When Constipation Isn’t Just IBS: Understanding Pelvic Floor Dysfunction

Chronic constipation? Maybe it's not IBS.

If you’ve been diagnosed with chronic constipation due to IBS or told to “just eat more fiber” but you’re still dealing with chronic constipation, straining, or that frustrating feeling of never quite finishing, there might be something else going on — and it’s not in your head.

For many women, constipation isn’t just about what’s happening in the gut. It’s about what’s happening in the pelvic floor.

What’s really going on

Chronic constipation is often caused by pelvic floor or anal sphincter dysfunction. Basically, the muscles that are supposed to relax and coordinate during a bowel movement aren’t working together the way they should.

When the abdominal, rectoanal, and pelvic floor muscles don’t “team up” properly, it can lead to symptoms like:

• Chronic straining

• Incomplete evacuation (that “still full” feeling)

• A sense of blockage or pressure in the rectum

Over time, this cycle can lead to discomfort, frustration, and even anxiety around bowel movements.

The pelvic floor connection

Research shows that people with chronic constipation often have trouble relaxing the pelvic floor muscles — especially during attempts to have a bowel movement.

The good news? It’s treatable — and without medication or surgery.

The power of pelvic floor physical therapy

The American Gastroenterological Association recommends pelvic floor physical therapy, specifically biofeedback and relaxation training, as a first-line treatment for constipation caused by pelvic floor dysfunction.

Biofeedback-based pelvic floor therapy teaches you how to relax and coordinate the right muscles during defecation. With the help of a trained physical therapist (and some surprisingly simple tools), you can retrain your body to do what it’s supposed to do naturally.

Clinical studies show that women who complete this therapy experience:

• Less straining

• Decreased feelings of incomplete evacuation

• Better ability to relax pelvic muscles during defecation

• Improved quality of life and satisfaction with treatment

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In short — fewer worries, less discomfort, and a lot more confidence in your body’s ability to do what it needs to do.

Bottom line

If you’ve been struggling with constipation that doesn’t respond to diet changes, hydration, or over-the-counter remedies, it might be time to look deeper — or, rather, lower. Pelvic floor physical therapy can be a game-changer for women with defecatory disorders.

You don’t have to keep pushing through (literally). Relief is possible, and it starts with understanding that your pelvic floor plays a major role in digestive health too.