Is Your Poop REALLY A Pelvic Floor Issue?
Did you know that constipation is one of the most common GI complaints in the US?
Constipation is defined as having a bowel movement fewer than three times per week. It can also include stomach pain, difficulty or straining to poop. Occasional constipation happens to everyone. Chronic constipation can be a sign of a more serious problem. Many women have difficulty with bowel movements even if they do occur more than 3 times per week. Symptoms can be hard, painful stools, difficulty to start pooping, or an overwhelming urge to poop. Fecal incontinence is the inability to hold in your stool. It often goes hand-in-hand with chronic constipation. It can result in a minor amount of stool leakage or a larger amount, and can vary in consistency. This can be a frustrating and embarrassing problem and which often causes great emotional distress.
Common Treatment of Constipation
Standard medical treatment of constipation includes increased fluids and fiber. Experts recommend upwards of 20-30 g of fiber per day for adults. Also, increasing exercise and avoidance of constipating medications and foods. In some cases use of laxatives will often give relief from constipation.
However, there is another common underlying factor that is harder to treat. The condition which goes hand-in-hand with constipation is dyssynergic defecation, or sphincter dyssynergia. A person feels an urge to have a bowel movement, but when they sit down on the toilet, they can’t get the poop to come out.
This study found that upwards of 40% of people with chronic constipation are dealing with underlying dyssynergic defecation. That’s a big deal! Telling someone who’s been dealing with years of constipation to “add more fiber” is not going to fix the problem.
The study found that two thirds of patients with difficult defecation also had decreased gut motility. They did not respond to increased fiber intake. Those without decreased gut motility had improvement in their constipation with more fiber. Those 2/3 of patients who had decreased gut mobility show that there is definitely an overlap between constipation and dyssynergic defecation. People struggling with dyssynergic defecation will not respond to simple treatments. This is where pelvic floor therapy comes in.
Your colon and pelvic floor muscles work together for easy bowel movements. The colon should contract and then the pelvic floor muscles relax to allow the stool to pass easily. In contrast, someone struggling with dyssynergic defecation will experience the opposite. The colon contracts then pelvic floor muscles tighten and close the anal sphincter. People struggling with this often have no idea they are tightening their pelvic floor muscles!
Another study looked at the use of a biofeedback device in treating dyssynergic defecation. Again they found that conservative measures did not work. They found that clients with or without IBS who also had dyssynergic defecation benefited from use of biofeedback as treatment. Biofeedback training is the treatment of choice for dyssynergic defecation in chronic constipated adults.
So how do we treat constipation in pelvic floor therapy?
There are a variety of treatment options pelvic floor therapist utilize. Your pelvic floor therapist will determine if behaviors and habits need adjusted. They will also determine if your pelvic floor muscles are working in coordination. Pelvic muscle strength and tightness will also be assessed. Your therapist will also check to see if you can relax your pelvic muscles. All these things can help determine which treatments would be best for YOUR unique needs.
Besides muscle coordination and strength, positioning for bowel movements is important. Use of a stool to promote a squatting position as well as wide-knees is the optimal position for a bowel movement. We’ve all seen the Squatty Potty video, but I’ll link to it in case you need a laugh 🙂
Don’t settle for poor GI health!
Our GI health is so critical to our daily sense of well-being, as well as our underlying physical health. It can be easy to accept that “I’ve always struggled with constipation.” Fully treating constipation or other GI difficulties can be challenging. Taking a multidisciplinary approach including your physician or homeopathic doctor, nutritionist as well as a pelvic floor therapist can give your body the opportunity to finally heal, even if you’ve been struggling with constipation for years. It’s worth it!
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Getting Started Is Easy
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Step 1 - Book a free 30 minute in-person discovery session
Step 2 - Meet your therapist and see if we would be a good fit for each other!
Step 3 - Schedule your first 90 minute PT session - and get ready to regain control and feel your best again.
