Constipation and Pelvic Floor Dysfunction

Constipation and pelvic floor dysfunction are often closely linked. Our pelvic floor is a group of muscles that support the organs in the pelvis, including the bladder, uterus, and rectum. When the pelvic floor muscles are not functioning correctly, it can lead to many problems, including difficulty passing stool and chronic constipation, pelvic pain, Incontinence, prolapse, and painful intercourse.

Up to 50% of women with constipation can also suffer from pelvic floor dysfunction. It is common but treatable. Women who suffer from constipation know how it can affect their confidence and ability to feel comfortable in many situations.

How does constipation affect the pelvic floor muscles?

If the pelvic floor muscles are too tight, they can make it difficult for stool to pass through the rectum and out of the body. Alternatively, if the pelvic floor muscles are weak or damaged, they may not be able to provide the necessary support for the rectum and anus.

When the stool stays in the rectum for an extended period, the rectal walls can become stretched and weakened, leading to a loss of sensation in the rectum, making it more challenging to feel the urge to defecate.

Pelvic floor muscle strength is essential for both bowel and bladder control. Chronic straining from constipation can lead to excessive stress on pelvic organs and nerves, weakening of the pelvic floor muscles, bladder dysfunction, and recurring accidental bowel leakage known as Mixed Incontinence.

The rectum and the bladder sit very close. If the rectum is too full it puts pressure on the bladder, reducing the amount of urine the bladder can hold. This may cause you to “leak” urine or feel as if you need to pass urine immediately or frequently, known as Urinary Incontinence.

When the pelvic floor muscles are weakened by straining to have a bowel movement, it can contribute to recurring accidental bowel leakage known as fecal or anal incontinence. 

Constipation can be a risk factor for rectocele prolapse when the rectum bulges into the vagina from weakened or damaged pelvic floor muscles. The rectum can become enlarged and filled with hard stool due to chronic constipation and increase the pressure on the pelvic floor muscles and weaken them over time.

Suggested Treatments

You can improve your pelvic floor muscle strength with exercises. In some cases, bowel training may be necessary, including learning to go to the bathroom at a particular time of day.

Increase your fibre intake to 25-35 grams per day. Fibre helps general bowel health by bulking and softening stool, making it easier to pass.

Making dietary modifications can be an effective way to alleviate constipation. Avoiding foods that can contribute to constipation (such as processed foods, dairy products, and red meat) can help regulate bowel movements.

Stay hydrated and drink at least 6-8 cups of water daily to help keep the fibre moving through your system.

While we sleep, our bowels are usually inactive. In the morning, take your time for your bowels to wake up and allow time for the body’s natural emptying reflex to kick in, which usually occurs 30 minutes after a meal or hot beverage and is the body’s automatic mechanism to move stool. 

When sitting on the toilet, you want your pelvic floor muscles relaxed as much as possible, so try to position yourself properly. Use a footstool if necessary to place your knees higher than your hips. Lean forward and support your elbows on your knees, which is also helpful. Pay attention to the relaxation of your pelvis.

I have used a squatty potty for years and recommend everyone use one. The makers of Squatty Potty claim they’ve designed a product that makes emptying the bowels easier and more comfortable by ensuring the user is squatting — not sitting — at the best angle and reducing strain. A 2019 study it noted that in countries where squatting toilets are the norm, there are fewer incidences of several pelvic-related conditions.

28-Day Buff Muff Challenge

Regular exercise can help promote bowel movements by stimulating the muscles in the digestive tract. Exercise helps to stimulate a sluggish bowel and move everything a little faster. Also, when your breath and heart rate rise, it encourages the natural contraction of intestinal muscles, which moves stools out even faster.

The 28-Day Challenge and Buff Muff Membership

I recommend checking out my comprehensive pelvic health education and fitness programs on my Buff Muff App. The most complete Pelvic Floor & Kegel exercise App to strengthen the pelvic floor.

The Buff Muff 28-Day Challenge (housed in the App) gets you started, and the Annual membership keeps you progressing so you can laugh, run, jump, and lift without the pesky leaks and annoying discomfort of prolapse symptoms.