When most people think about constipation, they often blame diet, hydration, or a sedentary lifestyle, and rightly so. However, there’s another cause that often goes undiagnosed: pelvic floor dysfunction (PFD).
If you’ve tried fiber, water, and laxatives without success, your pelvic floor might be playing a role in your digestive troubles.
What Is Pelvic Floor Dysfunction?
Your pelvic floor is a group of muscles and ligaments that support your bladder, rectum, uterus (in females), and prostate (in males). These muscles are crucial for maintaining continence, aiding sexual function, and importantly controlling bowel movements.
Pelvic floor dysfunction occurs when these muscles don’t function as they should. They may be too tight (hypertonic), too weak (hypotonic), or not coordinate properly.
The Connection Between Pelvic Floor Dysfunction and Constipation
To understand the link, let’s look at how a normal bowel movement happens.
When you feel the urge to go, your rectum fills with stool. The puborectalis muscle, which wraps around the rectum like a sling, should relax to allow stool to pass. At the same time, the anal sphincters also need to relax while abdominal muscles contract to push the stool out.
In people with pelvic floor dysfunction, these muscles don’t relax or coordinate properly. This leads to a type of constipation called dyssynergic defecation, where the muscles are actually contracting instead of relaxing during a bowel movement.
Signs of Dyssynergic defecation:
- Incomplete emptying: Stool doesn’t fully exit the rectum.
- Straining: Repeated effort is needed, which can lead to hemorrhoids or rectal prolapse.
- Delayed transit: Poor coordination slows down stool movement through the colon.
- Using your fingers to help pass stool (e.g., pressing on the perineum or vagina)
- Having to change positions on the toilet to defecate
- Chronic constipation that doesn’t improve with diet changes or laxatives
- A sensation of blockage or obstruction in the rectum
If these sound familiar, it may be time to talk to a pelvic health specialist.
Treatment
The good news? Pelvic floor dysfunction is treatable!
1. Pelvic Floor Physical Therapy
This is the gold standard for treating PFD-related constipation. A specially trained therapist will help you:
- Learn how to relax and coordinate pelvic muscles
- Use biofeedback to retrain muscle patterns
- Perform stretches and exercises tailored to your needs
2. Behavioral and Lifestyle Modifications
- Timed toileting and bowel retraining
- Proper toileting posture (a footstool can help mimic a squatting position)
- Stress reduction, which can affect muscle tension
- Diet adjustments.
Pelvic floor dysfunction is an often-overlooked but very real cause of chronic constipation. If you’re dealing with persistent bowel issues and traditional treatments haven’t worked, your pelvic floor may be to blame.
You don’t have to live with chronic constipation. With the right approach, relief is possible.
Looking to optimize your well being with pelvic floor physical therapy? Reach out to us at Pelvic Health Center in Madison, NJ to set up an evaluation and treatment! Feel free to call us at 908-443-9880 or email us at [email protected]