Constipation

What is Constipation?

Constipation is the infrequent ability to empty your bowels. This generally occurs as the stool (faeces / poo) is often hard and dry and as a result can be difficult to pass.

What Causes Constipation?

Many factors can lead to constipation, including:

Lifestyle factors:

• Not drinking enough water
• Not eating enough fibre / a change in diet
• Lack of regular exercise
• Delaying having a bowel movement
• Change in daily routine
• Stress
• Age

Medical / Physiological and Psychological Factors:

• Metal health conditions, e.g. anxiety and depression
• Medical conditions that affect the nervous system, e.g. Parkinson’s disease or MS
• Medical conditions that affect the endocrine system, e.g. diabetes or hypothyroidism
• Medical conditions that affect the digestive system, e.g. IBS
• Blockage or obstruction of the colon/rectum, e.g. tumour, haemorrhoids, prolapse
• The slow movement of the faeces through the colon
• Injury to the pelvic floor, abdomen or anus
• Surgery
• Stress
• Obesity / overweight
• Some medications
• Long term use of laxatives
• Pregnancy
• Hormonal change
• Illness
• Reduced mobility

What are the Symptoms of Constipation?

The symptoms of constipation may include:

• Decreased frequency of passing a bowel movement (two or less every week)
• Difficulty passing a bowel movement if the stool is hard and dry
• Needing to push and strain to assist with passing a bowel movement
• Taking longer than a couple of minutes to pass a bowel movement
• A feeling of incomplete emptying of the bowel
• Abdominal pain and bloating

How Is Constipation Diagnosed?

Usually, a clinical diagnosis can be made using your information based on your medical history, toileting habits, and lifestyle (diet, fluid ingestion, medication, and exercise). Occasionally a physical exam may need to be performed. During this examination, your physiotherapist may need to complete an internal exam to assess the position of the organs in the pelvic cavity and the strength and ability of the pelvic floor muscles to activate and coordinate correctly. If further information is required, your doctor can perform other tests and investigations, including using a bowel diary, imaging, e.g. x-rays, colonoscopy. Sigmoidoscopy, as well as other anorectal and colorectal tests. However, these tests will only be performed if required based on your presentation.

Treatments For Constipation?

There are many treatments for constipation that physiotherapy can achieve. These treatments can include:

• Education
• Diet recommendations regarding fibre intake
• Recommendations regarding water / fluid consumption
• Recommendations regarding exercise
• Pelvic floor exercise program
• Adjustment of usual toileting habits
• The addition of stool softeners
• Splinting

Other Treatments:

A large proportion of people with constipation will have their symptoms improved or resolved with physiotherapy treatment. However, depending on the cause of your constipation, you may also need to follow up with your doctor for additional treatment if required, including:

• Medications review/ prescription (including some laxatives)
• Medical treatment for conditions that may put you at risk of constipation
• Enemas and suppositories

Your physiotherapist will work closely with your doctor to ensure the best possible treatment outcome for you.

What Results Can You Expect?

A large proportion of people with constipation will have their symptoms improved or resolved by adjusting lifestyle factors through physiotherapy treatment. However, if left untreated, the problem worsens gradually and may affect other areas, including the pelvic floor and bladder.

Will You Need Surgery?

There is a percentage of people who may not experience enough improvement with physiotherapy treatment alone. This often depends on the underlying cause of constipation, and as a result, they may need to have surgery to resolve their symptoms.

For more information please consult your physiotherapist with a special interest in pelvic floor conditions.

Related Articles

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2. Women’ss Health Physiotherapy – Addressing a diverse range of women-specific concerns, Women’s Health Physiotherapy focuses on assessing and treating various conditions.
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4. Exercise Advice for Chronic Conditions – Find out how regular physical activity can help manage constipation and improve overall digestive health.
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