Constipation Is Not Just Something To Live With
Chronic constipation can significantly impact your quality of life, and although very common, is rarely something we like talking about, even with our doctors.
But did you know that it is very much treatable, even if you have been experiencing it for as long as you can remember?
It is important to know that not every bowel concern has to do with the pelvic floor, and sometimes people need a medical doctor before they need us. Here is how to work out your best starting point.
When To See A Doctor First
Some symptoms mean a physician rather than a physical therapist, and it is worth putting that at the top rather than at the bottom. See your doctor first if you have a fever, blood in your urine or stool, an inability to empty your bladder, days without a bowel movement, abdominal or pelvic pain that is progressively worsening, pain that wakes you at night, or blood pressure changes alongside your symptoms.
This helps rule out medical concerns that should be addressed before starting something like pelvic floor physical therapy. Your primary care doctor may refer you to a GI specialist for further work up.
Why We Would Rather You Went There First
If you came to us with those, we would be assessing you and then sending you to a doctor anyway to rule things out. Going straight there saves you a step.
Dr. Amy Pannullo, PT, DPT, PWCS, CLT
How Does The Pelvic Floor Play A Role In Constipation?
Having a bowel movement requires that the pelvic floor muscles coordinate well and understand when to relax and when to tighten. To have a bowel movement, those muscles have to fully relax at the right moment. When they are holding too much tension, relaxing becomes difficult. That can prevent a bowel movement, or cause you to strain, which, believe it or not, makes the pelvic floor muscles tighten more.
Constipation can occur alongside other pelvic floor concerns including pelvic pain, pain with intimacy, and urinary symptoms. It can also cause fecal or gas leakage, as well as abdominal bloating and distention.
That tension often arrives through pain. The body guards what hurts, and the guarding does not stay local, which is why the constipation can persist after whatever started it has been treated.
What Treatment Involves
Treatment depends on the individual and varies with how the constipation is affecting them. Some of the strategies we use are colonic massage and other hands-on work to improve mobility of the abdominal wall and GI motility; education on fluid intake and dietary changes that may improve symptoms; instruction in proper defecation mechanics, meaning how you sit, how you breathe, and what you do with your abdomen; and strategies to reduce pelvic floor tension and improve overall coordination.
How Long Does It Take To Treat?
Chronic constipation often takes longer to treat than some other pelvic floor concerns. Where a straightforward strength or coordination problem might resolve quickly, a very chronic constipation is more often twelve to fourteen or more visits over several months, as the GI system is complicated and influenced by many factors. We will work together to tailor your program as you make progress.
New to Pelvic Floor Therapy?
We'll walk you through what to expect: what a first visit involves, what to bring, what it costs, and how a course of care usually progresses.
What to Expect ➝What About IBS?
Irritable bowel syndrome affects roughly 5 to 10% of the world population. It is diagnosed more commonly in women under 50, though it can affect anyone across the lifespan.
It is a diagnosis of exclusion, based on particular clusters of symptoms once other conditions have been ruled out. Symptoms can trend towards constipation, towards diarrhea, or fluctuate quickly. How it shows up is different for everyone.
Your symptoms can also change over time, so one thing we focus on is tracking them and learning to listen to what the body has to tell us.
People who have IBS often experience other symptoms of pelvic floor dysfunction, including abdominal bloating and distention, pelvic floor muscle tension, and urinary leakage. If you are experiencing any of these, it is worth having a conversation with a pelvic health physical therapist. Book a free call and we can talk about what you are experiencing.
References
- Oka et al., Global prevalence of irritable bowel syndrome according to Rome III or IV criteria: a systematic review and meta-analysis, The Lancet Gastroenterology & Hepatology, 2020. Reported prevalence varies with the diagnostic criteria used. https://pubmed.ncbi.nlm.nih.gov/32702295/
Worth A Conversation
Book a free 15-minute call and we can work out whether this is ours to help with.
Schedule an AppointmentBowel symptoms rarely sit on their own. These often travel with them: Tight Pelvic Floor, Chronic Pelvic Pain and Urinary Leakage & Bladder Issues.