What Constipation Feels Like

What constipation feels like Tips To Ease Your Pelvic Pain: Dr. Maureen O'Keefe sitting in the Purple Mountain Treatment Room

Are You Wondering What Constipation Feels Like and Whether Physical Therapy can Help You?

At Purple Mountain Physical Therapy, we are specialists at treating adults and children who have pelvic problems, pelvic pain, bladder and bowel troubles, pelvic floor dysfunction and constipation. Many of our patients are pleasantly surprised to learn that physical therapy can help their constipation, or their child’s constipation. Many patients aren’t sure what constipation feels like and sometimes don’t even think they have constipation, but when we assess, we often find constipation is a problem for them. Contact us here to speak with our staff about getting relief.

What is constipation? And if I have it, what does constipation feel like?

Many of our patients tell us that they or their child have daily bowel movements, therefore they are not constipated. This is not true! Constipation feels like one or a few different presenting symptoms, which we’ll cover today. Constipation, when properly assessed, is a function of:

  • how often you have a bowel movement
  • how difficult it is to pass the bowel movement
  • the shape/consistency of the bowel movement
  • Whether you completely empty

Therefore, you may be having daily bowel movements that are incomplete and having a shape of a golf ball, this is constipation.

Bloating is a sign of constipation and feels like you are full:

If you notice your abdomen or your child’s experiences bloating, this can be a sign of constipation. In this case, the constipation may feel like you are gassy or you may have some abdominal cramping. In some cases, there is no pain with bloating, but just a visual change that is notable. We have some patients measure their abdomen before and after eating to determine if bloating is happening. Bloating can be a sign that the foods you eat are not agreeing with your body, so pay attention to any particular triggers for bloating. We commonly find that dairy can be a bloating trigger, for example. Very often we work with children who love cheese sticks and bloating is a problem for these kids. When this is the case, we try to have the parent and child develop different food choices to reduce cheese intake, bloating and constipation. Check out this blog we wrote about the connection between constipation and proper chewing habits. Connect with us here or call us at (616) 516-4334.

Bloating in children is a sign that stool is backing up & peristalsis is altered

If your child experiences constant bloating after eating, there can be a problem with stool backing up in the colon and, constipation. Constipation of this nature feels like bloating or feeling full. It is common that there is a decrease in appetite when someone has bloating. When stool is backed up in your child’s colon it disrupts the natural peristaltic contractions in your gut. Peristalsis is the normal smooth muscle contractions that occur in your gut to support digestion and gut motility. Typically, we are not aware that these contractions are happening and they are not voluntary. However, you may have felt peristalsis before as a “tummy rumbling”. In cases of irritable bowel syndrome, your gut may even become overly sensitized to these contractions and cause pain as a result. Connect with us to learn more about model of care.

Weak abdominal muscles can contribute to constipation

If you or your child are not engaging your abdominal wall effectively, then there will be less tension at the front of their trunk muscular canister. We need good abdominal wall integrity to support and facilitate normal colon motility. We commonly see women who have a diastasis recti abdominus postpartum who also have constipation. Our postpartum recovery program works to heal their DRA to allow for a stronger core and resolution of constipation. We also see children who have low tone in their core muscles and find these kids have constipation.

The Muscular Canister of your abdomen explained.

This canister is formed by 4 muscles: the diaphragm on top, the pelvic floor on bottom, the multifidi supporting the back, and the transversus abdominis in the front.

The transversus abdominis is the deepest muscle of your abdominal wall and performs a tensioning effect at the center of the rectus abdominis (or 6-pack muscle) called the linea alba. A well-controlled transversus abdominis muscle creates an abdominal wall that is taught, like a brand-new balloon. A weak, or poorly activating transversus abdominis is like an old balloon that has been blown up many times. A new balloon requires a lot of force to inflate and is more likely to maintain its shape. An older balloon stretches easily and requires less effort to fill. In the case of a weak transversus abdominis, even a mild amount of gas in the belly can cause a distended or bloated stomach. With targeted core strengthening directed by a physical therapist, this can often improve; a stretched balloon can become a taught well-functioning balloon again! Give us a call to speak with our knowledgeable and caring staff about our treatment.

Can you engage your deepest abdominal muscle, the transversus abdominus? If you are constipated, you might feel like you cannot.

Try engaging the transversus abdominis yourself! Place your hand just inside one of your hip bones. As gentle as you can, attempt to draw your lower abdomen toward your spine. If you feel a slight flutter and drawing in under your hand, then you have contracted your transversus abdominis.

This muscle is part of our anticipatory core and foundational for most movement. The anticipatory core prepares us to be stable as we move our limbs. Having an active and properly functioning transversus abdominis is critical to support gut health and overall mobility.

Constipation can feel like you can’t get it all out.

A person who has constipation may experience difficulty getting their stool out. When this is the case, they might feel like they have to sit on the toilet a long time and still only a small piece of stool comes out. In some cases, people with constipation experience hemorrhoids or bleeding with defecation. Reach out to us here with your questions and inquiries and we will be in touch!

Constipation can feel painful in the anus or abdomen.

To effectively eliminate we must be able to open the anal sphincter and lengthen/relax the pelvic floor muscles. Very often our patients, adults and children, have learned defecation backwards. This is called dyssynergic defecation. Instead of relaxing and opening the area to defecate, they tighten it up and try to push a stool out of the tight area. This is difficult and painful, in the anus. These patients will tell us that they have pencil shaped stools. Sometimes they have huge stools that are painful to pass. This huge stool can be due to a lengthy back up of stool that caused the size/shape to get larger than ideal. Imagine passing a too-large stool through a tightening-up anus. It hurts! We teach our patients, both adults and children, how to correctly relax these muscles to allow for a pain-free defecation. In many cases, children have toilet-avoidance because they associate bowel movements with pain. Avoiding a bowel movement will, obviously, worsen constipation.

Pain in the abdomen, including cramping, a sense of fullness or general malaise is another sign of constipation. We perform visceral mobilization on our patients and we can feel their stool. Quite often we are able to help promote peristalsis during an appointment so that the person can defecate by the end of the session. If you are experiencing anything like this, please give us a call to connect to go over how we might be able to help you.

Constipation can feel like you never need to have a bowel movement.

If you have lost the urge to defecate and you rarely feel the need to have a bowel movement, then this is a sign of ongoing constipation. We have patients who regularly come to us and tell us that they might need to have a BM twice a week, 3 times if they are lucky. Or other people who only need to go every other day. If this is your situation, then your body may not be producing strong signals to defecate. We can work with you, by providing specific pelvic physical therapy treatments, that help your rectum recovery its sensory function and begin to tell you that you need to defecate. At the same time, we need to retrain you to listen to these sensations and honor them. In this case, you cannot delay defecation; you must go when you feel the urge. Connect with us here or call us (616) 516-4334 to speak with our knowledgeable and caring staff.

Constipation feels like incomplete emptying.

When someone is constipated, they often do not have a complete bowel movement. So, what happens is they have their bowel movement and then afterwards they still feel like they have to go. Or they have their bowel movement and they look at it and think “that’s all there is? That doesn’t seem right.” With incomplete emptying a person can see that their stool size and shape is too small for the amount of food they consumed. They also may feel bloated in the abdomen or full in the rectum or anus afterwards.

We hope this gives you an idea of what constipation feels like and an understanding that even if you are having daily bowel movements, you might be constipated. Incomplete emptying, bloating, abdominal pain, shallow breathing and diastasis recti abdominus all need to be considered when you see a properly trained pelvic health physical therapist. You can expect your physical therapy at Purple Mountain PT to be holistic and comprehensive. In order to resolve your constipation, we have to assess and treat all of the things that might be contributing to it. These things include the food choices you make, how you chew your food, your habits when attending to an urge to defecate, your posture on the toilet, your ability to let go and open your anus and pelvic floor, your abdominal wall, your breathing, your low back and hips. A comprehensive treatment program will effectively resolve your constipation and if you have any other symptoms (like pelvic pain or urinary incontinence), these will improve also. Give us a call at (616) 516-4334 to get your questions answered.

Constipation can feel like Fecal Urgency or Diarrhea. You or your child might have a blow-out.

When a person has constipation, there might come a moment in time when your body has reached the edge, it must empty the rectum! This symptom of constipation feels like fecal urgency. It comes on so stealthily that some of our patients have experienced fecal incontinence in the car. It is very common for children and, if they are still wearing diapers, it is common that the parent tells us their child had a complete blow-out that was a mess to clean up.

What happens is that your body is backed up with stool, usually for many days, and on the day of fecal urgency, the body is determined to rid itself of this stool. You will feel a sudden urge to defecate, sometimes not having enough time to get to the toilet. If you do get to the toilet you may find that at first you get rid of the large, old, hard stool. After this you may experience a rush of diarrhea. If this is your circumstance, please know that high quality physical therapy, in conjunction with working with a GI specialist and/or dietician, can truly change your life for the better. Our physical therapy will teach your body how to defecate, how to attune to the signals that you need to defecate, how to let go of the pelvic floor muscles and how to retrain your system so you don’t get backed-up as readily.

Purple Mountain Physical Therapy, located in Grand Rapids, Michigan is a specialty pelvic health clinic that helps people who are experiencing constipation. We have developmentally appropriate treatments for children who have constipation and find that these kids often do have have good perception of the need to defecate. Our treatments for adults and children who have constipation, pelvic floor dysfunction, pelvic pain or urinary problems can improve people’s quality of life. We work in person at our clinic and also via telehealth. To learn more contact us at 616.516.4334 or fill out this online inquiry and we will be in touch!

Peace,

Dr. Maureen O’Keefe, DPT