One third of the population experience constipation at some point during their lifetime. Not only is it an irritating condition, but it can also cause an array of issues in the long term.
Constipation is the most common cause of faecal incontinence. Although it can be an unpleasant topic to talk about, it’s important that you to learn how constipation can cause pelvic floor problems and how to solve them.
How Can Constipation Damage Your Pelvic Floor?
Like any other muscle, the pelvic floor muscles can be damaged. Chronic constipation can weaken the pelvic floor muscles in men and women. For women, childbirth is the most common cause of damage due to the strain and stretching that is involved; large babies and forceps use can increase the damage. Weak pelvic floor muscles may also lead to prolapse of one or more of the pelvic floor organs; the bladder, womb or bowel. In fact, Constipation is seen in 70% of patients who suffer with rectal prolapse.
Constipation appears to be as important as childbirth in the development of pelvic floor damage. Therefore, it is increasingly important to recognise and treat constipation to reduce the risk of developing a pelvic floor disorder.
Constipation also increases the risk of urinary incontinence; an enlarged bowel puts pressure on the bladder and reduces its holding capacity, risking accidental urinary leakage. Straining on the toilet due to constipation also risks stretching and weakening the pelvic floor muscles, which are important for closing off the urinary and anal sphincters.
What Causes Constipation?
Constipation occurs frequently when waste moves too slowly through the digestive tract or if it cannot be eliminated effectively from the rectum, which can cause the stool to become hard and dry. Some of the causes of constipation include:
- Blockages in the colon or rectum – These can slow or stop stool movement completely. This can be the fault of an anal fissure, rectal or colon cancer, rectocele, and more.
- Nerve issues around the colon and rectum – Nerves that cause the muscles in the colon and rectum to contract and move stool through the intestines can be affected by neurological problems such as multiple sclerosis, Parkinson’s disease, and stroke.
- Muscle difficulty – Chronic constipation may be caused if the pelvic muscles are weakened.
- Hormone imbalances – Diseases and conditions that disrupt the balance of hormones can lead to constipation.
What are the Symptoms of Constipation?
Signs and symptoms of chronic constipation include:
- Passing less than three stools a week
- Passing hard or lumpy stools
- Straining to pass bowel movements
- The feeling of a blockage in your rectum that is preventing bowel movements
- Not feeling completely empty after passing stool
- Having to use your hands to press on your abdomen to help empty rectum, or using a finger to remove stool from your rectum.
If you’ve experienced two or more of these symptoms for the previous three months, constipation may be considered chronic.
What are the Risk Factors for Constipation?
Factors that can increase your risk of developing constipation include:
- Being a woman (Studies don’t show an exact cause of why women are more affected than men, but it’s thought to be because of hormone changes)
- Being dehydrated
- Eating a low-fibre diet
- Being an older adult
- Not exercising regularly
How Can You Prevent Constipation?
Prevention is better than cure. That’s why we have collated our tips for preventing constipation all together. Kegel8’s top tips for avoiding constipation are:
- Doing your Kegel exercises – Improving the strength of your pelvic floor muscles can help you to pass stool more easily. If you struggle to perform manual Kegels, try using the Kegel8 Ultra 20 Electronic Pelvic Toner to quickly locate and exercise your pelvic floor muscles.
- Using a toilet stool – A toilet stool can help you to lift your knees and change your anorectal angle, making it easier to pass stool and lessens the strain on your pelvic floor muscles.
- Embracing your inner animal – Saying ‘MOOOO’ on the toilet can help relax your vital muscles.
- Improving your diet - Dietary guidelines in the UK recommend a daily intake of at least 30 grams of fibre. The majority of the UK falls far short of this target: average daily intake is just 18 grams. Cancer research recently estimated that 28% of bowel cancers in the UK are caused by eating too little fibre. Eating high-fibre foods within your diet (whole grains, fruit and vegetables) can help ease stool movements.
- Drinking H20 to help you go – Avoid fruit juices and drink plenty of fluids to help with bowel movements.
- Being active – You should get moving to keep things moving.
- Not ignoring the urge to pass stool – If you’ve got to go, then you’ve got to go. Don’t hold it.
- Taking your time - Don’t be afraid to sit for longer on the toilet. There’s a theory that women have more constipation than men because women are always in a rush, whereas men take their time. Maybe sit with a newspaper or iPad to help pass time.
- Supplementing with magnesium – Magnesium can help to improve your muscles and get things moving.
- Indulging in a Sitz bath – An Epsom salt bath can also help your body to absorb magnesium.
What Do You Think?
Jay - "[Using the Kegel8 Ultra Vitality meant] less constipation. My muscles feel stronger and my movements more natural. I no longer require that really strong cup of coffee every day in hopes that it will get my bowels moving."
Hindsight is a wonderful thing, but remember, you can start preventing pelvic floor disorders right now! Please don’t have any regrets; let’s make sure the problems that women experience today don’t continue for future generations. It’s time to change! #TogetherWeAreStronger
Watch physiotherapist, Michelle Kenway, talk about how to empty your bowels effectively and overcome constipation problems.
Sources
[1] Amselem, C., Puigdollers, A., Azpiroz, F., Sala, C., Videla, S., Fernandez-Fraga, X., Whorwell, P., Malagelada, J.R. (2010) Constipation: A Potential Cause of Pelvic Floor Damage? [online]. Neurogastroenterology & Motility. 22(2), pp. 150-153 [viewed 15/10/2018]. Available from https://www.ncbi.nlm.nih.gov/pubmed/19761491
[2] Bharucha, A.E., Pemberton, J.H., Locke III, G.R. (2013) American Gastroenterological Association Technical Review on Constipation. The American Journal of Gastroenterology.114, pp. 218-238.
[3] Bladder & Bowel Community (2018) Pelvic Floor Exercises [online]. Bladder and Bowel Support Company [viewed 15/10/2018]. Available from https://www.bladderandbowel.org/help-information/resources/pelvic-floor-exercises/
[4] Continence Foundation of Australia (2015) Healthy Habits: At home and at school. Bridge. 9(3).
[5] Desmond, A. In Praise of Fibre As A Way to Help Bowel Health. New Scientist. Issue 3199, p. 52.
[6] Higgins, P.D., Johanson, J.F. (2004) Epidemiology of Constipation in North America: A Systematic Review. American Journal of Gastroenterology. 99, pp. 750-759.
[7] Locke III, G.R., Pemberton, J.H., Phillips, S.F. (2000) AGA Technical Review on Constipation. The American Journal of Gastroenterology. 119, pp. 1766-1778.
[8] Mayo Clinic (2018) Constipation [online]. Mayo Clinic [viewed 15/10/2018]. Available from https://www.mayoclinic.org/diseases-conditions/constipation/symptoms-causes/syc-20354253
[9] Rao, S.S.C., Go, J.T. (2009) Treating Pelvic Floor Disorders of Defecation: Management or Cure? [online]. Current Gastroenterology Reports. 11(4), pp. 278-287 [viewed 15/10/2018]. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3883497/