Bloating, gas, feeling full and unable to poop…do these symptoms sound familiar?
Unfortunately, interstitial cystitis (IC) is often overlapping with other conditions including constipation. According to the National Institute of Health, constipation affects approximately 25% of the adult population,with women and those with comorbidities (such as IC) being in the higher risk categories.
Constipation comes in many forms but medically it is defined as fewer than 3 bowel movements a week. If you are straining to pass bowel movements or have hard, pellet-like poops, you may also be suffering from constipation - even if you are passing stool daily.
In this post, we will look at the correlation between the bladder and the colon, explore the potential causes of your constipation and how to treat the cause instead of the symptom.
Let’s dive in…
Constipation and Bladder Pain
If constipation wasn’t enough of your troubles, have you noticed that your IC symptoms appear to be exacerbated with the difficulty to go? A full colon and rectum can put excess pressure on the bladder and pelvic floor muscles. Straining to go or that feeling of not being “empty” can also put pressure and stress on the pelvic floor. Researchers have been studying the cross connection between the bladder and the colon for years. The evidence is quite clear that constipation can and will exacerbate your IC symptoms.
When you are in a bladder flare, you will do almost anything to make your symptoms go away. But you may wonder, is taking a laxative going to help or exacerbate my symptoms? Will I get “addicted” to using stool softeners? Which laxatives might flare my bladder even more? Or maybe you are just tired of throwing yet another supplement or medication into your daily routine.
Causes of Constipation
Constipation can come from many different external and internal sources as well as lifestyle and eating habits. First and foremost, it is important to get to the root source of your constipation. Medications, pelvic floor dysfunction, stress, hormones, lack of activity, diet, and fluid intake all play an important role in keeping your gut healthy and regular.
Medications: According to Harvard Health, tricyclic antidepressants such as amitriptyline (Elavil) and allergy meds, such as diphenhydramine (Benadryl), slow down muscle and nerve functions. This can lead to less movement in the gut and thus constipation issues.
If you are taking one of these medications and suffer from constipation, you will want to consult with your medical team for the best remedy. This is the one place where diet and lifestyle changes may not be enough to provide relief.
Pelvic Floor Dysfunction: Given the anatomic and functional role of pelvic floor in elimination of waste, it is not surprising that constipation is often comorbid with other pelvic floor issues. If you experience pelvic floor muscle spasms, pain in the rectum or lower back, you may want to talk to your doctor about diagnosis and treatment for pelvic floor dysfunction (PFD). Typically physical therapy will be advised along with at home exercises.
If you believe your constipation is directly tied to PFD, consult with a pelvic floor physical therapist. They can recommend various massage techniques, stretches, exercises or yoga poses to help. Also remedies such as bowel massage and/or using a Squatty Potty may also be beneficial. If you’re on Tiktok, here are a few of our favorite PT accounts: The Pelvic Dance Floor, PhysioKels, Don’t Kegel Chronicles, and Madelaine Golec.
Stress: Have you ever noticed you get a bit constipated before traveling or a big meeting at work? Why is this? Stress and your gut health are directly related in many ways. Stress can and will affect digestive hormones, bacteria, and inflammation in the gut.
When you are feeling anxious or stressed your body produces hormones such as cortisol and adrenaline. These hormones cascade into a fight or flight scenario within your body. Preparing for a fight or flight the body shuts down the digestive system. For those in a chronic state of stress this can mean that the digestive system slows to a crawl. For others it can cause spasming in the gut and lead to diarrhea.
Stress management and other relaxation techniques can help those with chronic constipation. Yoga poses, daily movement, meditation and deep breathing are just some of the recommended stress management techniques that will also stimulate digestion and have been proven to alleviate constipation in some people. A bowel massage can be relaxing and helpful as well.
Hormones: Have you ever noticed that your bloating or bowel irregularity is worse before your period? You are not alone. Most women will definitely notice changes in the bowel habits during the luteal phase of their cycle. New studies show that both estrogen and progesterone have been linked with reduced gut motility and constipation among women.
For hormonal induced constipation, the Registered Dietitians at Callie K Nutrition often recommend that our IC clients increase their aerobic activity and drink lots of water during this time. Aerobic exercise has been clinically proven to reduce excess estrogen in the body. Extra water helps the liver flush out excessive hormones and helps decrease water uptake in the colon.
Lack of Activity: Prolonged sitting and lack of physical activity has been directly correlated to constipation in several medical studies. In fact, it is one of the most common lifestyle changes that people can make to have a lasting impact on the bowel health.
Low-intensity exercise is typically best tolerated by those with interstitial cystitis. Better yet, you don’t need to join the gym to obtain these benefits. A basic fast walking routine can be added to your day or find a virtual yoga class online that you hop on during your lunch hour.
Diet: When on the IC diet, you may find that your fiber intake is limited, as you are not eating as many whole grains, fruits and vegetables. IC friendly high fiber foods include oatmeal, cruciferous vegetables, nuts and legumes, and fruits such as dates, plums, pears and blueberries. Limit your intake of cheese, red meat and white rice as these foods can be constipating.
For those struggling to get 25 to 30 g of fiber into their diet daily, alternative natural supplements may be recommended.
Natural Remedies For Constipation
Some IC safe stool softener options include:
1. Metamucil (Psyllium Husks), unflavored
2. Magnesium Oxide
3. Fish Oil or Castor Oil
In addition to adding fiber to your diet, try adding a warm cup of fennel or peppermint tea to your morning ritual. Sometimes a warm drink is all your body needs to get the digestive system stimulated.
With constipation and other comorbidities, having interstitial cystitis can feel overwhelming and exhausting. As you can see, there are so many lifestyle and diet related factors that can help you find relief. The Registered Dietitians at Callie K Nutrition are waiting to help you navigate your symptoms and find the best natural course of action, when indicated. You can discover how to manage your symptoms and more with our free IC Masterclass.