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Constipation and the Colon - Mayo Clinic

welcome back to our second video series

on constipation let's go ahead and find

out the role of the colon what it looks

like and how it works most literature

states that the colon is anywhere from

three to five feet in length layers of

muscle line its wall the muscle layers

are both circular and longitudinal the

muscle contractions produce movement or

motility that helps propel the stool

through the body there are four main

functions of the colon it absorbs water

insults from the waist it moves or

propels the waste through the colon it

stores waste until it's expelled

eventually the waste is evacuated this

is a perfect illustration of what the

colon looks like the colon actually

looks like a goalpost the right hand

side of your colon moves up the right

hand side it's called the ascending

colon the transverse colon moves across

the upper part of the abdominal area

your descending colon is the left hand

side it goes out the sigmoid colon and

down the rectum over here we have a

gentleman that looks like he's just

getting out of bed in the morning we

really encourage our patients to stretch

before they get out of bed in the

morning that increases the heart rate

enough to where that blood flow goes to

the stomach and it helps produce those

peristaltic contractions preparing the

colon to have that first evacuation of

the day another helpful hint we

encourage our patients to do is always

eat breakfast we encourage patients to

eat breakfast within that first 30 to 45

minutes of getting up that really

stimulates that colon again helping us

to have those times predictable bowel

movements back over here at the picture

of the colon you can see the small bowel

sits right in the middle of the colon it

empties liquid stool into the right hand

side of the colon the colon holds

anywhere from eight to ten cups of

liquid stool in a 24-hour period the

mechanism of the colon is to start

pulling that water off of the stool to

make it a firm stool you can see the

motility of the colon as it propels that

stool up you have these little

peristaltic waves that are always

producing movement and and

increasing the the movement of stool

through the colon appear same thing

you've got that motility going on

looking here on the left-hand side of

the colon you can see where that colon

is getting really skinny in it it's

propelling that stool into the rectal

vault this is actually called a mass

peristalsis we have about 6 mass

peristalsis per day it increases when we

get up in the morning or after we've had

a meal this actually produces our bowel

movement it pushes that stool into the

rectum once that stool hits the rectum

we develop an urge here we have an

illustration of that stool actually

sitting in the rectum once that stool

hits the rectum the stool distends the

rectum developing our urge indicating to

us that we need to go to the bathroom

once we get to the bathroom

we are beginning to evacuate our stool

our sphincter muscles stay completely

relaxed and we evacuate our stool

looking at this gentleman here it looks

like he is in the wrong seated position

when having a bowel movement we really

encourage our patients to sit more

upright when they have their bowel

movement we also encourage our patients

to use a footstool so that they can get

their feet up a little bit higher so

their knees are higher than their hips

this picture actually shows an excellent

position that a patient should be

sitting in while they're having their

bowel movement again if you'd like to

put a foot stool under your feet to get

your knees a little bit higher than your

hips that's going to help with that

evacuation of the stool when you're done

with your evacuation your rectal vault

should be completely clear your

sphincter muscles return back to resting

position this concludes the first two

videos in our series on constipation

we've gone over the common causes and

symptoms of constipation the role the

colon plays in constipation now we're

going to be moving on to video three and

four which is going to include lifestyle

modifications and helpful hints