The Answer to Constipation is Not Always Fiber and Laxatives

Nearly 30% of the US population experiences constipation. While some causes involve diet, hydration, stress, and even which medications you may be taking, an often-overlooked source is the function of the pelvic structures themselves.

The pelvic floor does much more than stop us from peeing our pants and providing contributions to sexual function. The muscles of the pelvic floor have a vital role in defecation, in that they need to relax and react in a way that will let a bowel movement pass through. If you are experiencing what is called “Dyssynergic Defecation”, passing poop may be really difficult and uncomfortable, and it’s likely because your pelvic floor muscles are not functioning properly.

So what does this term mean to you?

Dyssyngergic defecation is a type of functional constipation (there are many different types of constipation) and is characterized by the inability to relax the external anal sphincter muscle when producing a bowel movement.

It is often associated with the following signs/symptoms:

- Having to strain/bear down to push out stool.

- Usually associated with hard/lumpy stools.

- Sensation of incomplete emptying.

- Feeling of blockage or feeling the need to manually assist stool out of the rectum (“digitation”) or support the perineum (“splinting”).

Other symptoms that are usually related to this form of constipation include:

- Urinary frequency, urgency, bladder pain, urge incontinence, etc.

- Dyspareunia or “post-coital ache”

- Low back pain that may or may not radiate to the groin/thighs

- Pelvic pain

How does physical therapy help with constipation?

While we often hear people talk about increasing fiber, taking probiotics, drinking more water, etc. If the true cause of the constipation is how the muscles are actually functioning, these things will only do so much. Don’t get me wrong, I suggest all of these tips as well if I find that they could be contributing to a person’s symptoms, but we need to actually get to the root cause of what you’re experiencing.

The good news? Since all of the above symptoms are associated with a dysfunction in the pelvic floor muscles, often working through the pelvic floor dysfunction addresses all of the symptoms.

If you have been experiencing constipation, pelvic pain, urinary urgency/incontinence, painful intimacy, reach out to tyler@absolutekineticspt.com to learn more about how pelvic health PT can help you.

Written by Dr. Tyler Kornblum, PT, DPT, ATC