Is it straining or not?

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Is it straining or not?

Postby howtobepositive » 17 May 2013, 00:39

Hi guys,
This one is a stupid question but I was wondering that although I dont really suffer form constipation - well on most days I do feel the pressure to go. But on some of the days even when I have the pressure to go, I feel like I have to push - Im refraining from using the word straining - because its not constipation, the stool is there, it just needs to be pushed once in a while.
Is it just that my passage is too narrow? Also, the size of the stools doesnt seem to matter, sometimes I have large stools but pass ok and on other days I have normal size stools but still require pushing.
Additionally, I take docusate sodium as softner every night and if I feel like Im plugging up, I take one dose of miralax but thats may be once a week on average.
Any help is greatly appreciated.
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Re: Is it straining or not?

Postby BootyMcOuchersons » 17 May 2013, 09:42

Hi positive,
I have no idea what is normal, as I can only speak for myself, but I have always had to push a little to get my BMs going, even before I had problems. I have IBS and am not sure if that plays a part for me. Sometimes I would even have to use my hand to try to push around my anus from different angles to try and help express the poop out. Not good, as this is how I think I got my fissure. Once the poop started coming out, it would usually come on out without my "help", but sometimes would require pushing midway.
So, that's how it's been for me. Of course, I'm not healthy down there...I've had hemorrhoids for years and now a large fissure. But I can't imagine just sitting down and not having to push, even a little bit.
Lets see how others chime in. I'm curious too.
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Re: Is it straining or not?

Postby Savaici » 17 May 2013, 11:41

Everyone will tell you not to push; easier said than done!
I too have to push a little. From what I have read it is better to push with the muscles of your abdomen, but I have found that impossible to do.
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Re: Is it straining or not?

Postby Ever the Optimist » 17 May 2013, 12:21

Howtobepositive,
Sav is right in that I think everyone has a natural instinct to push to some degree. When you imagine a woman having a baby, there has to be pushing to get a large living object out of a very small hole! I see it as similar to having a BM in some respects. It is easier said than done but it can be done.
For me personally, I have almost had to retrain my way of thinking when I squat on my toilet seat!....My morning BM is never an issue. The minute I get up, my bowels are ready to open easily with no pushing at all and my first BM is generally very soft, largish (but not huge!) and well-formed. The whole process happens quickly & painlessly usually and everything literally does just "fall out".
I get 2-3 BM's a day depending on what I eat/ how stressed I feel/ my period/ my IBS - Generally almost always 2, the later in the afternoon. This one challenges me more - maybe I am less relaxed than first thing in the morning? but although this is always as soft & well-formed as the first one of the day, I have mixed results as to how this one expels. Sometimes, as easily as my morning BM, other times, I'm there a little longer and I absolutely confess to pushing just a little (only a very shallow and normally just one push - no major pressure at all) and that seems to do the trick. I have just started to learn to push with the muscles of my abdomen and have accomplished this a couple of times, so this is also possible but a totally different technique.
Booty - the IBS does not help, when it flares up. Mine has been back with a vengeance recently - The problem for me is that my bowels seem to be so sensitive when the IBS is bad that I often keep feeling I need to go to the toilet and expel, when actually there is very little or nothing there to expel. Unfortunately, I had the other extreme last night - the urgency to go with explosive consequences, which is also not at all good when dealing with a fissure!!!
Another good tip to help the BM along naturally, is to apply a little pressure at/ massage the base of the tailbone just above the anal opening. I only read this recently on another thread and it is actually a really helpful tip......
Chronic Fissure diagnosed December 2011
Healed by Diltiazem around Feb 2013
Anal Fistula followed burst abscess in June 2012
2 internal troublesome piles remain & suspected, but undiagnosed, ongoing Levator Ani type symptoms & flare-ups
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Re: Is it straining or not?

Postby jr2 » 17 May 2013, 12:59

Part of the key is to focus on your breathing. If you are pushing with your pelvic floor muscles, you are holding your breath, even if only briefly. You don't want to hold your breath. You want to breathe deeply into your lower abdomen so it expands like a balloon. You will feel the pelvic floor relax and drop when you do this.
It is also really beneficial to either squat or at least raise your feet on a footstool if you can't squat. This position will naturally straighten out the rectum and increase intra-abdominal pressure without causing straining.
To practice the difference between using your abdominal muscles to naturally assist you with a BM, out loud make the sound of 'mmmmmmmm" like a hum and "ohhhhhhhhhhh" . Feel how your abdominal muscles engage when you make these sounds out loud.
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Re: Is it straining or not?

Postby Darkeyes » 17 May 2013, 18:31

How to be positive-I have the same pushing issue. I don't strain but I do push during a BM even when my stool is very soft (the consistency of toothpaste). I have a very strong sense of urgency to go but will still need to push.
Last week I switched to squatting and that has helped a bit. I still have some days where I push but I have had a day or two without pushing.
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Re: Is it straining or not?

Postby Guest » 18 May 2013, 04:20

Pushing while you are eliminating is fine. The butt-hole is open during the process, so the pressure on the butt is not felt. However, pushing just to eliminate is not fine. It will give rise to additional problems, "Hemorrhoids, bleeding, or pelvic floor prolapse". And very rarely "rectal prolapse".
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Re: Is it straining or not?

Postby howtobepositive » 20 May 2013, 03:10

Good replies guys. Im glad Im no the only one who pushes, sometimes I almost feel guilty but honestly nothing I can do, I do have to push no matter what.
Optimist - this is going to sound freaky, but though I get 1 or 2 BM's, my first one is always easier too as compared to the second one. My second one seems to always be a small BM as well, meaning less comes out.
Also, I have IBS too :( and unfortunately there are no good and bad days for me, its always bad and very bad days. It never actually goes away....it was my number one problem until the AF arrived and IBS seems like a breeze! One of my biggest issue is the feeling of incomplete evacuation, even when I go in the morning, I always feel like I havent finished but I can sit there and push all I want that last bit never comes out.
Now about the pushing around tail bone, I dont know how to do it, anybody have any online references on this? And I tried using a footstep as suggested, there is actually a product called squatty potty that helps you squat, and I think it does help a bit. But when I started using it, I feel like Im stretching a bit on my LIS wound (guessing its still there as Im only 2.5 weeks post op) or the fissure, hopefully not the fissure :)
I must confess Im a little confused between when pushing is ok and when it isnt?! I honestly dont think anyone can just go and not have to push at all, unless you have diarrohea.
And for those of you who have the incomplete evacuation feeling, how do you deal with the urge of going to poo when you know nothings going to come out and even if you try its useless pushing. I also find that a lot of times when I have that feeling, I tend to push more than usual.
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