so that I could have any chance to see improvement in the pelvic floor stuff that I was dealing with. So it's just it's so so overlapping and intense. So let's talk about poop. What do you guys think? Let's talk about poop. I mean, who wants to talk about poop more than some naturopathic doctors and a pelvic floor physical therapist?

SPEAKER_02 1:53

Right the words are right out of my mouth. Every time somebody's like, oh, this is too TMI, I'm like, no, this is just right. I just right information. Let's come to the right place.

SPEAKER_03 2:06

Let's do it. Well, so in a previous episode, we talked a lot about hormones and Karen and Aliza, you guys shared a lot about the impact of our bowel health on helping to clear hormones and hormone stability, hormone balance. And so we've got this really tricky situation that we get into in perimenopause where it's like all of the things are working against each other, right? That we've got changes in our hormones that can contribute to constipation. And then the constipation can also have a feedback loop on how it impacts the hormones. And then we've got all the stuff with the impacts that that we talked about in the last episode on how things like stress and various different things can impact the pelvic floor. So, Cindy, tell us where the pelvic floor comes into play when it comes to poop.

SPEAKER_04 2:56

Okay. So let's talk about what's normal first. So normal bowel frequency, I mean, I would love once per day. But technically there's a range up to three times a day or once every three days. That seems like a lot. But if you look it up, if you ask good old chat or one of these other things, it's going to give you that range.

SPEAKER_03 3:20

Yeah, but how much are people having to push if they're getting to the three days?

SPEAKER_04 3:24

Why I'd like my patients to poop once a day. That being said, if you skip a day, I don't want people to get all up in a bunch about it. Because some people can get hyper focused on, oh my God, I skipped a day, I skipped a day, and now, you know, life is over, and now I need an enema, and now I need laxatives, and and that's bad. I want people to be educated in what is normal. So every day would be great. Ideal. If you go twice a day, fine. If you eat a lot of fiber, you might have two, three bowel movements just in the morning and then be good for the rest of the day, right? But I don't want people going four or five times a day, and I don't want them going so often because they're incomplete emptying. But I also don't want them going three days, four days. When I do my evaluation with a client first session, I also ask very open-ended questions. So, how are your bowel movements? And most people will say, fine. Well, how often do you go? Once every seven to ten days. I kid you not. I have had clients say that. And that is bad. And I have to keep my poker face, which I suck at. And I have to say, wow, we gotta, we gotta work on that. Because every seven days is not good for anyone. Then my goal is how about how about twice a week? That should be our goal for that person. But there are a lot of factors impacting bowel regularity. I mean, every single client, when I talk about this, I say, you know the old saying, an apple a day keeps the doctor away. It's because it's the perfect fruit mixture of soluble and insoluble fiber. Makes you poop. And then you won't have to go to the doctor as often. And by the way, most people are addicted to their coffee or their Starbucks or their bird rock brew or whatever. Not for just the caffeine to wake them up. It's so everyone poops because caffeine is a bowel stimulant. But again, if that's if that's the only thing we need to do to poop every day is have a cup of coffee, then I'm okay with a cup of coffee. I have treated a few baristas who were drinking so much during their shift, caffeinated drinks, that they're going six, eight times a day, and you can really screw up your gut and get out of whack drinking too much caffeine. But a cup of coffee and an apple a day, we should be able to do that. But there are a lot of other things that that have an effect, you know, our hormone changes. And then don't forget the medications and the HRTs we take to manage all the symptoms we get with menopause, right? So, and and things people have taken their life for their whole life. I mean, what about antihistamines? What about antidepressants? And that's a antidepressants are a huge one. The side effect is basically constipation. No one takes an antidepressant and gets diarrhea. They all get constipation. All the pain meds, all of them, not necessarily Tylenol, but all the big ones, also leads to constipation, right? Thyroid meds, definitely, right?

SPEAKER_03 6:45

It's causing constipation. Most people end up taking thyroid medication when they are constipated and that's part of their symptoms.

SPEAKER_04 6:52

Right. So if your thyroid's out of whack and your medication doesn't match what you need, then you can get constipation. So sometimes they have to level up their thyroid meds to match what they actually need. Does that make sense? Yeah. And then it might help. But if you're too low, if your thyroid's out of whack, then you might be constipated. But I I think honestly, the biggest ones are the pain meds and the antidepressants, but there are other medications that just cause constipation. So then it's not just about the regular amount of fiber we need, because I have clients, men and women. Um I eat plenty of fiber. Yeah, but your gut is as old as you are. As we're aging, right? We look in the mirror every morning. I'm like, I get another wrinkle. Like I see it on my face. I see my gray hair coming in, right? We're aging on the outside. But our organs are aging on the inside and we need to pay attention to them. Our bladder ages, our heart ages, right? But our gut ages too. And if you they take clients take meds, oh, by the way, tamoxifen's another one. That makes you constipated. So some of the cancer meds people have to take can make you constipated. But if you have to take these meds to improve your overall life, then you might need more fiber than just that apple, right? They need the salad. They need to really need to get rid of all the white stuff, right? I educate people a lot about getting rid of the white stuff, get rid of the potatoes, the rice, the tortillas, the pasta. You got to just get rid of it because we need to support our gut from the inside. We need to do those prebiotic foods. We need to do all the healthy grains and nuts. We need all the fruits and way more vegetables. And potatoes don't count unless they're sweet potatoes. But we we need that, right? And bowel regularity really affects bladder regularity. So if you're constipated, then your bladder is not going to get appropriate signals because your rectum is too full, right? Uh, and it can lead to painful sex too. So we need the poop to keep moving through, right? And we need to hydrate enough, right? And then it's a slippery slope because if you're constipated and that's giving you bladder urgency, then you decrease your fluid consumption because you don't want to pee as often, but then you're gonna get more constipated, right? And so it's it's getting people back into uh a good, healthy diet and movement. We need movement for a bowel movement, right? We need to be vertical, we need to be standing. When I first graduated PT school, one of my first clinical instructors was like, I was working in the hospital. They're like, just make sure you wear shoes you either don't care about or are somewhat waterproof. I was like, what are you talking about? Because you stand these little old people up, and the first thing they're gonna do is they're gonna want to go to the bathroom. They've been in bed back in the day, even for an ACL, they used to be hospitalized for three to five days, but a total hip was in the hospital for five to seven days. So they're just laying in bed all day, they're getting pain meds, they're eating hospital food. The first thing that happens, you stand up, your feet better be in the clear, and you better pray that they can make it to the bathroom on time. Otherwise, they're gonna poop on your shoes. So, but if what's happening in our lifestyle today is that people are sitting, they're at their computers, right? They're not hunting, they're not gathering, they're sitting all day long. And it's leading to constipation. So I get my constipation patients moving, moving around a lot, tons of exercises, tons of core, tons of upright, weight-bearing studies show if you just go for a walk, it helps constipation. So we have lots of tips and tricks for constipation, but it's it's a huge problem and it really can affect a lot of other systems.

SPEAKER_02 11:19

My mind is blown at the constipation triggering bladder urgency. Because my mind was always the other way around, you know, working with nurses or people who have to withhold fluids because they literally cannot get to the restroom in time and they come in with constipation. And so my mind immediately goes to, okay, we need to figure out a way for you to drink more water. But you mentioned that constipation can create that bladder urgency, which is really the most motivating thing for them because they really don't want to have to be going so frequently.

SPEAKER_04 11:55

Yeah. So this is extremely apparent in the pediatric population. And caprices, right? Late bed wetting. Yep. Really due to constipation. Kids are so little. And again, this is the importance of signals. And so our pediatric pelvic floor, physical therapists, they actually focus on this, but it's all about getting into poop regularly so they understand their bladder signals and don't wet the bed at night or don't, you know, pee in their pants in kindergarten or third grade or fifth grade. And again, some of these habits that people have, they're like, well, I've always been like this. You know, it goes back to early training, early diet. What's the family doing at home? Well, kids today, they're eating pizza, chicken nuggets, and mac and cheese. It's all white stuff. That's exactly the stuff I said not mentioned not to eat, right? I'm like, how about giving the kid apples, getting them used to broccoli and carrots and fruits and you know, I really think kids should be eating what parents eat. And hopefully the parents are eating a healthy diet. I mean, parents are eating pizza, the kids are going to be eating pizza. But hopefully you have a side salad and eat that first.

SPEAKER_03 13:17

I think it goes beyond just what you're eating too, though. I think, especially for kids and for adults for to a degree, we can get so focused on the thing we're doing, or we don't want to move away from the thing we're doing, or we feel like we can't. And so we can end up in some bad habits, or it, you know, especially for younger kids, not so much for adults, though. I'm sure there's some adults that have this experience too, that you start to have something happen and then you clench it up so you can wait. And that like reinforces it, right?

SPEAKER_04 13:46

Well, there's the FOMO, right? The fear of missing out. That's what little kids have. They don't want to stop their play to go to the bathroom, right? But I've had this in adults. I've had professors come in and they're horribly constipated because they don't want to go until after they've given their morning lecture. I'm like, whoa, whoa, whoa, timeout. We got to get you up out of bed earlier. You got to poop before the lecture. Otherwise, you're getting all backed up. You're gassy, you got pain, then you're cramping, then you're nervous that you're gonna fart. By the way, some people don't like to pass gas. So when they're up there, like it's it just becomes these other issues, just like we talked about with bladder and anxiety. People can have that with bowel movements. Like, you know, if they're not pooping first thing in the morning, their whole day is blown. And again, I want them to poop every day in the morning. That would be ideal. But some people are afternoon or evening poopers. It's after dinner. They they have to normalize that, right? That has to be their pattern, but they have to have the time, set aside the time so that their body can function regularly at that time. But I'm a big fan of the morning. So I'm a big fan of drinking warm anything in the morning. I drink tea. I mean, but I also just drink a lot of warm water. That'll get the bowels moving more than cold. I want people to eat in the morning because just eating, consuming especially warm foods stimulates the gastrocolonic reflex. Then you have to make the time to actually take that opportunity. So when the gastrocolonic reflex kicks in and you have that urge, you got to make the time to go. Even if you didn't get breakfast ready for your kids, even if you have a meeting coming up, even if you don't have time to blow dry your hair, you know, the poop should take precedence. I know, I know, but a lot of people don't make the time, right? They're like, oh, well, I don't want to close the door because my kids and blah, blah, blah. You have to have the opportunity to have a good bowel movement, right? So you might have to get up earlier.

SPEAKER_02 16:14

This is such a beautiful intersection between your work and this podcast. Yeah, it really is. Um taking the time. I think I hit on a little nugget.

SPEAKER_04 16:26

Feeling, huh?

SPEAKER_02 16:27

Feeling like, you know, all the things that make this so such a messy time in our lives is feeling like we have to do all the things. And in many instances, we are the only ones that are doing all of the things. And, you know, remembering this is such a wonderful reminder of how central our self-care, having a bowel movement once a day is critical self-care. Just the basics. Yeah, and how easily that can well, I'm feeling the urge, but it it's literally time for the kids to go to school right now. Or they're needing food because and they're losing their minds about it. And and how easily one after one moment after another after another, our needs get pushed away. And then we pay for it. We pay for it with these old hormones that get reabsorbed because they're not getting out through the stool, or because now we're having you know, uh urination incontinence or frequency or urgency because there's constipation or whatever the case may be, there's a domino effect that happens. And we're just talking about bowel movements right now, but the picture is is broad.

SPEAKER_04 17:44

So just the bladder, you know how we talked about the bladder has a certain capacity. Well, your rectum does too. So if you ignore and postpone the bowel urge and you keep expanding and expanding, it has the ability to really overstretch. So remember, I said it's okay to ignore the first bladder signal. It's not okay to ignore the bowel signals. I want you to be at two to five hours for that bladder. But with that bowel, for most people, I want them like you got the urge, go capitalize on it. Have a moment to yourself. And you know what? Who cares if the kids are late for school? You know, who cares if breakfast isn't perfect? You know, but you got to take that time for yourself. You got to sit, you got to have the moment. And again, remember, it's with bowel movements. I only want people to barely push for initiation. If you don't have to push, don't push. Okay. You got to be in the right position. Like I said, I am a huge fan of the squatty potty, or put your elbows on your knees and sit forward. You got to really relax for a full, complete empty. That pelvic floor needs to let go. Take a deep breath. I don't want people to have to push and push and push and push because you can get a rectaceal or a rectal prolapse, even worse. Those are those are rough. So we shouldn't be pushing too much. So a rectaceal is actually the rectum bulging into the vaginal canal. Okay. So if there's a tear between the rectum and vaginal canal, and there is a fistula in opening, then the feces could get into the vaginal canal and there's infection, there's all kinds of issues. It's it's it's basically trauma related, whether that's childbirth, other medical, or sexual assault. So we really don't want fistulas. That's the worst that can happen. But rectociles ain't great either. When the rect the rectum pistons on itself, that's the issue that's really hard. The rectoceal, when it's just bulging into the vaginal canal, we can manage that mostly with position and support. But when it starts to piston on itself, a full rectal prolapse, that's problematic. So fistulas and rectal prolapse are the worst. Fissures, we can usually get better, but that requires people to be aware enough to relax their anal spinctor. If people are up tight and they're tight all the time, and they're trying to have a bowel movement, and they're not relaxing their pelvic floor or not relaxing their anal spinctor, you can push all you want. You're not going to get it out, and most likely you're going to have a tear, either hemorrhoids or fissures. You got to relax the anal sphincter to have a good bowel movement. Should happen reflexively, but if people are in these holding patterns and habits, sometimes it's really hard to let go, or if they've had pain with a bowel movement before, they don't want to let go because they don't want the pain again. But you got to let go so that you can fully evacuate.

SPEAKER_02 21:12

One of the best takeaways that I had from my hypnobirthing class that I did was breathing down, the down breathing. I don't know if Jen, did you do hypnobirthing? Yeah.

SPEAKER_03 21:24

I did I did a like a recorded thing, so I just did it on my screen.

SPEAKER_02 21:29

So the idea, theoretically, is you breathe the baby out by breathing down, which, you know, that's another story for another time. But but but she had us practicing breathing down so that you imagine the breath moving down the body, and that by practicing that with bowel movements, you're practicing, you know, the relaxation of everything. And my husband, interestingly enough, I'm sure he's gonna love that I'm sharing this, was really excited about it because he His the amount of time that it took him from initiating a restroom visit to the end was cut down significantly because he started doing this this down breathing to relax the pelvic bowl. Is it a bowl for men as well? I imagine so. Yeah.

SPEAKER_04 22:16

Yeah, yeah, yeah. But the the the breathing diaphragm up here, right? When you when you take that deep breath, it's a it's a dome, right? So you're like this. So you take that deep breath and it pushes down. And then you inhale, you go down, exhale, it comes back up. So it's like a piston and it's pushing your organs down every time you inhale that way. So we should do that in kind of a relaxing way. I will say there are some yogis that overdo that and can also wind up with prolapse because of it. But it should be focused on relaxation of the pelvic floor in its normal range. You know, too much of a good thing is usually not a good thing anymore, right? So regular, good deep breathing. But, you know, I don't know what your husband does for a living, but if he's a desk guy, he's sitting all the time. So maybe those desk workers, I mean, they're engineers, they're at their computer, they're not breathing, they're stuck in that frozen posture all the time. So having those deep breaths not only downregulates the sympathetic nervous system, but it it your GI system down and getting things to wiggle all the way down to the bottom so the rectum can actually fill. If your pelvic floor is tight all the time, your rectum doesn't fill all the way. That's another issue. So you got to have your pelvic floor relax so the rectum can fill. The rectum's not fill, filled up. You're you can push all you want, nothing's gonna happen except hemorrhoids. Right. So we only again want to bear down when we have that rectal urge, right? When there's rectum's actually full to actually bear down. So you got something empty. Does that make sense? And proper position. So when you were in your birthing class, I bet you got your you're in a squat or knees are up towards your shoulders, right? You're not really laying flat on your back or standing, like knees towards shoulders, because that's a modified squat, right? So that's happy baby pose, child's pose, all modified squats. So all great positions to practice your breathing in so that you can really feel that pelvic floor expand, right? So on inhale, that pelvic floor should expand and relax. On exhale, you might feel it lift a little bit. But I'm a big fan of getting into those deep postures and taking those deep breaths to get people to get the pelvic floor to relax so the rectum can fill so that they have more of awareness of what relaxation feels like upon bearing down for a bowel movement when they have the urge.

SPEAKER_00 25:16

So we're talking a lot about constipation. I'm curious if you see a connection with more frequent bowel movements also and how the pelvic floor, pelvic bowl is being affected there and what does that connection look like?

SPEAKER_04 25:30

Yeah, so fecal incontinence uh and fecal urgency, super tough. And talk about limiting interactions with people. Man, when someone has an FI issue, they don't want to go anywhere. They feel very housebound. It's an issue and it's it's tough. So I want to learn why. There are there are pathologies that lead to FI, but there's also a lot of dietary issues that can lead to FI. And again, just habits. So uh Crohn's, uh, inflammatory bowel disease, you know, tough, tough, tough, tough, usually high frequency. I don't have a huge solution for that, except making sure we're very much aware of the urge, what it feels like, and how strong the pelvic floor is. So there are tests we can do. Remember, I said that the rectum can overstretch if people wait too long. It can also get stiff and shrink down in size. So uh I have some people where I've tested them with a balloon catheter to figure out what their capacity is. If their capacity is too small, you know, it meaning lower than the normal limits, I might work on stretching the rectum with this internal balloon. But then, you know, it once we regulate that, it's what can we do to support the gut in how it's processing foods, right? So we look at that Bristol scale. You know, I'm a huge fan of people being like a four, maybe a five, but you get to a six, you know, you get to the super runny fecal matter, it is tough to hold back. You know, you just can't trust the liquid. It doesn't give us a good enough signal. So we might work on certain foods that might be a little more binding for those folks. So I don't want my people that have a high bristle, meaning their stool is too loose. I don't want them having too many fruits, too many raw vegetables. That's the time that I want binding foods. Still healthy. I want some vegetables, but maybe we cook them. And maybe those folks are okay eating a potato or some rice so that the liquid could be more absorbed. Does that make sense? But it it really is so patient uh dependent and specific. Uh, I really go through diet a lot. I've definitely had uh FI patients that fecal incontinence patients or fecal urgency patients, that they're just they're overdoing it with the greens. They got the green drink every day and it's gigantic, and and they've inflamed their gut in a different way versus people that have a diagnosis that their gut isn't functioning as others do, and leading to frequency and loose stools. And um, so I I work with them on what can we do? What have you tried um so far? Um trying different things, things that people may not have thought about. So beni fiber, okay. When people have fecal urgency, fecal incontinence, their doctors will say, Hey, uh, how about some benifiber? And patients are like, no, I because you think about fiber for the people that are constipated. But taking fiber for someone that has loose stools may absorb the extra fluid and actually give the stool some form so we have more control. And when I explain that to patients, their minds are like, well, why did my doctor tell me that? I haven't been listening to my doctor because I'm not taking fiber because I don't have constipation. I have urgency, right? But they they just didn't have the full explanation. Um, but I'll tell you, it's always scary for my loose stool patients to start adding fiber. And I tell them just to do it very, very gradually. I'm a huge fan, especially with FI. Just have a day at home. Take a teaspoon, take a teaspoon twice a day. Do that for seven to ten days and see how your gut changes. The gut is a very slow learning organ in some cases. I mean, sometimes, you know, you eat something, you're sick to your stomach, and you're either gonna puke or poop your pants. That's like the the emergent, but most of the time to create a new habit, it's a very slow learner. And so I always want my patients to go very slow. A teaspoon of metamusle, a teaspoon. You know, I know that's not what the directions say, but start very gradually so you can see how that changes your stool, and then you can modify it. Maybe you need more, maybe you need less, maybe you need less twice a day versus more once a day. So it's it's walking that line. It's tough. It's definitely tough. But again, you got to do the evaluation. You got to go through the whole medical history, dietary history, and then think about okay, has anyone looked at pelvic floor strain? But has anyone actually looked at rectum capacity? So uh I think those are very important factors for loose stool. And I'm really glad you brought it up. The other, the other thing about fecal incontinence, there are people who are so constipated that they will leak around the constipation. So that's an issue too.

SPEAKER_03 31:42

I had a uh patient that had that experience. Yeah, she she was insisting, she was so upset, she's like, I'm telling the GI doctor that I have diarrhea and they're telling me I'm constipation, and didn't explain what the findings and the report meant and all the different things that I had to say, like I had to do it for them and say, no, this actually does show that there's constipation, and here's what can happen when you have constipation. And sure enough, once we got the constipation cleared up, the diarrhea stopped.

SPEAKER_04 32:11

I was just gonna say, as much as I want people, I would like people to have a bowel movement once a day. Like I said, I don't want people to get hung up on that number. It's okay to skip a day. Technically, it's okay to skip two days. What I don't want people to do is taking laxatives or senna products. So sentee, smooth move, man. It's addicting. I remember the colon, slow learner, super lazy. You start giving that colon any senna products, senna cot, right? Senna tea, it's gonna be like, I don't have to do anything, I don't have to work. She's gonna drink that smooth move tea, and she's gonna poop, but but then it's addicting. And then you're gonna need more. I do treat a lot of whether it's constipation or bowel urgency frequency with people that have had uh in the past or are still dealing with eating disorders. So anorexia, bulimia, it comes in many forms, but whether that happened when they were in college and now they're menopausal or the habits they had as a kid. I mean, I've had people say, you know, their grandma made them sit on the toilet and drink castor oil, you know, when they were five years old until they pooped because they had to get the demons out. I kid you not. And when people tell me these stories, I'm never shocked by because just when I think I've heard it all, I hear something else. But some of these habits that we've had can really have an effect on what our guts like now, 50 years later, you know, it can be tough. Um, I just think that really doing an important evaluation, you know, looking at all supplements that people take, all medications, the lifestyle habits, the dietary habits that are so important. But then doing that pelvic floor exam. And again, when it comes to uh constipation, it may just be, you know, positional. I also do a lot on the abdomen. I teach people about a colon massage, super effective. I call it the magic poopy rub. I've actually been asked at parties. I've had girlfriends say, Hey, can you do that thing to me? I haven't pooped in three days. Can you can you do the magic poopy rub for me? I'm like, absolutely. I will do the magic poopy rub. But I teach people that for constipation. It's great, works great on kids, but works well on the elderly as well. So it's just, again, it's just movement. I'm just, I'm taking the place of peristalsis. But anyway, back to some of those addicting products, you know, the the colon works on a stretch reflex, right? So it's a tube. And as food, fecal matter moves through, right? As it's digesting, it's gonna stretch and push it further, stretch and push it further. It's gonna contract after it stretches. When you clients have the unfortunate habits of taking laxatives, instead of having all those undulations in the colon, becomes as smooth as a bicycle tire. They lose the peristalsis ability. And it's really tough to get it back. Super tough.

SPEAKER_03 35:31

All right. I got a couple of, I think, hopefully closing questions just because we are coming up to our time for today that we all have available. So last episode, you talked a lot about the time, the amount of time it should take to pee and how frequently you should go. We've talked a lot about how frequently you should poop today. We haven't talked about the time other than don't push. I would assume that with poop, it's more on the don't take too long rather than it being too fast, assuming that it's you're not having liquid that's coming just really quickly. Is there a too fast or a too long that we should be thinking about? And I'm also thinking about Karen's husband who was happy about the breathing because it helped him go faster. And all of the people who either take a long time actually to poop or the people who are perhaps hiding from their children on the or their dogs or their somebody else's dogs come with them to the bathroom. Oh, yeah. My dog tries to watch me poop all the time.

SPEAKER_04 36:26

All the time. My dog's always in there. But there are some really bad habits forming in people. So at one of my offices, the whole floor shares that bathroom. People across the hall go in there. They they take their break time on the toilet. And I can hear them. They're on Netflix, they're on Insta, they're like scrolling and sitting on the toilet. And, ladies, let me tell you, that's how you get hemorrhoids. You shouldn't be sitting on the toilet for that long. Certainly not 15 minutes. Even if they're not bearing down, it's just a terrible position. And I'm not kidding, that's how you get hemorrhoids. So usually I've already gone in there, done my business. I've I've peed, I've gotten myself together, I've washed my hands, and on my way out, I usually say something to the effect of, hey, ladies, it's a bathroom, not a break room. And that's how you get hemorrhoids. But for bowel movements, I mean, it really, you should have the urge go to the bathroom. The magic should happen. If it takes a little bit, if it takes a minute, if it takes two minutes, I would argue you get to three minutes and it is taking too long. And then people are gonna want to push. So what I have people do is try to get in the poop prep position rather than make the toilet toileting last too long. So when you have your cup of tea and breakfast in the morning, be sitting, or if you're gonna check your email in the morning, I want people to sit on their couch and get down low, put their computer on their coffee table and put their elbows on their knees. It's basically toileting position, but they're on their couch. But their gut is getting moving while they're in that low position. So that way when the urge hits, you can go, okay, now I can make the magic happen. I can walk to the bathroom, sit down, have a bowel movement without having severe urge or without having too strain. People that have had less than optimal habits through childhood or college years, some of them will get down and kneel or squat or get even lower for the poop prep position. And you need your pelvic floor to relax so the rectum can actually fill all the way. So therefore, when the urge comes, you can go and empty all the way. Does that make sense? Yeah, but it shouldn't take too long. And I definitely don't want people straining. Long gone are in the days when people had magazines in the bathroom. Anyone have a dad that used to take a magazine to the bathroom? It's not great because it's it's just too long, right? Hemorrhoids are really varicosities. When your pelvis sits in that bowl, it can really put a strain on those varicosities around the anus. And then you get bleeding or pain, and it just becomes this horrible vicious cycle.

SPEAKER_03 39:40

Well, don't take too long, don't push. Get yourself ready if you are somebody who attends to take a little bit longer, maybe do some deep breathing, like Karen was a little bit more.

SPEAKER_04 39:46

Get a squatty potty in the bathroom.

SPEAKER_03 39:48

Get a squatty potty.

SPEAKER_04 39:49

And train your kids with having their feet up, right? Because no one likes to dangle. I'm really short. I'm very vertically challenged. So toilets these days have gotten a lot higher. So if I go to a hotel somewhere, especially in the United States, the toilets are so high, my feet don't even touch the floor. That's a bad position for me to be in. I gotta tip over the garbage can and put my feet up, right? Because I'm not bringing my squatty potty with me. In a lot of European countries or in Asian countries, toilets are much lower, or we have the squat pot. So it's a little, it's easier for me. But in America, toilets are just way too high. So I would recommend getting the squatty potty, especially if you live in a newer home. And I know people remodel their homes and they want the fancy toilet, like make it low. But in America, everyone wants a higher toilet, like it's a throne.

SPEAKER_00 40:43

Like literally. You gotta get you gotta get down there.

SPEAKER_04 40:46

You gotta get down low so that your pelvic floor can relax. Or lean all the way forward, or both, or use a squatty potty.

SPEAKER_02 40:54

And for our listeners specifically, if you feel that urge, give yourself a gift of self-care in that moment, set the things aside and go to the restroom.

SPEAKER_03 41:06

Because just remember, it's all stardust. Nothing matters. You can pause for a minute and you can go poop. And if you're two minutes late to school or five minutes late to work or a meeting or whatever, it doesn't matter in the end because we're all stardust and we're all gonna go back to Stardust and none of this actually matters in the big picture. So let's all go poop.

SPEAKER_02 41:26

Yeah, let's just poop. But you will feel better in the interim if you just go now.

SPEAKER_03 41:31

Yeah. I think it's just really important to point out, especially because so much more focus, I think, is put on incontinence when you're older, um, when you're in, you know, a perimenopause and menopause age, that are specifically urinary incontinence, that there's so much interplay between the bowels and the urinary tract. And that as Cindy was saying before we got started recording, if you're not pooping, yeah, you're not peeing, here's a TMI, but we're here we are, that as I was dealing with some prolapse and all the stuff going on with the endometriosis and the swelling and everything, there would be times that I noticed as I got older that if I really had to poop and I don't have a constipation issue, but if it even if it's just I had a very full rectum, sometimes it interfered with my ability to pee. And like I would have some pain and I couldn't empty one until the other one had been emptied. And so those are things that really paying attention to can become vital because you can inadvertently contribute to, cause, or exacerbate additional problems if you're not tending to the totality of what's going on in your pelvic region down there. On that note, we got to talk about sex, but we do not have time today. So, Cindy, will you come back so we can talk about sex? Because that's obviously a big thing that shifts and changes in perimenopause and menopause, and is also really important to our personal health, our mental and emotional health, our relationship health, all of those things. So, can we get you to come back again? Absolutely.

SPEAKER_04 43:03

I'll do it. It's gonna be a long one. We got a lot to talk about.

SPEAKER_02 43:08

Thank you for having me, ladies. Thank you. Thank you so much, Cindy. This is wonderful. All right, well, we'll look forward to talking to you again soon. All right. All right, ladies, love you. Bye. If our messy is your kind of messy, we'd love for you to rate, review, and follow or subscribe wherever you get your podcasts.

SPEAKER_00 43:30

We'd also love to know what's on your mind. If you were to join us, what would we be talking about? Email us at messy midlife podcast at gmail.com or message us on Instagram or TikTok.