The Women's Journal

Tackling Constipation 

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Dr. Bianca-Alexis Ferrante PT, DPT

Abdominal pain and bloating are common symptoms associated with food allergies and sensitivities, stress, the flu, irritable bowel syndrome, overeating, carbonated beverages, indigestion, and pregnancy. These symptoms though can also be associated with one of the most common GI complaints: Constipation.

After eating, food moves through the colon, which absorbs water from the food, and waste (stool) is produced. Muscle contractions then push the stool through the colon to the rectum. If the muscle contractions are too sluggish or the colon absorbs too much water in this process, the stool can become hard and dry, resulting in it moving too slowly through the colon and getting stuck.

Constipation is defined as having a bowel movement less than three (3) times per week. More than 4 million Americans, including women of all ages, are affected. Millions of dollars are spent each year on laxatives and over two million physician visits are made per year. Causes of constipation include dehydration, abuse of laxatives, constantly ignoring the urge to have a bowel movement, change in lifestyle and/or routine, lack of movement, too little or not the appropriate fiber, and medications. 

Abdominal pain and bloating, and difficulty with emptying your bowels are common symptoms of constipation. Anyone who has experienced constipation knows exactly how frustrating and uncomfortable it feels. However, some simple lifestyle changes and pelvic floor physical therapy can definitely help! The pelvic floor is a group of muscles, tendons, and ligaments that act as a sling to your organs in your pelvic region, and play an important part in urination, bowel movements, and sexual intercourse. Restrictions (caused from adhesions, tight musculature, and inflammation) in the diaphragm, intestines, and pelvic floor muscles can contribute to symptoms of constipation. When having a bowel movement, the pelvic floor muscles are supposed to relax, however many times they contract instead (due to neurological or musculoskeletal conditions), stopping the process of emptying one’s bowels and causing constipation. 

Adequate hydration is one of the key solutions. The recommended amount of water is half one’s body weight in ounces. It is important to note that other fluids such as juice, milk, coffee, and soda are not included in this recommendation, as they can add to dehydration. Also, abuse of laxatives can lead to the body’s dependence on them, giving one the illusion of needing them in order to eliminate stool. In addition, constantly ignoring the urge to have a bowel movement can retrain the body into holding onto the stool, causing constipation. Movement is another key solution, as it promotes circulation, muscle contraction, and peristalsis (muscle contractions creating wave-like movements to push food through the intestines). 

Another important factor is positioning, which is often discussed with regard to improving your sitting or standing posture, to prevent low back pain. Positioning though is especially important with constipation as well. Most toilets provide a 90-90 sitting position, so your hips and knees are each at 90-degree angles. This specific positioning blocks the rectum and prevents the elimination of stool, causing you to strain. In a squatting position (with 35 degrees of hip flexion), the intestines and rectum are properly aligned to allow elimination of stool with decreased physical effort. A squat can be easily achieved by placing a stool under your feet, allowing the knees to be higher than the hips.

Many times, the lifestyle tips addressed above are not sufficient enough on their own in addressing constipation. At Revive Health & Wellness, patients are given specific exercises and stretches to address tight or weak pelvic floor musculature. Abdominal massage, including cupping and myofascial release, are also incorporated in treatment sessions.

Patients can also learn to self-massage at home. Relaxation and breathing techniques, which are extremely important as well, are taught. There are many different approaches that you can take to initiate relaxation of the pelvic floor muscles and in getting one step closer in helping empty your bowels. For more informantion please contact Revive Health & Wellness at 302-482-2237 or email [email protected].

“Constipation.” National Digestive Diseases Information Clearinghouse, National Institute of Diabetes and Digestive and Kidney Diseases – National Institutes of Health, NIH Publication No. 06–2754, February 2006.


Dr. Bianca-Alexis Ferrante is the owner & founder of Revive Health & Wellness. A graduate of the University of Hartford, she treats women with pelvic floor dysfunction. After graduation, Dr. Ferrante worked in various physical therapy settings (skilled nursing facility, outpatient, acute care hospital, and home health care). While treating rehab patients, Dr. Ferrante saw the correlation between aligning the body and successful treatment of incontinence and pelvic discomfort. The Herman and Wallace Pelvic Floor courses provided her with the knowledge to properly treat these patients. Seeing how women were limiting themselves and not living life to their potential, instilled the desire within her to create an environment that would empower women to heal. 

(302) 482-2237