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constipation

Pelvic floor physical therapy addresses a host of health issues including constipation. This page will define constipation, how it is diagnosed, treated and how pelvic floor physical therapy can benefit this condition.

What is constipation?

Constipation is any dissatisfaction with bowel movements. This can mean infrequent bowel movements, incomplete bowel movements, difficulty passing stool, or straining to defecate. Constipation is a multifactorial issue and is effected by diet, water consumption, activity level, pelvic floor muscle dysfunction, medication, hormones, aging, ignoring urges, and other conditions such as irritable bowel syndrome (IBS). Constipation can also be caused by prolapse of the bladder, rectum, or uterus for females. A prolapse can compress the rectum, compacting the bowels, or create “pouches” in the rectum where stool can get stuck. Other symptoms associated with prolapse include a feeling of heaviness, a feeling of something stuck in the vagina, or need to press on perineum, vagina, or rectum to assist with defecation.

Diagnosis

A diagnosis of constipation is determined by the patient’s symptom, medical, and pharmacological history. The provider will perform a pelvic exam to assess for presence and severity of prolapse . If conditions such as irritable bowel syndrome (IBS), small intestinal bacterial overgrowth (SIBO), or inflammatory bowel disease (IBD) are suspected, patients are referred to gastrointestinal specialists for further testing.

Treatment options

  • Diet and activity modifications
  • Medication
  • Pessary (for prolapse)
  • Pelvic Floor Physical Therapy

How can pelvic floor physical therapy help with constipation?

Pelvic floor muscles play a role in bowel function. The puborectalis muscle wraps around the rectum and must be able to relax enough to allow stool to pass but also maintain enough tension to support the rectum during defecation. Both tight and lax pelvic floor muscles are dysfunctional and can impact bowel movements.

Pelvic floor physical therapy employs manual techniques, exercise programs, diet and activity modifications, and education to help resolve constipation. A technique called connective tissue manipulation releases connective tissue restrictions in areas surrounding the pelvis including abdominals, inner thighs, groin, buttock, and low back. Manual release of pelvic floor muscles (specifically puborectalis)  and relaxation exercises can help to alleviate muscle tightness. Exercises for the pelvic floor strengthen muscles and restore optimal function. Lifestyle modifications such as adjusting daily activities, diet, and water consumption can help to address underlying causes of constipation.


Contact Urology Austin to schedule a consultation with one of our pelvic floor physical therapists.