How Pelvic Health Physiotherapy Helps with Constipation and Abdominal Cramps

Clients often ask me, “How do I know if I am constipated if I don’t know what regular means?”

Great question. 

Some people only go once every other day, while some people have bowel movements twice a day! Clinically, chronic constipation is generally having less than three bowel movements a week. I always mention that chronic constipation depends not only on the frequency of bowel movements but also on the ‘look’ of them.

Have you ever heard about the Bristol Stool Chart? It tells you what level of constipation you are based on the appearance of your poop. Usually if you are hitting Type 4: a smooth, soft sausage or snake, you are good to go! But if it’s looking more lumpy and pebbly, and it’s infrequent and difficult passing the poops, then you want to consider consulting a healthcare professional. 

Here are some reasons why you should see a healthcare professional, including a pelvic health physiotherapist, if you’re constipated:

  1. Chronic constipation can affect your quality of life,

  2. It may cause abdominal pain, which in turn affects your daily activities, 

  3. You may be practicing poor toilet habits like straining, which can lead to more trouble including pelvic organ prolapse!

To treat constipation and abdominal cramps, you could take stool softeners, laxatives, and other medications. However, there are more conservative ways in pelvic health physiotherapy to manage chronic constipation too. 

Here are some hot tips:

  1. Don’t ignore the need to have a bowel movement - just go when you need to go.

  2. Drink plenty of fluids (non-carbonated, non-caffeinated fluids). Aim for at least 2L a day.

  3. Sip throughout the day. Avoid gulping fluids to avoid shocking the system

  4. Increase your fibre intake to 30-40g/day. This should be done gradually because if you suddenly hit 40g/day you will feel bloated and uncomfortable.

  5. Elevate your feet so that your knees are higher than your hips when you are on the toilet. This will relax the Puborectalis muscle (a pelvic floor muscle which constricts the poo passage).

  6. Practice abdominal ‘ILU massages’ where the hands move in the direction of poop moving through the colon 

  7. Decrease the amount of unnecessary stress in your life and get more involved in physical activities that move your system as a whole (that’s including mental health!)

There can be a huge improvement in the quality of life once chronic constipation is managed. It can be embarrassing to bring it up to other people but let’s keep it happy down there. 💩

Michiko Caringal