Constipation is common, with up to 27% of the US population experiencing chronic constipation. Many people have a general idea on how to manage their constipation and understand that diet and exercise are key, but most don’t understand how to tailor these general concepts to their individual circumstance.
With so much information available out there to self-diagnose and endless supplements to self-treat constipation, it can be confusing to know what may work best for you. Many people try dozens of different products with minimal relief, which can feel discouraging and leave them wondering what they are missing.
Constipation is not always as simple as “eat more fiber” or “drink more water.” While fiber, fluid intake, and exercise are important, chronic constipation can also be affected by how well the pelvic floor muscles are relaxing, coordinating, and supporting bowel movements. This is why two people can do the same general things and have very different outcomes.
Constipation experienced chronically is not only frustrating, it can have a detrimental impact on mood, mental health, daily routines, and overall quality of life. It can make people feel uncomfortable in their body, worried about leaving the house, or unsure of what their body is going to do day to day. If not managed appropriately, constipation symptoms can worsen over time and may lead to further pelvic floor dysfunction symptoms.
When constipation is ongoing, the body can start to develop patterns around it. Some people strain more often, hold tension in their abdomen or pelvic floor, avoid going when they feel the urge, or become dependent on certain habits or products to have a bowel movement. Over time, these patterns can make it harder for the body to return to a more natural and consistent rhythm.
Pelvic health therapists are uniquely trained to assess how the muscles of your pelvis may be affecting constipation symptoms and guide specific exercises and habit changes that can make all the difference.
The pelvic floor muscles play an important role in bowel movements. These muscles need to be able to both support and relax at the right time. If the muscles are too tense, weak, uncoordinated, or not relaxing well, it can make it harder to fully empty the bowels. This can contribute to straining, incomplete emptying, bloating, discomfort, and the feeling that you still need to go even after you just went.
A pelvic health therapist can help look at the bigger picture. This may include your bowel habits, toileting posture, breathing mechanics, abdominal pressure, pelvic floor coordination, exercise routine, fiber and fluid intake, and any patterns that may be contributing to symptoms. Instead of guessing which product or supplement to try next, pelvic health therapy can help you better understand what your body specifically needs.
SIMPLY, it comes down to three different things:
Fiber/fluid intake: adequate fiber and hydration are KEY for healthy bowel movements. Fiber helps add bulk and consistency to stool, while fluid helps keep stool easier to pass. However, more is not always better for every person. Some people need to increase fiber slowly, some need more fluids, and some may need to adjust the type of fiber they are eating. The goal is to find what works best for your body and your symptoms.
Exercise: movement helps support digestion and bowel regularity. This does not mean you need an intense workout routine. Walking, strength training, mobility work, and consistent daily movement can all help support bowel function. Exercise also helps with circulation, abdominal mobility, stress management, and overall pelvic floor function.
Pelvic floor function: the pelvic floor muscles need to coordinate properly for bowel movements to happen comfortably. If the muscles do not relax well, or if they tighten when they should be lengthening, constipation can become harder to manage with diet and exercise alone. Learning how to breathe, relax, coordinate, and use the pelvic floor muscles appropriately can be a key missing piece.
For many people, constipation management is not about trying harder. It is about getting more specific.
If you have been increasing fiber, drinking more water, taking supplements, exercising, and still feeling stuck, your pelvic floor may be part of the reason. Pelvic health therapy can help you understand the “why” behind your symptoms and give you a plan that is specific to your body, your habits, and your goals.
Constipation is common, but that does not mean you have to keep living with it or guessing your way through it. With the right guidance, small and specific changes can make a big difference.
Shana Hoke, PT, DPT, CLT
Specialist in Pelvic Health Physical Therapy
Better With Physical Therapy, Madison, NJ
(973) 791-8337