
CONSTIPATION
The Role of Pelvic Floor Physical Therapy in Resolving Constipation
Constipation is unfortunately much more common than most think and in many individuals it is a chronic condition they may have had since child hood. Many people may not even know they have constipation if it what they have always experienced. Constipation is when your pelvic floor has to strain to have a bowel movement. You may not know that you are straining and a pelvic floor physical therapist can assess for this. Constipation can sometimes be pain-free and thought of as "normal" and other times it can be painful and lead to fissures or hemorrhoids. If you experience persistent constipation over many months or years, this can also lead to conditions such as pelvic organ prolapse. This is where the pelvic organs undergo such excess intra-abdominal pressure that, in females, the bladder, rectum, and uterus can begin to descend downward into the vaginal canal. You could be even more predisposed to this if you have the combination of a family history of pelvic organ prolapse in conjunction with chronic constipation. Pelvic floor physical therapy can treat all the various causes of constipation for full resolution of symptoms.
Pelvic floor physical therapy for treating constipation goes far beyond the physical retraining of the pelvic floor musculature. There are usually multiple contributors to constipation due to the fact that factors such as diet and hydration play such a crucial role. Hormones, blood sugar regulation, food allergies, and even stress can be significantly exacerbate constipation. Your pelvic floor physical therapist will take a history before the physical exam that will screen for these and refer you out to other health disciplines. These other health professionals can these assess you through blood work and any other testing that may be required. These external factors that go beyond your pelvic floor physical therapy treatment must be addressed in conjunction so that you can get to the root cause and get long-lasting relief.
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You pelvic floor physical therapist will perform as physical exam which will include assessment of full body movements as well as an assessment of your spine, abdomen, and pelvic floor. An internal rectal exam will be performed in order to fully assess the pelvic floor musculature, as well the function of the internal and external anal sphincters. Through a rectal exam your pelvic floor physical therapist can help to cue and train you to perform the healthiest way for your pelvic floor to bear down for a bowel movement. In addition, you may benefit from visceral work in order to stimulate your large intestine to mobilize your bowels. Your pelvic floor physical therapist can perform this as well as teach you to perform it on yourself. Your pelvic floor physical therapist has the skills to educate you on everything from toileting posture to appropriate strategies for bearing down to diet/nutrition, pelvic floor muscle coordination, and any other habits or functional activities that may be contributing to the constipation.
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If you have suffered from constipation, or did not even know you suffered from it, you are now aware of what pelvic floor physical therapy can do to resolve it once and for all!