The Links Between Constipation and Pelvic Floor Dysfunction
Abdominal massage during pelvic floor therapy for constipation
As pelvic floor therapists, we are constantly discussing bowel function and bowel health with our patients. The truth is, constipation can significantly contribute to common symptoms of pelvic floor dysfunction. When there is extra stool in the colon and rectum it can put excessive pressure on the rest of the organs and tissues inside the pelvic bowl including the bladder, urethra, uterus and vaginal wall resulting in symptoms such as;
Urinary urgency and/or frequency
Urinary or fecal incontinence
Urinary retention
Pain with intercourse
Prolapse
Hemorrhoids
In the case of chronic constipation, straining patterns can also lead to extra pressure on the pelvic floor impacting their function over time.
In addition, constipation itself can be a symptom of pelvic floor dysfunction. Pelvic floor muscle tension and decreased coordination of the pelvic floor muscles. These muscles need to be able to relax and lengthen in order to allow for complete and functional emptying of the bowels. There are many different causes for pelvic floor tension and discoordination, but once it is present, it can be challenging to maintain regular, easeful bowel movements. The more time that goes by in this cycle, the more challenging it can be to reverse.
Therefore, many times we are dealing with a chicken or egg scenario and this is why it can be very helpful to see a pelvic floor therapist to evaluate if your pelvic floor function itself could be a contributing factor to your constipation.
It’s a common belief that constipation only occurs when we go an extended period of time without having a bowel movement. In reality, constipation can exist even if you have a movement everyday.
The National Institute of Diabetes and Digestive and Kidney Diseases (NIH) defines constipation is a condition in which you may have:
Fewer than three bowel movements a week
Stools that are hard, dry, or lumpy
Stools that are difficult or painful to pass
A feeling that not all stool has passed
What does healthy bowel function look like?
Frequency of bowel movements between 3 times per week to 3 times per day (we like to see 1x per day as an optimal goal but what is most important is consistency)
Stool consistency type 4 (soft/formed) sausage like shape
Feeling of complete emptying - satisfying
No need to strain, stools pass easily and without pain
Ability to wipe clean with about 3-4 wipes (versus feeling like you need to use ½ the toilet paper roll)
No leaking of feces
Although getting to the root cause of constipation may require more in depth and individualized assessment with your healthcare provider (including your pelvic floor therapist), here are some things you can do to help improve your situation:
Hydration:
Drinking enough hydrating fluids daily is very important to ensuring your stool can move through your digestive system and supporting a soft/formed consistency. We recommend aiming for half your body weight in ounces with 90% of that being plain water if you can.
Fiber intake:
The Academy of Nutrition and Dietetics recommends consuming between 25-40 grams of fiber from food or 14 grams per 1,000 calories. Some natural sources of fiber include; fruits and veggies (with skin/peel on), lentils, beans, whole grains, and seeds.
Movement:
Daily physical activity helps to stimulate the digestive system and keep fluids and our bowels moving. Even just a 15- 20 minute walk in the morning or on your lunch break can make a difference!
Breathing:
Breathing encourages diaphragm, pelvic floor and abdominal movement and can improve relaxation and mobility of the organs and pelvic floor muscles. It can also help improve relaxation which can help improve overall digestion and bowel function.
Toilet habits and posture:
Sitting with feet fully relaxed on a stool or “Squatty Potty”with your knees higher than your hips can allow your pelvic floor muscles to relax and allow the stool to pass through more easily and completely. Taking relaxed lower abdominal breaths will also help when on the toilet to keep your pelvic floor relaxed
Listen to your body’s signals:
When you get the urge to go, don’t delay or ignore it if you can. If we skip past the urge often, it can lead to decreased overall signals and contribute to more constipation.
Seek individualized support and guidance:
If you’re experiencing chronic constipation or pelvic floor issues, pelvic floor therapy can provide personalized evaluation and treatment to address the underlying causes of your condition and achieve lasting results.
Healthy bowel function can drastically improve your quality of life if you are struggling with constipation and we are here to help!
At Root to Rise Physical Therapy & Pelvic Health, we believe in a holistic approach to physical therapy. Our Doctors of Physical Therapists are specialized in treating both orthopedic and pelvic health conditions. Our practice also integrates acupuncture and yoga and we are always excited to be a resource for the community we practice in. We are located in Scarborough, Saco, and Bath, and are here to support you!
~Dr. Jenn & The Root To Rise Team
