Chronic constipation is a common but often misunderstood condition that affects millions of people. While diet, hydration, and lifestyle factors can contribute to constipation, pelvic floor dysfunction (PFD) is an often-overlooked culprit. The pelvic floor muscles play a crucial role in controlling bowel movements, and when they do not function properly, it can lead to straining, incomplete evacuation, and chronic discomfort. Understanding the connection between pelvic floor dysfunction and constipation is key to finding effective treatment options.

What Is Pelvic Floor Dysfunction?

The pelvic floor is a group of muscles and connective tissues that support the bladder, rectum, and reproductive organs. These muscles also control bowel and bladder function. Pelvic floor dysfunction occurs when the pelvic floor muscles become weak, overly tight, or fail to coordinate properly. This condition can lead to symptoms such as urinary issues, pelvic pain, and constipation.

How Does Pelvic Floor Dysfunction Cause Constipation?

For a healthy bowel movement, the pelvic floor muscles must relax to allow stool to pass through the rectum. However, in individuals with PFD, these muscles may contract instead of relaxing, leading to dyssynergic defecation—a condition where the muscles do not coordinate properly. This can result in:

• Difficulty passing stool – Straining and pushing without success
• A sensation of incomplete evacuation – Feeling like stool remains in the rectum
• The need for manual assistance – Using fingers or other techniques to help stool pass
• Painful bowel movements – Caused by excessive straining or muscle tightness

Signs That Constipation May Be Related to Pelvic Floor Dysfunction

If constipation persists despite a high-fiber diet, proper hydration, and regular exercise, it may be due to PFD. Additional symptoms that indicate pelvic floor involvement include:

• Chronic straining during bowel movements
• A feeling of blockage even when stool is present
• Pain or pressure in the pelvic region
• Difficulty starting a bowel movement or weak pushing effort

Diagnosing and Treating Pelvic Floor Dysfunction-Related Constipation

If PFD is suspected, a specialist may perform tests such as anorectal manometry or a defecography study to evaluate muscle coordination. Treatment often includes:

• Pelvic floor physical therapy – Biofeedback and targeted exercises can help retrain the muscles to function properly.
• Bowel retraining techniques – Learning proper posture and breathing methods during bowel movements.
• Medications – Stool softeners or laxatives may provide temporary relief but do not address the underlying muscle dysfunction.
• Minimally invasive procedures – In some cases, procedures may be recommended to address structural issues contributing to PFD.

Find Relief with Expert Care

If you struggle with chronic constipation and suspect pelvic floor dysfunction may be the cause, the experienced medical team at Piedmont Colorectal Associates offers specialized diagnostic and treatment options. Our professionals can help you to restore proper function and improve your quality of life. Schedule a consultation in Atlanta, Georgia by calling (404) 351-7900.