To poo or not to poo (and how to do it right)


Victoria White (pelvic floor physiotherapist) writes about the correct way to empty your bowels, and prevent constipation:

Do you remember the time when you were in nappies, free to do your business whenever you wanted? When did you figure out whether it was a number one or two making it’s way down?

It’s highly unlikely for this to be a strong memory for many of us, and it’s something you often don’t pay another thought – unless something isn’t working quite right.

Constipation is when your poo gets hard & lumpy, and takes more effort to get out. Commonly it is associated with not going regularly enough, but you can actually be constipated if you strain and pass tiny little pellets a few times a day. It is defined as “less than 3 bowel movements per week or bowel movements with stools that are dry, hard and difficult to pass”. It affects many people, often women more than men, and the incidence increases with age – again another common issue that people are reluctant to talk about!

Factors such as diet, medication, pain, pregnancy, dehydration and poor awareness of the urge to go can all contribute to a little steam coming out of your ears when it’s big business time! It’s important to treat constipation (with lifestyle modifications & laxatives if required) before it becomes chronic – otherwise the risk of anal fissures, haemorrhoids or rectal prolapse can increase.  Constipation can also make a vaginal prolapse worse, increase urine leakage or urine urgency.

Individual habits can range from going every other day, to up to three times in one day  – but your poo should ideally be a 3-4 on the “Bristol stool chart”, or represent a smooth, soft, sausage that is passed easily.


Unfortunately when our modern porcelain throne replaced the “squat toilet” we inadvertently obstructed the course of nature. Although the hole in the ground may require a little more balance and finesse in your white shorts – the squat position actually opens out the kink in your anal canal (that helps to maintain continence), which makes releasing the chocolate hostage a whole lot easier!


The best position to poo:

  • Place a small stool underneath your feet, or a few rolls of toilet paper will do just fine – you want your knees above your hips
  • Keep your back straight, lean from your hips to let your elbows rest lightly on your knees
  • Relax your belly outwards, and take a few moments here to relax, meditate or read
  • Without pushing or straining heavily, the bowel movement should pass with ease

How to develop a good bowel routine:

  • Sit at the same time every day (preferably 30 minutes or so after breakfast and a cup of coffee helps!)
  • Eat a good diet with enough dietary fibre (kiwifruits & pears are great if things are a little slow!)
  • Drink enough fluid (especially water)
  • Maintain a healthy exercise regime
  • And always respond to a bowel urge. The more you hold on, the hard the poo becomes and the more difficult it is to pass. So ‘to poo or not to poo’? ALWAYS POO!

If you want to know more about how to protect your pelvic floor whilst doing a number two, need a little help or have any questions – get in touch with your GP and a pelvic health Physiotherapist.

– Victoria White, Physiotherapist, Blenheim NZ

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