Pelvic Floor, Bowel, Gut Motility, Constipation & Abdominal Bloating
Abdominal bloating, constipation, fecal smearing, incomplete emptying, IBS, reflux, and other GI symptoms are common conditions that can have a pelvic floor component.
Digestion & the Pelvic Floor
Digestion begins in the mouth with the mechanical breakdown of food through chewing. The food then makes its way into the stomach and through the intestines by way of many processes. Normal breathing patterns use the diaphragm and pelvic floor together and can help with digestion.
The mechanics of an inhale—the diaphragm lowering to expand your lungs, the abdominals expanding to allow for the air to push the guts down, and the pelvic floor lengthening—are followed by the reverse movement during exhalation. Together, these movements create our own sump pump effect inside our bodies.
It is almost like an accordion, but from top to bottom and then front and back. This movement helps with:
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Abdominal bloating
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Lymphatic drainage
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Digestion
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Gut motility
Pelvic Floor Tightness & Abdominal Bloating
Hypertension, or tightness, in the pelvic floor muscles limits their ability to lengthen or descend as the bottom component of this sump pump. Limitations in this movement can create a more outward push, contributing to abdominal bloating.
Pelvic floor muscle assessment and treatment can allow the muscles to lengthen normally to aid in digestion. Assessment of breathing patterns and abdominal massage can also help with bloating, constipation, and gut motility. There are also many lifestyle, eating habits, and modifications that can help reduce symptoms.
Constipation, Incomplete Emptying & Fecal Smearing
Because digestion starts in the mouth with chewing and then continues through the stomach and intestines, constipation problems can occur anywhere along that route. However, they can also occur specifically at the end of the digestive process while attempting to have a bowel movement. Often, people are diagnosed with dyssynergic defecation. This is when the pelvic floor muscles do not relax with bearing down to evacuate stool and instead contract or tighten. I sometimes explain this as “pushing down into a closed door.” Sometimes the pelvic floor muscles will partially relax, creating long, stringy bowel movements and/or other problems with incomplete emptying and fecal smearing.
How Pelvic Floor Physical Therapy Can Help
After an assessment of the pelvic floor muscles, treatment may include:
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Soft tissue mobilization
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Fascial release
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Neuromuscular re-education
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Biofeedback techniques
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Retraining the muscles to relax and lengthen with bowel movements
The goal is to help retrain the pelvic floor muscles to coordinate properly during bowel movements and address the muscular components that may be contributing to constipation, incomplete emptying, fecal smearing, bloating, and other GI symptoms.