Digestive Health Constipation How to Reduce Straining From Constipation Using Relaxation Techniques and Positioning By Barbara Bolen, PhD Barbara Bolen, PhD Twitter Barbara Bolen, PhD, is a licensed clinical psychologist and health coach. She has written multiple books focused on living with irritable bowel syndrome. Learn about our editorial process Updated on July 06, 2021 Medically reviewed by Robert Burakoff, MD, MPH Medically reviewed by Robert Burakoff, MD, MPH LinkedIn Robert Burakoff, MD, MPH, is board-certified in gastroentrology. He is the vice chair for ambulatory services for the department of medicine at Weill Cornell Medical College in New York, where he is also a professor. He was the founding editor and co-editor in chief of Inflammatory Bowel Diseases. Learn about our Medical Expert Board Print What can you do to reduce strain on the toilet from constipation? If you suffer from constipation, it may be reassuring to know that the use of relaxation techniques and positioning may be helpful in reducing straining while on the toilet and may help to ease your struggle to have a bowel movement. Straining can also lead to developing hemorrhoids and even rectal prolapse. While you can take some steps to reduce straining, it is also good to seek help from your healthcare provider to give you some solutions to prevent chronic constipation. One of your first steps towards reducing straining is ensuring you have been drinking enough water. If you are dehydrated, that will contribute to hard stools and constipation. JGI / Tom Grill / Blend / Getty Images Relaxation Techniques to Reduce Toilet Straining What type of relaxation technique could you use? One is visualization. Close your eyes and visualize yourself in a calm and beautiful scene such as at the beach, in a garden, or in a forest. Open up all of your senses to imagine what you would be seeing, hearing, smelling, and touching. Deep breathing exercises are another relaxation technique. Muscle relaxation exercises, tensing and releasing groups of muscles from head to toe, are yet another technique. You can alternate these three types of relaxation exercise or choose just one or two. For best results, practice your relaxation techniques two to three times a day in a quiet, comfortable place, and then use the techniques to help keep you relaxed while you are sitting on the toilet. The best time to encourage a bowel movement is in the morning when intestinal contractions are likely to be at their peak. Enjoy a fairly large breakfast, preferably with some fatty foods, to stimulate the gastrocolic reflex. Then make time for a relaxing visit to the toilet. Refrain from straining, and use your relaxation skills to help you to stay calm. Try to visualize the muscles in your intestines contracting in a calm rhythm to comfortably move the stool along. Toileting Position: Knees Higher Than Hips There are some research studies that show that defecating in a semi-squatting position with your knees higher than your hips can reduce straining. In this case, squatting doesn't mean hovering over the toilet but rather being seated on the toilet with your feet propped on a low stool. You are in a seated squatting position with your knees higher than your hips while sitting on the toilet. The semi-squatting position is not recommended if it causes you any pain, or if you are recovering from a hip replacement surgery. There are toilet accessories made for this purpose, or you can use whatever is at hand. The research on this position is becoming more definitive, so you may want to give it a try. You may also try leaning forward when you bear down, as that increases the abdominal pressure without straining. A Word From Verywell Using relaxation and positioning, you may be able to strain less and reduce your risk of hemorrhoids and prolapse. However, if you have ongoing difficulty with constipation and straining, see your healthcare provider so you can get advice, diagnosis, and treatment. 6 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Patcharatrakul T, Rao S. Update on the pathophysiology and management of anorectal disorders. Gut Liver. 2018;12(4):375-384. doi.10.5009/gnl17172 American Gastroenterological Association. Constipation. Norelli S; Krepps J. Relaxation Techniques. NCBI StatPearls. Modi R, Hinton A, Pinkhas D, et al. Implementation of a defecation posture modification device: impact on bowel movement patterns in healthy subjects. J Clin Gastroenterol. 2019;53(3):216-219. doi.10.1097/MCG.0000000000001143 Bhattacharya S, Chattu V, Singh A. Health promotion and prevention of bowel disorders through toilet designs: A myth or reality?. J Educ Health Promot. 2019;8:40. doi.10.4103/jehp.jehp_198_18 Bharucha A, Pemberton J, Locke G. American Gastroenterological Association technical review on constipation.Gastroenterology. 2013;144(1):218-38. doi.10.1053/j.gastro.2012.10.028 Additional Reading Constipation. Johns Hopkins Medicine. Sakakibara R, Tsunoyama K, Hosoi H, et al. "Influence of Body Position on Defecation in Humans." LUTS: Lower Urinary Tract Symptoms. 2010;2(1):16-21. doi:10.1111/j.1757-5672.2009.00057.x. By Barbara Bolen, PhD Barbara Bolen, PhD, is a licensed clinical psychologist and health coach. She has written multiple books focused on living with irritable bowel syndrome. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! 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