It’s not always stress or your diet that causes constipation. Sometimes it’s your pelvic floor.

Everyone experiences a certain amount of constipation from time to time, and it can occur for a number of different reasons including poor fluid intake, a low fibre diet, stress, lack of mobility and the menopause. If you suffer with constipation frequently and have worked on your diet, fluid intake and exercise levels, all to no avail, the cause may be excessive tightness and tension in the pelvic floor. Persistent tension encourages your body to store faeces in the rectum, leading to constipation and difficulty emptying the bowel. Haemorrhoids and anal fissures are often a sign of pelvic floor tension, particularly if you’ve had more than one episode.

To empty your bowel effectively the pelvic floor must relax and stretch to allow the rectum to open fully. If the pelvic floor doesn’t relax fully, you have to strain to empty the bowel, increasing pressure in the rectum and inflaming the blood vessels and rectal tissue. Rectal bleeding after a bowel motion and pain when emptying the bowel are highly suggestive of a pelvic floor dysfunction.

One of the ways of encouraging the pelvic floor to relax when emptying the bowel is to place a stool under your feet to raise the knees higher than the hips. Sitting with your hips and knees at 90 degrees (as we would on a standard western toilet) means that faeces must pass around a natural kink or angle in the bowel. Straightening this angle by raising the knees and adopting a more squat-like position straightens this angle and removes much of the need to strain, allowing us to have a natural, gravity-assisted bowel motion. You can buy a specially designed ‘Squatty Potty’ that fits around your toilet and ensures the feet rest at the desired height. Emptying the bowel in this way reduces pressure on the pelvic floor, reducing the risk of prolapse and pelvic floor dysfunction in later life.

While this may help, it will only be a partial solution. The goal should always be to reduce tension in the pelvic floor and resolve constipation long-term, and this is where pelvic health physiotherapy can offer an effective and lasting solution.

A full assessment of the pelvic floor is required to establish the cause of the tension and develop an appropriate treatment plan. Proven and effective treatment methods include tailored pelvic floor stretching, relaxation techniques, manual therapy, bowel emptying techniques and pelvic floor and abdominal strengthening.

If you’d like to speak to one of our specialist Women’s Health Physiotherapists, please complete the following enquiry form and we’ll contact you to arrange a convenient time.

Self-paid pelvic floor consultations can also be booked online.

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