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Poop Emoji Photo by Sincerely Media on Unsplash
Photo by Sincerely Media on Unsplash

Your Stress Levels Affect your Bowel Movements and Vice Versa

Psychological stress affects your bowels. Perhaps you know this through personal experience, but research in the past decade has strengthened the link between stress and bowel problems including IBS, nausea, vomiting, abdominal pain, and constipation (Chang et al., 2014).

Chang et al. (2014) found that heightened stress levels increased inflammation and permeability in the GI system, which were tied to increased IBS symptoms.

In 2018, Chan et al. found a dynamic relationship between bowel symptoms, stress, and emotional well-being. Study participants reported stress levels affected bowel function, and that also when they had were experiencing bad bowel function (loose stools, abdominal pain) that this affected their emotional well-being.

Qin et al. (2014) found evidence from their clinical and experimental studies that psychological stress had impacts on intestinal sensitivity, motility, secretion and permeability. Furthermore these changes in the GI system had affects on other systems of the body including the immune system, central nervous system, peripheral nerve function, and the healthy levels of bacteria in the GI system.

Bowel Function and Pelvic Floor Dysfunction


A lot of our clients with pelvic floor dysfunction, pelvic pain, endometriosis, and prolapse have some trouble with their bowels - either constipation, straining, or diarrhea. These bowel-related issues can cause abdominal pain, painful bloating, rectal pain, and pelvic floor problems. It’s a connection that is very important to consider!

The connection between your bowels and your pelvic floor

If you think about what is housed inside of the pelvic bowl, three important systems have to co-exist and share a limited amount of space:

  • Urinary System: the bladder and urethra
  • Reproductive Organs: Uterus, ovaries, fallopian tubes, and vaginal canal
  • GI System: sigmoid colon, rectum


Image Source: Wikimedia Commons

If you are constipated, the sigmoid colon will have to expand to house the extra stool you are storing. This makes the colon take up more space—and take space away from the other systems that need to be housed down there- this can lead to extra pressure on your pelvic floor, low back pain, pelvic pain, among other things. Also, people with constipation tend to strain when they are on the toilet, contributing to issues like pelvic organ prolapse (read more about prolapse in this previous post).


Diarrhea and Loose Stools
Most people have experienced fecal urgency with loose bowels at least once in their lives- the experience of rushing to the bathroom to have a bowel movement or having an accident.

Although management of conditions like irritable bowel syndrome should be multidisciplinary, pelvic floor Physical therapy can play a role in regaining control of your bowel movements instead of allowing them to control you.

Bowel incontinence (also referred to as fecal incontinence, or FI) is defined as the involuntary loss of liquid or solid stool that affects quality of life or hygiene. Between 2 to 24% of the adult population suffer from bowel incontinence in a year, with 1 to 2% experiencing significant impact on daily activities (Scott, 2014).

Read more about Diarrhea, IBS-D, and the pelvic floor in this previous blog post.

Constipation
Constipation and pelvic floor disorders often go hand-in-hand for clients with hypertonic (tight) pelvic floor muscles and with associated symptoms like pelvic pain, pain with sex, and urge incontinence. We also find there is a problem with coordination of muscle function that must be addressed. So, getting your constipation under control is a key piece in healing your pelvic floor.

Read more about Chronic Constipation here.

Read more about Bowel Health in this previous blog post.

Healthy Habits for Bowel Regularity (Both Constipation AND Diarrhea)

  • Stress Reduction. Keeping your stress under control will help your gut stay balanced and functioning. Meditation, exercise, creative expression, and having social contact with those who offer you emotional support are all great ways to reduce stress.
  • Exercise. Motion is lotion! Approximately 30 minutes of daily cardiovascular activity can help improve motility of intestinal waste.
  • Massage your belly. Abdominal lymphatic massage– a self-care technique we teach at the clinic, it is used to decrease the edema and bloat in the belly caused by IBS issues, constipation, loose stools, and pelvic pain.
  • Drink water! Your GI system needs water to keep things moving. Drink approximately 64 oz daily.
  • Take care of your body tissues. Stretch daily, use a foam roller to release tight spots and mobilize connective tissue, get monthly massages.

Pelvic Floor Therapy and Bowel Function

If you find yourself dealing with chronically loose stools or constipation, consider checking in with your doctor and also check in with a licensed pelvic floor therapist to see if pelvic floor physical therapy might be a good choice for you.

The pelvic floor muscles extend from the pubic bone all the way to the tailbone. One main function of the muscles is controlling the sphincters, including the anus. Having healthy and functional pelvic floor muscles is essential to having easy and stress-free bowel movements.

Get in touch with a therapist at Femina PT today if you have any questions.

 

Resources

Shariati, A., Maceda, J. S., & Hale, D. S. (2008). doi:10.1097/01.aog.0000308660.48204.7

Chang YM, El-Zaatari M, Kao JY. Does stress induce bowel dysfunction?. Expert Rev Gastroenterol Hepatol. 2014;8(6):583-585. doi:10.1586/17474124.2014.911659

Chan Y, So SH, Mak ADP, Siah KTH, Chan W, Wu JCY. The temporal relationship of daily life stress, emotions, and bowel symptoms in irritable bowel syndrome-Diarrhea subtype: A smartphone-based experience sampling study. Neurogastroenterol Motil. 2019;31(3):e13514. doi:10.1111/nmo.13514

Qin HY, Cheng CW, Tang XD, Bian ZX. Impact of psychological stress on irritable bowel syndrome. World J Gastroenterol. 2014;20(39):14126-14131. doi:10.3748/wjg.v20.i39.14126

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What Our Patients Have to Say

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Testimonial by M.M.

A personal journey and testimonial from one of my patients:

My husband and I were married for 5 years before we were able to have intercourse due to my vaginismus. There was nothing traumatic in my past but for some reason, even though I wanted sex, I mentally avoided "that area" of my body and didn't even admit to myself that there was a problem for a long time, even though I was never able to put tampons in. Once I finally opened my eyes up to the fact that I had a problem, I had a surgery that was supposed to fix the issue.

Read more: Testimonial by M.M.

Testimonial by J.H.

My last appointment with Heather was over 6 years ago but I still think of her every day. I don’t take for granted that I can easily get out of bed, care for my two active and busy young boys, run, play tennis, clean my house, or sit at a desk for several hours at a time. None of these tasks were easy for me before meeting Heather. Eight years ago my car was struck from behind by a tractor trailer that was estimated to have been speeding. I spent 3 years working with different PTs and Drs trying to heal and move on with my life. When I became pregnant and the hormone relaxin that “relaxes” all the joints of the body and the additional weight gain erased all my progress and I was suddenly in a lot of pain again. My OB sent me to Heather for one last try.

Read more: Testimonial by J.H.

Testimonial by J.B.

My husband and I were having problems with painful intercourse. My therapist recommended that I go and get a pelvic floor evaluation from a physical therapist. Having never been treated by a physical therapist, I wondered how this really was going to help me. My husband who is a physician was very supportive and agreed that a PT evaluation would be a great idea. So i made the appointment and was blown away by what I learned. I had no idea that pelvic floor muscles could get tight and have trigger points just like any other muscle in the body. I'm a massage therapist and very familiar with tight muscles, and this new thought really amazed me. Heather's program to help relax and strengthen these muscles made such a difference. I can say that I am 100% pain free during intercourse now. Yippee! Going to the PT appointments and doing the at-home exercises was definitely a discipline, but it's 100% worth it! The rewards are amazing.

-- J.B.

Testimonial by A.M.

Months after giving birth, it was difficult for me to go from a sitting or lying position up to a full standing position without feeling that I had to remain hunched over until a bit of time had passed to get fully upright. However, after taking Heather’s course, I learned exercises to get my body back to normal. She also showed me correct ways to lift and carry my son as well as put him in/take him out of the carseat and stroller. This class was really beneficial and Heather is a wonderful teacher who made me feel very comfortable.

-- A.M.

Testimonial by A.M.

Months after giving birth, it was difficult for me to go from a sitting or lying position up to a full standing position without feeling that I had to remain hunched over until a bit of time had passed to get fully upright. However, after taking Heather’s course, I learned exercises to get my body back to normal. She also showed me correct ways to lift and carry my son as well as put him in/take him out of the carseat and stroller. This class was really beneficial and Heather is a wonderful teacher who made me feel very comfortable.

-- A.M.

Testimonial by A.W., age 32

I wanted to let you know that my pelvic floor held strong and gave me no trouble whatsoever in my trail race this morning (12 miles)! In a way, I felt like I ran better than ever because my core feels so rock solid from all the exercises you have me doing. That was especially valuable on the technical downhill - I just flew down the trail because I had confidence in my balance and form. Thank you for helping me get back to doing what I love.

-- A.W., age 32
(completed Post-partum Renewal Program using the InTone biofeedback/stim unit)

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