The Surprising Reason You’re Constipated That No One’s Talking About ...Saudi Arabia

If you only poop once a week, and when you do, your stool is hard and lumpy and difficult to get out, you’re likely constipated. While it could be caused by lifestyle factors—like not eating enough fiber or sitting too much—there is one surprising condition that could be to blame. Understanding what’s causing your constipation and treating it is not only good for your digestive system but also impacts other aspects of your health, doctors say. “As a urogynecologist, I am often the first to tell patients that constipation can affect their bladders,” says Carolyn Botros, DO, a urogynecologist at Atlantic Health. “We talk about how a full colon and rectum can put direct pressure on the bladder and cause problems with urgency to urinate and bladder control problems. It seems to surprise people all the time.”Here’s an overview of what constipation is, what may be causing it, and how to address it. Related: Gastroenterologists Are Begging People Over 50 To Start Doing This One Thing Every Morning

What Is Constipation?

Everyone’s pooping habits are different. But constipation is technically defined as having fewer than three bowel movements a week, according to the Cleveland Clinic. You may have other symptoms, too, including: 

Constipation is common and often results from not eating enough fiber (and most people eat enough) or from not drinking enough water. Stress, not exercising, certain medications (like pain medicines and antidepressants) and medical conditions (such as irritable bowel syndrome) can also cause constipation. So can one other thing you might not realize. 

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Constipation and pelvic floor dysfunction (PFD) are “interrelated,” says Dr. Nissrine Nakib, MD,associate professor, medical director and vice chair of urology at the University of Minnesota, and advisory board member at Flyte. 

It’s estimated that about 50% of people with chronic constipation also have PFD, according to the Mayo Clinic. But it’s difficult to say whether constipation causes PFD or vice versa, Dr. Nakib says. 

PFD is when the pelvic floor muscles “remain contracted during times where relaxation should occur,” such as when you need to poop or pee, Dr. Botros says. “This can cause problems with constipation because relaxation of the pelvic floor muscles is necessary to be able to fully evacuate bowel movements.” 

Related: It’s Not Just About Pee Leaks—Here Are 6 Surprising Signs Your Pelvic Floor Needs Help

So the pelvic floor muscles, which support your bladder, rectum, uterus and prostate for men, are “kind of holding onto things,” which can cause discomfort and pain, Dr. Nakib says. 

When pelvic floor muscles are too tight and won’t relax, it can make it difficult to poop. Dr. Nakib says the longer the stool sits in the colon, the more likely water in the stool will be reabsorbed into the body, making it harder to pass. It also puts pressure on the pelvic floor.

Then, if you strain while pooping, it can put extra pressure on your pelvic floor and cause you to overuse your pelvic muscles, potentially leading to more pelvic floor problems, according to the Cleveland Clinic. 

“It is a catch-22, however, because constipation can be very painful and worsen pelvic floor muscle spasms and PFD,” Dr. Botros says.

Along with constipation, PFD can cause difficulty emptying your bladder, leaking stool and urine, painful urination, low back pain, and pain with intercourse.

Will Addressing Constipation Improve Pelvic Floor Dysfunction?

You really need to address both your chronic constipation and PFD, says Aleece Fosnight, PA-C, a physician's assistant at Aeroflow Urology, who specializes in urology and women’s health.  

She suggests starting with the basics: “Are you hydrated? Are you getting enough fiber? Are you moving your body enough? And if those things aren’t happening, constipation may be almost like your 'trigger' for pelvic floor problems."

Related: The ‘Forgotten’ Core Muscles Women Over 40 Need To Strengthen—and How To Do It

However, if working out more, eating fiber and drinking water aren’t improving your constipation (or your pelvic floor discomfort), talk to your doctor, Dr. Botros recommends. Doctors will want to rule out a medical condition, such as an inflammatory bowel disease or motility issues, Dr. Nakib explains. 

According to Fosnight, your doctor may refer you to a pelvic floor therapist. These therapists will teach you exercises to help your pelvic muscles relax and improve their coordination. 

“It’s working on those relaxation techniques, being able to do some belly breathing, to open up the pelvic floor for constipation, and to evacuate those bowels,” she says. 

Up Next: 

Related: Pelvic Floor Doctors Reveal the One Exercise Every Woman Over 50 Should Be Doing

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