What is Chronic Constipation

Many patients with chronic constipation or pain with bowel movement may present with a history of hemorrhoids. A large number of people who are constipated also have pelvic floor muscle dysfunction or pelvic floor dyssynergia. The inability to have a bowel movement is caused by the poorly coordinated pelvic floor muscles (puborectalis plays a major role). When the puborectalis muscle is relaxed- the anal sphincter is open and allows stool to be evacuated.  When the puborectalis muscle is contracted, the sphincter is closed and prevents fecal incontinence.  In chronic constipation straining and difficulty in evacuating bowel movements can be very painful, before, during and after the bowel movement.  Many times, you may feel the need to have a bowel movement, but are unable to.

Pelvic Pain and Constipation

Now you understand what chronic constipation is and how it relates to pelvic floor muscles. Many of our patients ask,”Can constipation cause pelvic pain?” And more particularly how?

Constipation can often times be a bi-product of pelvic pain. Where the pelvic pain is an underlying tension in the pelvic floor muscles. Patients may come in with an excess amount of stress or physical tension. They are concerned about having chronic constipation without knowing pelvic floor muscle dysfunction could be what needs to be treated first. Through an individualized treatment plan, we can treat the root of your chronic constipation by bringing relief to the pelvic floor muscle. Our treatment along with some lifestyle and dietary changes will put you on the path for long-term relief.

anatomy of chronic constipation

Diagnosing Chronic Constipation

Chronic constipation is described as having less than three bowel movements a week. Also, the stool may be formed, hard and small. Evaluating your stool consistency using the Bristol Stool Chart can help you determine your level of constipation.  Our doctors spend time educating our patients on the proper way to have a bowel movement, the appropriate use of vitamins and supplements, and the importance of having regular painless bowel movements daily.

How to Treat Chronic Constipation

Often times simple lifestyle modifications can treat chronic constipation. If this is not enough, there are many options that include pelvic floor physical therapy as well as nerve blocks.  Our treatment protocol focuses on decreasing the muscle tension on the pelvic floor, which in turn causes the muscles of the pelvic floor to properly coordinate with bowel movements in a safe and effective manner.

bristal stool chart for chronic constipation

What are Hemorrhoids

Hemorrhoids are swollen veins in your anus and lower rectum, similar to varicose veins. Hemorrhoids have a number of causes, although often the cause is unknown. They may result from straining during bowel movements or from the increased pressure on these veins during pregnancy. People who stand or sit for long periods of time are at a greater risk for hemorrhoids. You can also get hemorrhoids from chronic constipation or chronic diarrhea. Coughing, sneezing, and vomiting can also make hemorrhoids worse.

Hemorrhoids may be located inside the rectum and are called internal hemorrhoids, or they may develop under the skin around the anus which are called external hemorrhoids.

Nearly three out of four adults will have hemorrhoids from time to time. Sometimes they don’t cause symptoms but at other times they cause itching, discomfort, and bleeding. Hemorrhoids are one of the most common causes of rectal bleeding. They typically are not dangerous and usually clear up in a couple of weeks. However, you should see your primary care doctor or gastroenterologist to confirm the cause of GI bleeding, as other causes are dangerous to your health.

If you are experiencing pain associated with chronic constipation and/or hemorrhoids please contact our office to set up a consultation to start you on the path to relief.