Effects of chronic constipation on the pelvic floor
What is Chronic Constipation?
Constipation is a common concern for many people. It is a serious problem which effects up to 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. Chronic constipation is diagnosed when it has been present for three months or more. There is not a true normal for how many times in a day or week someone has 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, chronic constipation is diagnosed.
The best action to take if you have chronic constipation is to contact your physician for guidance. Advise from a nutritionist can sometimes also be valuable to determine if 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. They are all in close proximity and therefore the action or dysfunction of one can affect the function of any of the other two. When one strains 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 and weaken pelvic floor muscles and the surrounding structures. Sufficient pelvic floor muscle strength is needed for continence. Eliminating medical diagnoses and medical causes, weak pelvic floor muscle strength contributes to bladder leaks as the muscles simply 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 of these same muscles difficult. You can perform all the right exercises targeting at strengthening the pelvic floor but if every time those exercises are followed by straining to evacuate the bowel on a regular basis strength gains are very difficult to make.
Pelvic Organ Prolapse
Another common consequence of chronic constipation is pelvic organ prolapse. The three main organs, bladder, rectum and uterus (including the cervix and vagina) are supported by the pelvic floor. According to womenshealth.gov, pelvic organ prolapse affects one in five women. This condition can be devastating and can 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
