Constipation

Pelvic Floor Physical Therapy can give hope to patients with constipation.

Constipation is a common disorder. According to the Mayo Clinic, 50% of patients with chronic constipation have pelvic floor dysfunction (PFD). In addition to ruling out anatomic, disease and diet related causes for a patient’s constipation, attention should be directed to the pelvic floor. The pelvic floor is a group of muscles in the pelvis that includes the puborectalis and levator ani muscles. These muscles work together to help control sexual, urinary, and bowel functions. These muscles must relax and contract properly to maintain urinary and fecal continence, sexual function, and proper voiding habits. 

PFD in constipation is characterized by reduced coordination between the pelvic floor muscles and abdominal wall motion, which is necessary for normal defecation. When the pelvic floor muscles fail to relax and contract properly this can cause constipation, which is referred to as dyssynergic defecation or anismus. This can then lead to straining with bowel movements and feelings of incomplete evacuation. In patients with constipation related to PFD, the muscles around the anal region often contract instead of relax during attempted bowel movements. Unfortunately, PFD is not widely recognized as a possible cause of chronic constipation. As a result, many patients with constipation do not receive the treatment that enables them to recover normal bowel habits.

How does Pelvic Floor Physical Therapy Help?

Our therapists will conduct a comprehensive evaluation to identify the root musculoskeletal and neuromuscular causes of the patient’s constipation. We will then develop an individualized treatment plan that may include: internal and external manual therapy such as biofeedback, nerve gliding/tension release, myofascial release, and visceral manipulation. Patients also receive instruction in correct elimination techniques to prevent straining, as well as therapeutic and core-strengthening exercises, which may include one on one sessions with our Pelvic Floor Pilates trained instructors.

“Successful physical therapy for patients with puborectalis dyssynergia is associated with improvements in constipation-related symptoms and in quality of life.” (1)

To ensure the best results, the therapists at Sarton Physical Therapy always spend an hour with each patient during every appointment. Let our expert Physical Therapists with advanced board certification in pelvic floor physical therapy help. Please contact Sarton Physical Therapy with any questions or to have your patients schedule an appointment.

Dis Colon Rectum. 2008 Nov;51(11):1686-91. doi: 10.1007/s10350-008-9392-3. Epub 2008 Jun 27.