Understanding Constipation

Research suggests that over 4 million people in the United States have frequent constipation. It is three times more common in women than men and it has a marked increase after the age of 65. Constipation is most frequently observed in people living in the South than anywhere else in the United States. Approximately 900 people die annually from diseases associated with or related to constipation. 

There are two different types of constipation: general constipation and outlet constipation. Both can negatively impact the pelvic floor. General constipation occurs when the muscles of the large intestine (the colon) have problems with peristalsis, which are waves of muscle contractions that move waste out of the body to form stool. This causes waste to move very slowly or not at all. Several factors can lead to general constipation such as limited fluid or fiber intake, imbalances in diet (increased sugar and animal fat), lack of exercise, lifestyle changes such as pregnancy and travel, certain medications (opiates), or improper use of laxatives. Outlet constipation occurs when the stool is stuck in the rectum, which is usually due to the dysfunction of the pelvic floor muscles. If the pelvic floor muscles in the rectum are too tight and unable to relax, it becomes difficult for stool to be passed. This can lead to straining during bowel movements which causes the muscles to tighten even further. 

How does constipation affect pelvic floor muscles?

Pelvic floor muscle strength is important for both bowel and bladder control. Chronic straining from constipation can lead to weakening of the pelvic floor muscles, excessive stress on pelvic organs and nerves, as well as bladder dysfunction and recurring accidental bowel leakage. 

How does constipation affect the bladder?

The rectum is very close to the bladder. When the rectum is overfull (due to constipation), it can press on the bladder, reducing the amount of urine the bladder can hold. This may cause you to actually “leak” urine or make you feel as if you need to pass urine right away or frequently.

Treating Constipation

• Increase fiber intake 
• Allow extra time in the morning 
• Mild-moderate physical activity
• Positioning on the toilet 
• Pelvic floor rehabilitation

Toilet Positioning:

• Position your knees higher than your hips
• Lean forward and put your elbows on your knees
• Exhale and use your abdominal muscles to gently push stool out 
• Relax your anus 

If you’re struggling with constipation, call us at (318) 396-1969 and speak to one of our pelvic floor therapists to see how we can help.