1. Physical ability to get to the toilet and to undress
2. Cognitive ability to sense and act on the urge
3. Coordinated and functional muscle activity of the Internal Anal sphincter and External Anal Sphincter, colonic transit, puborectalis muscle and anorectal reflex
4. A powerful colon and rectal contraction- M. O. P. regime helps (Dr Paul Hodges)
5. Soft poop – M. O. P. regime helps (Dr Paul Hodges)
6. Kids need to poop daily
7. Relaxed pooping muscles- Physiotherapy helps
• Chronic constipated children tense their pelvic floor muscle instead of relaxing it when pooping, an understandable reaction, given their history of large, painful bowel movements. • The pelvic floor muscle is often hypertonic- too tight with a constipated child due to contracting against the heavy load of a loaded rectum. It is difficult for the child to relax the pelvic floor to completely empty
• Some kids keep their pelvic-floor muscles tightened all day long. Having these muscles constantly “on guard” only worsens their difficulties. Eventually, all this holding inhibits the natural reflex to pee or poop, and these kids may not even feel the urge.
• What is more, the pelvic-floor muscles fatigue, like an overstretched rubber band that has lost its elasticity, and poop just falls out or pee leaks out during activities such as running or jumping.
• Sometimes these children not only contract muscles at times they should be relaxed, but they also relax muscles when they should be contracted.
• With examination externally there is reduced active range of motion of the Pelvic floor muscle due to continuous conscious contraction of the muscle called, Dyssynergia Defecation
