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Did you know that chronic constipation is often linked to a weak pelvic floor? Strengthening your pelvic floor muscles through targeted exercises can help restore normal bowel movements and significantly reduce the symptoms of constipation.
The management of chronic constipation involves a range of approaches, including dietary changes, lifestyle modifications, and medical treatments, in addition to pelvic floor exercises.
In this guide, we’ll explore how pelvic floor exercises can improve chronic constipation in adults, how to recognize constipation symptoms, and what treatment options—like biofeedback therapy—can help you regain control of your digestive health.
Understanding Bowel Movements: What’s Normal?
Bowel movements are a critical marker of digestive health. The frequency, consistency, and ease of your bowel movements can reveal much about your gastrointestinal system. In clinical practice, both stool frequency and stool form are important markers used to assess bowel health.
Healthy Bowel Movements Typically Involve:
- 1–3 movements per day or every other day (individual variations are normal)
- Smooth, soft stools (like a sausage or snake)
- Minimal straining or urgency
- A sense of full evacuation
Disruptions in this routine—especially infrequent or difficult bowel movements—may indicate chronic constipation or underlying bowel disease.
What Is Chronic Constipation in Adults?
Chronic constipation in adults is a long-term condition marked by difficulty passing stool, hard or dry stools, and a sense of incomplete evacuation. It affects millions and becomes more common with age, especially in women and people with sedentary lifestyles. The prevalence and risk factors of chronic constipation include demographic factors such as age and gender, as well as lifestyle factors like low physical activity and poor dietary habits. Functional constipation is a primary form of constipation that occurs without secondary medical causes, while idiopathic constipation and chronic idiopathic constipation refer to cases where no clear underlying cause can be identified.
Common Chronic Constipation Symptoms Include:
- Fewer than three bowel movements per week
- Hard, dry, or lumpy stools
- Painful defecation
- A feeling of blockage in the rectum
- A sense that you can’t completely empty your bowels
Causes and Risk Factors for Chronic Constipation
Chronic constipation doesn’t have a single cause—it’s often the result of several overlapping factors. One of the most common risk factors is a low-fiber diet, which can slow down the movement of stool through the digestive tract. Not drinking enough fluids and leading a sedentary lifestyle can also contribute to sluggish bowel habits.
Certain medical conditions, such as irritable bowel syndrome (IBS), diabetes, and hypothyroidism, are known to increase the risk of developing chronic constipation. Medications are another important consideration; blood pressure medications, opioid painkillers, and some antihistamines can all slow colonic motility and worsen constipation symptoms.
Other risk factors include being over the age of 65, female gender, and a personal or family history of constipation, especially if it began in childhood. Recognizing these risk factors is key to identifying patients who may benefit from early intervention and targeted strategies to treat constipation before it becomes severe.
Diagnosis and Testing: How Is Chronic Constipation Identified?
Diagnosing chronic constipation starts with a thorough review of your symptoms and medical history. Patients with chronic constipation often report infrequent bowel movements, hard or lumpy stools, and difficulty passing stool. Your healthcare provider will likely perform a physical examination, which may include a digital rectal examination. This can help to check for issues like rectal prolapse or faecal impaction.
To rule out more serious conditions such as colon cancer or inflammatory bowel disease, your doctor may recommend diagnostic tests like colonoscopy, sigmoidoscopy, or imaging studies. Specialized tests, such as anorectal manometry or the balloon expulsion test, can help assess how well your pelvic floor muscles and rectum are functioning and identify problems like dyssynergic defecation.
A diagnosis of chronic constipation is typically made when you experience two or more of the following:
- Straining during bowel movements
- Hard or lumpy stools
- A sensation of incomplete evacuation
- Fewer than three bowel movements per week.
These diagnostic steps help ensure that any underlying bowel disease is identified and that your treatment plan is tailored to your specific needs.
The Link Between Constipation and the Pelvic Floor
When you strain repeatedly to pass stool, you may unknowingly damage your pelvic floor muscles. These muscles support your bowel, bladder, and reproductive organs. Over time, excessive pressure can lead to pelvic floor dysfunction, which worsens constipation instead of relieving it. Pelvic floor dysfunction can result in evacuation disorders, where impaired coordination of the rectal and pelvic floor muscles makes it difficult to evacuate stool. It is also often associated with anorectal disorders—structural or functional problems in the anorectal region—that further impair normal stool passage.
How Pelvic Floor Dysfunction Affects Bowel Health:
- Impairs coordination needed for proper colonic transit (movement of stool through the colon)
- Disrupts the relaxation and contraction of anal and rectal muscles
- Increases risk of faecal impaction, a severe form of blockage where hardened stool becomes stuck in the rectum
Pelvic Floor Exercises for Chronic Constipation Relief
Pelvic floor exercises, often called Kegels, involve clenching and releasing the muscles that control urination and defecation. When done correctly, they help restore proper function and coordination of the pelvic muscles, improving chronic constipation over time.
However, identifying the correct muscle group is key. Without proper guidance, these exercises may be ineffective.
Biofeedback Therapy for Chronic Constipation
While pelvic floor exercises are a powerful first step, many patients achieve even greater success when combining them with biofeedback therapy—a highly effective, evidence-based approach that helps retrain the muscles for smooth, coordinated bowel movements. The effectiveness of biofeedback therapy is often measured by clinical response, which includes improvements in symptoms and increased bowel movement frequency.
What Is Biofeedback Therapy?
Biofeedback uses sensors and computer-guided visual or auditory feedback to help patients retrain pelvic muscles. During the session:
- You’ll learn to identify and relax the appropriate muscles
- You’ll receive real-time feedback on how well you’re performing the exercises
- Therapists will guide you to improve coordination for smoother bowel movements
This therapy has shown significant success in treating chronic constipation in adults, especially when linked to pelvic floor dysfunction.
When to Seek Professional Help:
If you’re unsure how to activate your pelvic floor muscles or aren’t experiencing relief, it’s essential to consult a trained physical therapist. At PELVIS.NYC, Dr. Adam Gvili PT, DPT, customizes treatment plans for each patient, using evidence-based techniques including biofeedback therapy, manual therapy, and behavioral training.
Other Causes of Constipation to Consider
Irritable Bowel Syndrome (IBS) Irritable bowel syndrome, particularly IBS-C (constipation-dominant), is a common functional gastrointestinal disorder that leads to abdominal pain, bloating, and irregular bowel habits.
Inflammatory Bowel Disease (IBD) Unlike IBS, inflammatory bowel disease involves structural inflammation of the digestive tract and includes conditions like Crohn’s disease and ulcerative colitis. Though more commonly associated with diarrhea, some forms can cause chronic constipation.
Bowel Disease and Colonic Transit Slow colonic transit is a key factor in many forms of bowel disease. A sluggish colon may prevent the movement of stool, leading to constipation that’s unresponsive to diet or fiber alone.
Diet and Lifestyle Tips for Constipation in Adults
A well-balanced diet rich in dietary fiber plays a significant role in managing constipation. Aim for 25–30 grams of fiber daily from whole grains, fruits, and vegetables. Adequate fluid intake is also essential for maintaining normal bowel movements and preventing chronic constipation.
A high fiber diet and dietary fiber treatment are considered first-line strategies for managing chronic constipation, with soluble fiber (such as psyllium) being particularly effective in improving symptoms. Hydration and regular physical activity are also crucial.
- Use stimulant laxatives only as directed by a healthcare provider and never for weight loss, as they do not promote actual weight reduction.
If you experience unintentional weight loss or fecal incontinence, these may indicate more serious underlying conditions and should prompt medical evaluation.
Additional Tips:
- Avoid over-reliance on laxatives
- Stay hydrated with at least 8 glasses of water per day
- Schedule time for daily, unhurried bowel movements
- Use a footstool to elevate your knees while on the toilet for optimal alignment
Preventing Complications of Chronic Constipation
Taking steps to prevent complications from chronic constipation is essential for long-term digestive health. Simple lifestyle changes, such as increasing your intake of high fiber foods, drinking plenty of water, and staying physically active, can help relieve constipation and reduce the risk of more serious problems. Avoiding foods that can worsen constipation—like processed foods and excessive dairy—while focusing on dietary fiber can make a significant difference.
Medical treatments, including stool softeners, over the counter laxatives, or pelvic floor therapy, may be recommended if lifestyle changes alone aren’t enough. Addressing underlying health issues, such as diabetes or thyroid disorders, and managing stress through relaxation techniques can also help prevent complications.
By staying proactive, you can lower your risk of developing issues like rectal prolapse, faecal impaction, or even colorectal cancer. Regular check-ins with your healthcare provider ensure that your symptoms are monitored and your treatment plan is adjusted as needed, helping you maintain healthy bowel habits and overall well-being.
When to Worry: Faecal Impaction and Severe Cases
In severe or untreated cases of chronic constipation, faecal impaction may occur, requiring urgent medical intervention. Symptoms may include nausea, vomiting, rectal bleeding, and inability to pass gas or stool. If you suspect this condition, seek professional care immediately.
In cases of severe or persistent constipation, colorectal cancer screening may be recommended to rule out serious underlying conditions.
Let Us Help You Break the Cycle
At PELVIS.NYC, we understand that no two cases of constipation are alike. Whether your symptoms stem from a weak pelvic floor, slow colonic transit, or a functional bowel disease, our approach is personalized and effective. We evaluate and treat conditions affecting the colon and rectum, including subtypes such as normal transit constipation and slow transit constipation.
Ready to Start Healing?
Book a free 15-minute teleconsultation with Dr. Adam Gvili today and begin your journey toward digestive health.
Final Thoughts
Chronic constipation in adults is more than just an inconvenience—it’s a signal that something in your digestive or pelvic system may be off-balance. With the right diagnosis, a tailored therapy plan, and consistent support, you can restore normal bowel movements and take back your quality of life.
Related blog: Addressing Sudden Urge to Poop in Men
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