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Constipation is such a common phenomenon that it is almost a cliché to say ‘just have plenty of water and fiber!’  It is actually a little bit more complicated than that...

Constipation: Is More Than just Inadequate Fiber Intake

What is constipation?

Constipation is defined as having bowel movements less than three times a week.


There are various reasons why people have constipation, ranging from side effects of medication, inactivity, inadequate fiber intake, and dehydration, to having a hyperactive pelvic floor.


I remembered the very first time I encountered an inquiry on constipation treatment from a friend’s friend. At the time, I was a first year physical therapy student and did not have any idea about pelvic health. The extent of my physical therapy knowledge of constipation was pretty much just


“drink plenty of water and have lots of fiber.”


I remember the response I got was - ‘I did all that. But I am still constipated!’ This is a common response.

Pelvic physical therapy as a treatment for constipation

What people do not realize is that constipation is a pelvic health issue and physical therapy may be able to help. When people have constipation as a result of a hyperactive or tight pelvic floor, increasing fiber intake often leads to even more abdominal discomfort and bloating. Often, they turn to over-the-counter laxatives. These may disrupt the natural rhythm of colon, and long-term use of laxatives ironically causes constipation!


A trained and experienced pelvic floor physical therapist can evaluate the pelvic girdle, to determine whether the constipation is related to a hyperactive pelvic floor. If so, the therapist can work with the patient to develop an appropriate treatment plan, leading to relief from the constipation.

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