Dr. Trisha Pasricha

Propulsion refers to how your muscles are generating these contractions in your own gut to push that poop forward.

So that's the second P. And then the third mistake that can come into play is in our pelvic floor.

And I think this is the most underappreciated part of it.

Like we were often like, oh yeah, we need more water.

We need more fiber.

how many of us are asking, what is my pelvic floor doing?

And the pelvic floor is this complex set of more than a dozen muscles that kind of hold all of our internal organs together and kind of the floor of this box.

And very paradoxically, when we bear down to have a bowel movement, we're building up all of this pressure in our chest cavities, but we're asking our sphincters to relax in that critical moment.

And it's actually the

kind of counterintuitive to what the rest of our bodies are doing.

Yeah, you're exactly right.

Sometimes when I suggest to people, you might need pelvic floor PT, a lot of the men are like, wait, what are you talking about?

My wife got that when she gave birth.

That's a different kind of pelvic floor PT or physical therapy than what I'm talking about for constipation.

It affects men and women.

And we sometimes just develop these problems where those sphincters clench instead of relaxing at the critical moment.

And so it's like trying to squeeze toothpaste out of a toothpaste tube, but you never take the cap off.

And sometimes when you can just retrain those muscles, finally it's like taking the cap off that tube.

And suddenly the toothpaste comes flying out.

But the whole issue was never that you needed more water or that you needed to soften the toothpaste.