Constipation and Pelvic Floor Dysfunction: How Straining Affects Bowel and Bladder Health
- May 15
- 8 min read
Updated: 2 days ago
What Constipation Is and Why It Affects Pelvic Floor Health
Constipation is something many people experience at some point, yet it is rarely spoken about openly. When your bowels are not moving regularly or comfortably, it can affect far more than digestion. Constipation can influence how the pelvic floor works, how often you need to use the toilet, how your abdomen feels and even how confident you feel day to day.
Constipation can build up slowly or appear quite suddenly. For some people, stools become harder or less frequent. For others, constipation follows pregnancy, hormonal changes, stress, medication, illness or a change in routine. Men may notice constipation linked to long periods of sitting, heavy lifting, high intensity exercise or tension held in the abdominal and pelvic muscles.
Women often see changes after childbirth, during perimenopause or when life becomes particularly busy or stressful. Whatever the cause, the experience often feels similar. Going to the toilet becomes difficult, you may need to strain and you might leave the bathroom feeling as though you have not fully emptied.
Constipation is not only about how often you go. It is also about how comfortable it feels. Some people go daily but still struggle with hard stools, incomplete emptying or a feeling of blockage. Others may only go a few times a week and feel bloated or uncomfortable in between. All of these patterns can place extra pressure on the pelvic floor and influence how well it can support you.
How Straining Causes Pelvic Floor Dysfunction
Straining is one of the most common reasons the pelvic floor becomes tired or uncoordinated. These muscles support the bladder, bowel and pelvic organs, but they are not built to cope with repeated forceful pushing. When you strain, pressure moves downward onto the pelvic floor. Over time, this can cause the muscles to tighten, lose strength or struggle to work in a smooth and coordinated way.
For the bowel to empty comfortably, the pelvic floor needs to soften and lengthen. If the muscles are held tightly because of stress, habit, pain or repeated straining, they can make bowel movements feel blocked or incomplete. This often creates a cycle where constipation leads to pelvic floor tension and pelvic floor tension makes constipation worse.
Many people are surprised to learn that straining can also affect the nerves that help the bowel and pelvic floor communicate. When the muscles become overworked or tense, the signals that tell the bowel to relax or contract can become less efficient. This can create a feeling of mixed messages. The urge to go may be there, but the body does not respond as smoothly as it should.
Why Sitting Too Long on the Toilet Makes Constipation Worse
Sitting on the toilet for too long is another habit that can affect the pelvic floor. Many people stay seated while scrolling on their phone, not realising that this position holds the pelvic floor lower and unsupported. This increases pressure on the muscles and the rectum, making them work harder than they need to.
Over time, this can lead to pelvic floor fatigue, difficulty relaxing the muscles properly, haemorrhoids and a feeling of heaviness or pressure. The longer you sit, the more blood collects in the rectal area, which can make the tissues feel swollen or sensitive. This can make passing stool even more difficult the next time you go.
A simple guide is that if you are scrolling, you are probably sitting too long. Bowel movements should feel natural and unforced and usually take only a few minutes. If it is taking longer, it may be a sign that the pelvic floor is struggling to relax or that the stool is too firm.
How Constipation Affects Bladder Health
Constipation can also influence bladder health. A full bowel sits directly behind the bladder and can reduce the space available for it to fill comfortably. This can irritate the bladder wall and lead to urgency, frequency or difficulty fully emptying. Some people notice they need to wee more often when they are constipated, while others feel a sudden strong urge that seems to appear from nowhere.
Men may notice this more if they already experience bladder changes related to prostate enlargement or pelvic floor tension. Women may notice it around their menstrual cycle, during perimenopause or after childbirth, when the pelvic floor is already adapting to hormonal or structural changes.
Many people are surprised to find that improving bowel habits can also improve bladder symptoms. When the bowel moves more comfortably, the bladder often settles naturally.
Constipation and Faecal Incontinence: Understanding the Link
Faecal incontinence is a symptom that many people feel embarrassed to talk about, yet it is far more common than most realise. It can range from small smudges or staining to difficulty holding wind or stool. This can happen when the pelvic floor becomes tired from chronic straining or when the muscles are so tight that they struggle to coordinate properly.
For some people, constipation leads to overflow leakage, where softer stool escapes around a hard blockage. This can be confusing and upsetting, especially when it happens unexpectedly. Others may notice leakage after a bowel movement and feel as though the rectum has not fully emptied.
Although it can feel worrying, faecal incontinence is something that can improve with the right support. Understanding the cause is the first step, and for many people, improving pelvic floor coordination makes a meaningful difference.
Diet and Hydration Changes That Support Easier Bowel Movements
Diet can play a helpful role in easing constipation and supporting pelvic floor health. Many people find that increasing natural fibre through fruits, vegetables, whole grains and pulses helps soften the stool and makes it easier to pass without straining. Fibre adds bulk and softness, helping the bowel move more rhythmically.
Foods with a high water content, such as berries, oranges, soups and smoothies, can also support bowel comfort. Hydration is equally important. When the body is well hydrated, the bowel does not need to draw as much water from the stool, helping it stay softer and easier to move.
Simple habits like drinking more water throughout the day or having a warm drink in the morning can help stimulate natural bowel movement. Some people find that eating at regular times helps the bowel establish a routine, while others notice that skipping meals or eating very little fibre makes constipation worse.
These changes are not about restriction or perfection. They are about supporting your bowel so it can work with more ease, reducing the need to strain and helping the pelvic floor stay relaxed and responsive.
How to Relax the Pelvic Floor for Easier Bowel Movements
Relaxing the pelvic floor is an important part of easing constipation. Relaxation does not mean weakness. It means allowing the muscles to soften so they can work in a healthy and coordinated way.
Breathwork is often a helpful first step. Gentle diaphragmatic breathing encourages the pelvic floor to move naturally with the breath and can help release tension.
Many people find that breathing down into the belly, rather than holding the breath or tightening the tummy, makes bowel movements easier and more comfortable. This type of breathing also helps calm the nervous system, which can reduce the stress related tension that often contributes to constipation.
Toileting Posture That Reduces Straining
Toileting posture can make a real difference. Sitting with your knees slightly higher than your hips, leaning forward with a relaxed belly and resting your elbows on your knees can help the pelvic floor open more naturally. This position reduces the need to strain and allows the rectum to straighten, making it easier for stool to pass.
Taking your time, relaxing your shoulders and avoiding breath holding can also help. Many people find that simply adjusting their posture allows them to empty more comfortably without pushing.
How Pelvic Floor Chair Therapy Helps Constipation and Pelvic Floor Dysfunction
At The Pelvic Therapy Suite, pelvic floor therapy focuses on improving the coordination, relaxation and strength of the pelvic floor muscles. For many people, pelvic floor chair therapy can be a supportive part of this process. It helps the pelvic floor contract and relax more efficiently, which can support better bowel emptying and reduce the strain that contributes to constipation.
For men, this can also support pelvic floor function affected by prostate related changes, tension from exercise or long term holding patterns. For women, it can help restore balance after childbirth, during perimenopause or when pelvic floor tension has built up over time.
When the pelvic floor becomes more responsive and better coordinated, symptoms such as incomplete emptying, urgency and even faecal incontinence can begin to improve.
Finding Support for Constipation and Pelvic Floor Dysfunction
Constipation, pelvic floor tension and bowel leakage can feel isolating, yet they are incredibly common and very treatable. With the right guidance, it is absolutely possible to improve your symptoms, restore confidence and feel more at ease in your daily life. At The Pelvic Therapy Suite, we support you with a complete view of your pelvic health and help you understand what your body is doing so you can move toward relief that lasts.
If you feel ready to explore what is happening or would like personalised support, you are always welcome to get in touch. You do not have to navigate this alone, and your comfort truly matters.
References
1. Prevalence and causes of constipation NICE. Constipation in adults: diagnosis and management. National Institute for Health and Care Excellence. Supports: common causes (diet, medication, illness, hormonal changes, pregnancy, ageing), patterns of bowel frequency, incomplete emptying.
2. Straining and pelvic floor dysfunction Rao SSC, et al. Mechanisms of pelvic floor dysfunction in constipation. Gastroenterology Clinics of North America. 2008. Supports: straining weakening pelvic floor muscles, impaired coordination, pelvic floor tension contributing to obstructed defaecation.
3. Pelvic floor hypertonicity and bowel symptoms Fitzgerald CM, Kotarinos R. Pelvic floor muscle tension and its role in pelvic pain and bowel dysfunction. Physical Therapy. 2003. Supports: tight pelvic floor restricting blood flow, increasing nerve sensitivity, creating resistance to bowel emptying.
4. Toilet posture and straining mechanics Sikirov BA. Comparison of straining during defecation in three positions: results and implications. Digestive Diseases and Sciences. 2003. Supports: knees‑higher‑than‑hips posture, reduced straining, rectal angle straightening.
5. Sitting too long on the toilet Johannsson HO, et al. Prolonged sitting on the toilet and its association with haemorrhoids. European Journal of Gastroenterology & Hepatology. 2005. Supports: prolonged sitting increasing rectal pressure, haemorrhoids, pelvic floor fatigue.
6. Constipation affecting bladder function Weiss BD. The relationship between constipation and urinary symptoms. American Family Physician. 2012. Supports: full bowel compressing bladder, urgency, frequency, incomplete emptying.
7. Overflow faecal incontinence and constipation NICE. Faecal incontinence in adults: management (CG49). National Institute for Health and Care Excellence. Supports: overflow leakage, stool retention, pelvic floor fatigue contributing to incontinence.
8. Dietary fibre and hydration for constipation Müller-Lissner SA. Effect of wheat bran on stool weight, intestinal transit, and gastrointestinal symptoms. Scandinavian Journal of Gastroenterology. 1988. Supports: fibre softening stool, improving transit, reducing straining.
9. Hydration and stool consistency Popkin BM, et al. Water, hydration and health. Nutrition Reviews. 2010. Supports: hydration preventing hard stools, supporting bowel movement ease.
10. Diaphragmatic breathing and pelvic floor relaxation Sapsford R, Hodges PW. The effect of breathing pattern on pelvic floor muscle function. Manual Therapy. 2001. Supports: diaphragmatic breathing reducing pelvic floor tension, improving coordination.
11. Pelvic floor therapy for constipation Heymen S, et al. Randomized controlled trial shows biofeedback is superior to laxatives for pelvic floor dyssynergia. Gastroenterology. 2007. Supports: pelvic floor retraining improving coordination, reducing incomplete emptying and straining.
12. Electromagnetic pelvic floor stimulation (HI‑EMT) Silantyeva E, et al. Comparative evaluation of electromagnetic vs electrical stimulation on pelvic floor muscles. Female Pelvic Medicine & Reconstructive Surgery. 2020. Supports: supramaximal contractions, improved coordination, neuromuscular activation.
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