Constipation and Incomplete Bowel Emptying
Condition Overview
Constipation or incomplete bowel emptying occurs when someone has difficulty initiating a bowel movement or has difficulty completing a bowel movement.
Constipation can be short lived or can be chronic.
The normal amount of times to poop is 3x/day to 3x/week. If you are falling out of these ranges you could be constipated and/or have incomplete bowel emptying causing you to go more frequently with smaller amounts emptied.
With constipation, you may also experience hemorrhoids, anal fissures, rectal pain, and urinary urgency. Check out our other blogs if you have questions about what these diagnoses are or feel like you may also be experiencing this adjunct symptom.
Additional Symptoms Include
Needing to strain to initiate or fully empty a bowel movement
Having firm, hard stools or pencil thin stools
Feeling like there is a blockage at your rectum that prevents further emptying
Requiring digital removal of stool from your rectum
Feeling constantly bloated
Causes of Constipation
Pelvic floor overactivity or tension
Dyssynergia (tightening your pelvic floor instead of lengthening your pelvic floor when you have a BM)
Bowel obstruction
Narrowing of the colon due to surgical scars, adhesions, endometriosis, IBS, etc.
Rectocele (prolapse of the rectum into the vaginal wall) or rectal prolapse (prolapse of rectum out of the anal opening)
Abdominal, rectal, or colon cancer
Constipation can also occur with a change in diet or activity, decreased fluid intake, increased stress, chronically delaying the urge to poop, or chronic reliance on laxatives
How Can Physical Therapy Help?
Upon our initial evaluation, we will discuss your bowel, bladder, and sexual health. We will discuss the onset of symptoms, exercise routine, water intake, general dietary habits, etc. With this information, we are taking note of habits and patterns that may be associated with the constipation or incomplete emptying you are experiencing.
We will assess your abdominal wall since the colon lives underneath these tissues and if there is excessive tension in this area it can affect colon motility.
With your consent we may perform an external and internal rectal or vaginal pelvic floor muscle assessment to determine muscle function, strength, endurance, and coordination.
From our findings we will set-up a treatment plan depending on your pelvic floor characteristics! Our bowels love a routine, so if you do not have a good routine set up in place, we may suggest making this a priority so your bowels learn when it is time to get going versus not. There may be lifestyle modifications that we need to address (changes in water or fiber intake, pooping habits, toilet posture/use of squatty potty, appropriate bearing down techniques, and exercise routine).
Constipation is typically not a one size fits all and we need to address many factors to see ultimate change, so it is a lot of effort on you outside of the clinic to make these changes happen! We may perform manual treatment to the abdominal wall, glute tissues, and pelvic floor to improve tissue tension if that is noted.
If necessary we may also use balloon training which is very effective in learning how to lengthen and bear down appropriately.
With each session we will progress as able and learn new activities to include in your daily routine to manage and prevent worsening symptoms!