What are the effects of chronic constipation on the pelvic floor? Let’s begin by better understanding constipation.

What is Chronic Constipation?

Constipation is a common concern for many people and is a serious problem that affects 20 percent of people in the United States. Constipation happens on occasion to many of us, it can be infrequent, lasting only a few days, or it can happen frequently. If you have symptoms for three months or more then you are more than likely dealing with Chronic Constipation.

Interestingly, there is not a true normal for the number of times in a day or week you shoul have a bowel movement. It varies from person to person. For one person every other day is their normal and for others daily or even several times per day constitutes their usual bowel habits.


How is Chronic Constipation diagnosed?

As previously noted, most people experience short-term constipation and it can happen at any time. Constipation can take several forms, for example, straining to have a bowel movement, having less than three spontaneous bowel movements in a week, or having a sensation of incomplete emptying or bowel blockage.  If two or more of these symptoms are present for a three-month period the diagnosis is chronic constipation.

The best action to take if you have chronic constipation is to contact your physician for guidance.  I also recommend speaking to a nutritionist to  determine whether dietary changes can help the bowel to function more efficiently.


How can Chronic Constipation affect the pelvic floor?

The organs of the pelvic floor include the bladder, rectum, and uterus. Each is supported and kept in place by the muscles, ligaments, and fascia of the pelvic floor.  Since they are all in close proximity to each other the proper function or dysfunction of one can adversly affectf any of the other two.

When you strain during a bowel movement, it places undue stress on the pelvic floor muscles and can affect the strength and integrity of these muscles. There can be several consequences to chronic straining. When bowel does not easily evacuate the normal response for anyone is to give it a little help by pushing down in an attempt to evacuate.


Urine/ Bladder Leaks

Straining over an extended period of time can be damaging to the pelvic floor. Frequent downward pressure weakens pelvic floor muscles and the surrounding structures. Sufficient pelvic floor muscle strength is necessary for continence. Eliminating medical diagnoses/causes, weak pelvic floor muscle strength contributes to bladder leaks.  The muscles are not strong enough to close the urethra, the tube that extends from the bladder to the outside of the body for urination. This loss of muscle strength can lead to urine leaks or incontinence. It also makes strengthening these muscles difficult. You can perform all the right exercises to strengthening the pelvic floor but if they are followed by straining to evacuate the bowel it’s difficult to make any progress.

Pelvic Organ Prolapse

Another common consequence of chronic constipation is pelvic organ prolapse. Pelvic organ prolapse is when 1 or more of the organs in the pelvis  (bladder, rectum, uterus, cervix) slips down from their normal position and bulges into the vagina.  According to womenshealth.gov, pelvic organ prolapse affects one in five women.  Prolapse although not lifethretening can be devastating and affect your activity level and sometimes your quality of life. Look for my next article for more information on pelvic organ prolapse.

Shelia Craig Whiteman PT, DPT, CLT

Shelia Craig Whiteman

Shelia Craig Whiteman

Dr. Shelia Craig Whiteman DPT, CLT is a doctor of physical therapy and a health coach. While practicing physical therapy, she specialized in pelvic health, lymphedema, and oncology. As a health coach, Dr. Shelia is particularly passionate about helping women to reduce and stop bladder leaks.

She is the best-selling author of “To Pee or Not To Pee?” The Guide for Reducing and Eliminating Urinary Incontinence. Her second book, Stop Worrying About Bladder Leaks, further explains how and why bladder leaks can happen. As an advocate for health and wellness, she participates in several educational presentations and volunteer activities in her community.

Dr. Shelia is a certified fitness instructor and has taught fitness and pilates classes over the past 20 years. She lives with her family in Mitchellville, Maryland.

Watch Dr. Shelia’s video on Bladder Leaks here: