Stress, Bowel Movements, and Your Pelvic Floor
- Written by Nancy Hoi Wong OTD, OTR/L, RYT200
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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 and occupational 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).
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.
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 or occupational 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.
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