What Is Constipation?
Do you find yourself sitting on the toilet for long periods of time? Do you rely upon over-the-counter stool softeners, laxatives, or fiber to have a bowel movement? Is passing a bowel movement painful, or do you find yourself straining excessively to fully empty your bowels? You may be suffering from constipation, a condition affecting millions every day.
Constipation simply refers to difficulty with emptying one’s bowels, although technically it can be categorized into more specific types (such as slow transit, functional, or idiopathic). Constipation is something every person has likely experienced before, although occasional constipation is not typically a major cause for concern.
However, those who experience constipation frequently may have underlying causes putting them at higher risk of chronic constipation. Long-lasting struggles with constipation can be very frustrating and distressing, so treatment should definitely be considered for those who often struggle in the restroom.
Constipation may sound like a simple condition, but it can actually vary from person to person and have varying symptoms. Some symptoms one may experience with constipation include:
- Hard, painful stools that are difficult to pass
- Incomplete bowel movements
- Straining or pain with bowel movements
- Infrequent bowel movements
- Feeling a sensation of blockage or fullness in the rectal area
- Fullness or bloating
- Abdominal pain or discomfort
- Fatigue or lethargy
- Needing to use fingers or tools to allow stool to pass
As mentioned earlier, having constipation once in a while isn’t always a major issue, as factors such as traveling, diet, water intake, and stress can cause occasional constipation. However, experiencing any of the above-mentioned symptoms regularly can be a sign of a more significant underlying issue. We’ll talk more about the causes of constipation below.
What Causes Constipation?
Constipation is often the result of multiple contributing factors. Things like medications, supplements, diet, and lifestyle choices can all impact your bowel movements. For example, not having enough water intake or fiber in your diet can make bowel movements difficult. Those who do not engage in regular physical activity may be at a higher risk of constipation as well.
Factors outside of lifestyle choices can play a role in bowel health, too. Those experiencing hormonal changes, such as with menstruation, menopause, or pregnancy may experience bowel changes. There are also many conditions that can affect bowel movements, such as hyperthyroidism, Crohn’s disease, IBS, and IBD.
Then there’s pelvic floor dysfunction—something that is often forgotten, but can be a major cause and contributor to constipation.
Constipation and the Pelvic Floor
The pelvic floor is a group of muscles that are positioned a bit like a hammock or bowl in your pelvis. While you may not realize that it is there, the pelvic floor is supporting your body and a variety of functions each and every day! Not only does the pelvic floor support your organs and upper body weight, but it also allows for urinary, bowel, and sexual function.
To allow for continence of the bladder and bowels, this important muscle group must contract, relax, and most importantly, coordinate between these two motions! In other words, the pelvic floor contracts and relaxes to allow you to pass stool or urinate at will.
Unfortunately, the pelvic floor can experience dysfunction, meaning that these functions are disrupted. Pelvic floor dysfunction means your pelvic floor is too tight, weak, inflexible, or uncoordinated, and therefore cannot function as normal. This can make bowel movements very difficult, resulting in constipation that may become chronic if left untreated.
Not only can pelvic floor dysfunction can cause constipation, but constipation can contribute to straining and tension that causes pelvic floor dysfunction, too. This cycle can actually worsen your overall experience with constipation and may create other complications, which is why treatment is so important. This just really shows how interconnected your bowel movements are with your pelvic floor health!
The pelvic floor is interconnected with more than just your bowels. Unfortunately, this means there are many other causes of pelvic floor dysfunction outside of constipation. If you’d like to learn more about these causes, check out the pelvic floor dysfunction page!
The good news is that pelvic floor dysfunction and constipation are both very treatable with pelvic floor physical therapy, which we’ll discuss next.
How Pelvic Floor Physical Therapy Can Help
You may be thinking, “Why a physical therapist? I thought they only looked at my neck, shoulders, or back.” There are actually physical therapists that specialize in these areas and more—including the pelvic floor! We are known as pelvic floor physical therapists.
Pelvic floor physical therapists are trained on the body just as any other physical therapist, but we go through extra training, education, and practice. This allows us to assess the impact of various behaviors, medications, and diseases on the pelvic floor. In other words, we are experts of the entire pelvic area, including your hips and bony pelvis, which can contribute to symptoms like constipation!
While pelvic floor dysfunction is a very common condition, it is often overlooked or underdiagnosed. In some cases, you may even have to seek a professional out for yourself. However, for many, many people, seeing a pelvic floor physical therapist is a major game changer for their long-term health!
If you’d like to know more about what it could be like to work with me, a pelvic floor physical therapist, keep reading! Thanks to my many years of training, education, and experience, I can identify pelvic floor dysfunctions such as weakness, tightness, inflexibility, and incoordination. I can help you understand your symptoms, and how they relate to your medical history, pelvic floor condition, lifestyle, and more.
With all of these details considered, I will create a comprehensive plan of care just for you, which will look to relieve tension, improve strength, and restore coordination in your pelvic floor. These goals will lead to easier bowel movements, less pain, and less symptoms overall! Let’s take a closer look at what this care plan could look like:
Evaluation & Treatment
Your first session will start with an evaluation. This evaluation process will include a discussion of your symptoms, medical history, and various aspects of your bowel health. This evaluation process lets me better understand your unique symptoms and individual needs!
In addition to a look at your past medical histories, your evaluation questions may include how long you have experienced constipation, which medications (prescribed or over-the-counter) are you taking, how much fluid you are consuming, and what your activity level is.
You may be asked to answer questions about the consistency (soft, smooth, hard, or lumpy) and frequency of your bowel movements, as well as whether you experience specific symptoms such as pain with bowel movements, excessive straining, or a sense of not fully emptying your bowels.
In some cases, your evaluation may include an examination, which can be both external and internal. Examinations are only done with your consent, and you are always in control! Don’t avoid treatment out of fear of examinations—I can always work with your comfort level.
While you’ll never be expected to participate in any examination or treatment without consent, it may help to understand the purpose of the process. The examination process can provide helpful information about your pelvic floor and its condition, which would be used to determine what treatments you might benefit most from.
Here’s what an examination could look like:
During an examination, I will typically look at the patient’s pelvic floor and observe how it moves when they breathe, relax, or contract. I may gently palpate the pelvic floor muscles to see if they are tight and tender, or soft and supple. Depending on the situation and the patient’s comfort level, I might also complete an internal assessment of the pelvic floor muscles to check for tightness or tenderness, and to evaluate their control over these muscles.
Once I have a solid understanding of a patient’s pelvic floor health, medical history, and care needs, I’ll develop a treatment plan specific to those needs. This treatment plan might be carried out over several sessions and may include a variety of hands-on techniques, such as:
- Manual therapies to aid in muscle relaxation and improve muscle awareness
- Behavioral modifications (fluid intake, toilet habits, and more)
- Exercises to help strengthen the pelvic floor
- Breathing techniques to reduce tension and stress
- Treatments to improve pelvic floor coordination
While seeing a pelvic floor physical therapist for constipation might feel a little embarrassing, I want to assure you that seeing treatment for long-term health and comfort is very worth it. I always try my best to create a shame-free treatment environment so that my patients can feel safe, motivated, and confident.
I also provide instruction and resources to continue your care at home, such as exercises, modifications to daily behaviors, and other strategies. Consistency and practice is the best way to see solid results and an improvement in your symptoms!
If you’re ready to get started with pelvic floor physical therapy, get started by making an appointment! I offer appointments both in-person and virtually, and welcome patients of all ages and gender identities. If you have any other questions about appointments or treatment, feel free to try out the discovery call.
