Let Squat Easy take the strain from constipation

Not only does constipation impact a sizable proportion of the population, but it also adds considerable costs to the NHS. In 2014/15, the total cost to hospitals for treating unplanned admissions due to constipation was £145 million not including additional costs for GP visits, referrals, investigations (eg. colonoscopies), home visits and prescriptions2, despite the condition being a preventable, treatable and easily manageable condition.

According to Dr Anton Emmanuel, Academic Consultant Neuro Gastroenterologist, University College London Hospital, UK, the causes of constipation vary but are typically associated with poor diet, lack of exercise, medication, stress and dehydration, as well as metabolic conditions such as hypothyroidism and hypercalcaemia.

“People who are on medication can suffer from constipation as a side effect, the elderly, the less mobile, young children particularly those who are toilet training and people who are undergoing stress, this can impact the health of a person’s bowel,” explained Emmanuel. “Usually, the muscular contraction through the gut is slowed – and this is evident in less mobile individuals or patients on medication – and/or when the rectum is not functioning properly, and this is usually a consequence of rectal surgery, diverticular disease, child birth and/or emotional distress.”

Although constipation is common and manageable, many patients are embarrassed to discuss the condition with a healthcare profession, sometimes exacerbating the problem. Research has revealed that nearly one in five people feel embarrassed talking to their GP about constipation and over a fifth of people would try and solve it themselves, without speaking to anyone about it, if they thought they were suffering from constipation2. Alarmingly, nearly one in ten people would wait between two weeks and a month before speaking with a healthcare profession, despite

constipation potentially leading to complex problems such as haemorrhoids, anal fissures or rectal prolapse.

“We know that the public are embarrassed about speaking to their GPs or nurses about constipation, but people must remember that it is a common condition and one we will all suffer from at some point in our lives,” said Emmanuel. “In addition, there is also a reluctance among some healthcare professionals to discuss the condition. I would encourage my colleagues that they must not shy away from addressing the issue with patients.”

There are several treatments available for constipation including pharmacological management (eg. stimulant and osmotic laxatives), increased fluid consumption, increased fibres intake, increased physical activity, enemas, stool softeners, as well as manual removal if the constipation is severe and refractory to other therapies. The British Medical Journal recently published guidelines for pharmacological and non-pharmacological options therapies for opioid induced constipation in adults with cancer, which includes lifestyles changes3.

“Historically, we have encouraged patients to eat more fibre, exercise more, drink more water and stay hydrated,” he added. “However, these changes should not be done in isolation, but all together, and usually for the rest of their lives. Constipation is a chronic problem, so patients need to understand that it requires a long-term solution.”

Squat EasyOne important aspect of constipation that patients and healthcare professional fail to appreciate is the importance of toilet behaviour and positioning on the toilet that can help a patient empty their bowel.

“Patients should always wait until they get a strong urge before they go to the toilet, they should not try to go to the toilet if they do not

feel the urge,” said Emmanuel. “Once they can feel a bowel movement they should take their time and not rush - but at the same time - do not take too long.”

In addition, correct positioning is also important, and Emmanuel explained that this means positioning the knees above the hips and leaning forward with your elbows on your knees with a straightened spine with their belly pushed out. This position will relax the puborectalis muscle and will prevent straining, one of the worst things a patient can do, as it weakens the muscles that control their bowel.

On the standard westernised toilet, our thighs are at right angles to our lower legs, meaning it is difficult to raise our knees above our legs. However, a recent innovative product – Squat Easy – helps patients assume a natural posture, whilst raising the thighs to the correct angle allowing the colon to optimally eliminate body waste. Correct toilet positioning was one of the recommendations included in the recently published recommendations in the BMJ3.

Squat Easy, launched in August 2017 by All About Digestion (AAD) Ltd, is made with a strong, non-slip, polypropylene with an anti-bacterial agent - making the Squat Easy the world’s first anti-bacterial stool!

FOR PEOPLE WHO suffer from constipation, it can be debilitating and significantly impact their quality of life - from a reluctance to attend social functions, hobbies and going to work, to going shopping or to the theatre - as well as living with chronic pain and bloating. Constipation is far more common than most people believe with one in seven of the UK population and up to one in every three children suffering from constipation at any one time1.

Coloproctologynews.net is a news website that reports the latest developments in the field of coloproctology to specialists and associated healthcare professionals - www.coloproctologynews.net

CNEWSOLOPROCTOLOGY

Dr Anton Emmanuel

“The Squat Easy product is a very simple idea that will benefit certain patients suffering from constipation. Our positioning on the toilet is something that is very important to allow the evacuation of our bowel,” said Emmanuel. “The product allows some people to overcome the physical inability to open up their pelvic floor, by elevating their knees about their hips. Another benefit of using Squat Easy is it gives users something to strain against, so instead of using their neck, they can push gently with their feet thereby focusing on the pelvic floor as opposed to pushing generically, helping to reducing unnecessary and potentially harmful ‘straining’ behaviour.”

According to Mr Graeme Smith, Founder & Director of AAD Ltd, Squat Easy can help with constipation, diverticulitis, haemorrhoids, IBS, post-operative Ileus and post-natal uro-gynaecological issues.

“We have designed and manufactured the SquatEasy in the United Kingdom. This was important for us as our engineering emphasis has been to ensure a super strong, stable and safe product,” said Mr Smith. “It’s a simple product - but its effective - and a lot of work has gone into the design. We believe that Squat Easy - along with appropriate nutrition, water and exercise - significantly aids efficient bowel movement. The Bowel and Bladder unit in Accrington, UK, has been trialling the product and the staff and patients found the product very helpful,” added Mr Smith. “The key point is that pharmaceuticals and lifestyle changes can’t change posture – the SquatEasy does!”

Further informationFor more information about the Squat Easy product please email Graeme Smith (gsmith@squateasy.com) or go to the web site: www.squateasy.com

In addition, the company is also supporting a new web site called: www.toiletposture.com - an information site providing assistance to healthcare professionals helping to raise public awareness. A growing number of pharmacies also stock Squat Easy and it is also available to purchase directly on Amazon.

References1. https://www.nhs.uk/conditions/constipation2. https://www.coloplast.co.uk/Global/UK/Continence/Cost_of_

Constipation_Report_FINAL.pdf 3. JW Boland and EG Boland. Pharmacological therapies for opioid

induced constipation in adults with cancer. BMJ. August 2017, http://www.bmj.com/content/358/bmj.j3313)

Infographic showing recommendations for ‘Managing opiod-induced constipation’. This infographic was reproduced with the kind permission of BMJ Publishing Group Ltd.