How Constipation Affects Your Pelvic Health

Constipation is a symptom that many of my patients with back pain and/or pelvic floor dysfunction experience. Sometimes patients are coming in because of bowel dysfunction, but more often than not I am seeing them for something else and as we work through their intake form, we find that constipation could be contributing to their symptoms. In this blog post, we’re going to dive into how to why constipation happens, how to know if you’re constipated, and how constipation can affect your pelvic health.

Why constipation happens

Food is moved through your digestive tract by muscle contractions in the colon. As it moves through the colon, it is broken down and water is absorbed by your intestines. By the time food reaches your rectum, it is solid due to most of the water being absorbed. However, if too much water is absorbed due to factors like dehydration or slow muscle contractions in the colon that slows down transit, your stool can become hard and dry.

Some common factors that can contribute to constipation include:

1)    Nutritional factors such as a lack of fiber and dehydration

2)    Lack of physical activity

3)    Medications

4)    Abuse of laxatives

5)    Specific diseases or conditions (including some neurological disorders, metabolic and endocrine conditions, and systemic disorders such as lupus and scleroderma)

6)    Problems with colon function

7)    Ignoring the urge to have a bowel movement 

Signs that you are constipated

Symptoms can vary from person to person, but the clinical diagnosis is having 2 or more of the following symptoms for at least 12 weeks (does not have to be consecutive weeks) in the previous 12 months.

1)    Less than 3 bowel movements per week. I think most people think of frequency of bowel movements as being a defining factor in whether or not that are constipated. However, frequency of bowel movements can vary quite a bit from person to person. You can have a bowel movement daily and still be constipated, or you may only go every other day and not be constipated. It really depends on some of the other factors on this list – frequency is just one thing to consider.

2)    Straining during bowel movements – breath holding, bearing down, and pushing hard to pass stool.

3)    Lumpy or hard stool – stool that comes out in small pieces, is hard, and/or is difficult to pass.

4)    Sensation of incomplete evacuation – feeling like you have not fully emptied your rectum.

5)    Sensation of anorectal blockage/obstruction – feeling like there is a blockage preventing the passage of stool.

How constipation can affect your pelvic health

Straining can affect your pelvic floor muscles. If you are holding your breath and bearing down to have a bowel movement, you are creating a lot of intraabdominal pressure and putting a lot of pressure on your pelvic floor muscles. This may actually cause your pelvic floor muscles to tighten, rather than lengthen, making it harder to pass stool.

Tightness in the posterior pelvic floor muscles can lead to symptoms such as tail bone pain, low back pain, and even hip pain. Straining can also lead to anal fissures or hemorrhoids, which can be painful and make having bowel movements even more challenging.

So what should you do?

If you have read this far and think you may be constipated, check out this blog on simple tips to reduce constipation.

If you want to dive deeper with a one-on-one assessment, schedule your free 15-minute phone consult here to get started.

Blog post written by Dr. Alexis Hutchison, PT, DPT, OCS