If you're experiencing difficulty with defecation, you know how terrible it can be. Constipation is uncomfortable and can cause a slew of other problems. If you find yourself needing to strain to empty your bowels, the problem may be related to your pelvic floor.
Pelvic floor dysfunction may be one contribution to constipation. Lack of proper coordination of your pelvic floor muscles leads to the inability to relax your pelvic floor when you need to defecate.
There are three major muscles involved in defecation: puborectalis, internal anal sphincter (IAS), and external anal sphincter (EAS). At rest, these muscles act as mechanical barriers to prevent leakage. When sool starts to move toward the rectum, the rectal wall is stretched. This sends signals to the brain causing the urge to defecate. The IAS relaxes to allow some stool content to move toward the anal canal.
If you are not ready to let the stool out, your EAS and puborectalis contract to keep the stool in. When you are ready to defecate, relaxing of your EAS and puborectalis allow the defecation to take place.
The puborectalis wraps around the anorectal region. When it contracts, it creates a forward pull on the rectum and increases the anorectal angle. Therefore, when it is tight or a lack of proper coordination control, stool is not able to pass through easily.
Having a tight pelvic floor is a common reason for difficulty relaxing when you need to defecate.
When you strain, your pelvic floor tightens even more to make going more difficult. This can eventually lead to other problems such as pain, bleeding and hemorrhoids.
One way to help ease
your defecation is to use a stool (or squatty potty) to our your body in a deep squat position. When you are in the deep squat position, your pelvic floor relaxes more easily. One particular pelvic floor muscle, the puborectalis, acts as a sling around your rectum. When you squat, it relaxes to open the rectum for better defecation.
Pelvic floor specialists can help you determine what might be the reasons for your constipation and address them accordingly. The treatment approach may include manual treatment to loosen the pelvic floor muscles, coordination training for the pelvic floor and abdominal muscles for defecation, posture training and education, bowel program, etc.
There are so many things that can cause constipation. Don't hesitate to contact a physician or pelvic floor therapist to discuss the causes and potential treatment options.
We can and we will get better together,
Dr. Yvonne Huang
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