We’ve all experienced constipation from time to time, but for some people this is a chronic condition. The pelvic floor muscles need to relax in order to have a bowel movement, if there is dysfunction with the pelvic floor muscles that can lead to serious bowel implications. The pelvic floor is a series of muscles, ligaments, and connective tissues that create a sling at the base of our trunk that support the pelvic organs including bladder, rectum, uterus, and small intestine. The pelvic floor also is responsible for controlling urination and bowel movements, aids in sexual function, and supports the core.
How are the Pelvic Floor and Constipation Connected?
In order for bowel movements to occur efficiently, the muscles of the pelvic floor must be able to relax in response to the body’s natural urge to eliminate. Problems arise when these muscles are either too weak or too tight.
1. Pelvic Floor Muscle Weakness
Pelvic floor muscles can become weak or stretched due to a variety of factors, including pregnancy and childbirth, natural effects of aging and dropping hormonal levels especially estrogen, obesity, and chronic straining as one of the number one factors!
When the pelvic floor is weak, it may not provide enough support to the rectum and anus, which can lead to a prolapse also known as a rectocele where the posterior vaginal walls actually descend into the vaginal space, it can make it difficult or impossible to eliminate stool.
2. Overactive or Tight Pelvic Floor Muscles
On the opposite end of the spectrum, pelvic floor muscles can also become too tight or overactive. When these muscles are tense, they can prevent the anal sphincters from fully relaxing in order to have a bowel movement. Tight pelvic floors can be a culprit of chronic stress and anxiety, pelvic trauma, or poor posture.
Tight pelvic floor muscles may cause discomfort during a bowel movement, a feeling of incomplete bowel movements, or the need to strain excessively to pass stool. Over time, this can also lead to prolapse and chronic constipation
Symptoms of Pelvic Floor Dysfunction Contributing to Constipation
Pelvic floor dysfunction can manifest in various ways, and its impact on bowel function may be subtle or severe. Here are some common symptoms:
- Straining during bowel movements: Difficulty passing stool even when there is a strong urge to go.
- Infrequent bowel movements: Having fewer than three bowel movements per week, accompanied by hard, dry stool.
- Incomplete evacuation: A feeling that the bowels are not fully emptied after a bowel movement.
- Painful bowel movements: Discomfort or pain during defecation, often caused by tight pelvic floor muscles.
- Abdominal bloating: A sensation of fullness or bloating in the lower abdomen, often due to the difficulty of passing stool.
Diagnosing and Treating Pelvic Floor Dysfunction and Constipation
If you are experiencing chronic constipation and suspect that pelvic floor dysfunction may be contributing to the problem, it’s important to consult a healthcare provider. This can be a pelvic floor physiotherapist. During a physiotherapy session, a physiotherapist with special training in pelvic floor can determine pelvic floor dysfunction by conducting a medical history, full body scan, rectal assessment to determine tightness and/or weakness of the pelvic floor. Once the assessment is completed treatment includes manual therapy and release, biofeedback, breath control, core strengthening, relaxation exercises, diet and lifestyle modifications including proper toileting techniques.
Conclusion
Pelvic floor dysfunction is a significant but often overlooked factor in the development of constipation. Whether caused by weak pelvic muscles, tight pelvic muscles, or coordination issues, pelvic floor dysfunction can alter normal bowel function, leading to chronic constipation and discomfort. However, with the right diagnosis and treatment plan—often involving pelvic floor physical therapy, dietary changes, and relaxation techniques—many women can experience significant improvements in their bowel function and quality of life.
If you’re struggling with constipation and suspect pelvic floor dysfunction, don’t hesitate to seek help from a pelvic floor physiotherapist. We have two on our team ready to help you out!