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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

What Our Patients Have to Say

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Testimonial by Lauren B.

Femina PT (née Fusion Wellness & Physical Therapy) has been such an answer to prayer, i'm so glad I found them! I've been struggling with vaginismus my whole life, but didn't have a name for it until about 6 or 7 months ago. Even once I did have a name for it though, I didn't know where to begin in getting help. My OB/GYN had me get a set of dilators, but I couldn't even insert the smallest one by myself. Most times I tried I just ended up frustrated and in tears. I felt really alone, like I was broken and didn't have the energy to keep trying. When I got engaged a few months ago though, I realized I needed to get answers so i wasn't dreading my honeymoon.

Read more: Testimonial by Lauren B.

Testimonial by S.P., Age 26

I would like to start off by thanking Heather Jeffcoat for educating me and curing me of Vaginismus. I had been married for almost three years before I was referred to Heather. I never knew about Vaginismus until almost three years into my marriage. I knew something was wrong when I went on my honeymoon and came back a Virgin. I had always imagined how magical my first night would be but boy was I wrong.

Read more: Testimonial by S.P., Age 26

Testimonial by T.C.

While pregnant with my twins, Heather took care with keeping me on my feet and pain free. She saved my back, my sanity and the holidays! I would recommend her to every “mom” looking to stay on her feet during pregnancy and post-partum.

-- T.C.

Testimonial by R.D., age 38

"I had a severe tear during childbirth that was not stitched together correctly and therefore healed poorly. Even after having a surgery a year later to remove the scar tissue, I was still having pain, and no one could explain why -- there was no overt 'reason' to explain the pain. I had tried other 'specialists' and even saw another physical therapist who had me do hip / leg stretches -- what a joke! I was about to give up and just 'live with it' until thankfully I kept searching online and found Heather.

Read more: Testimonial by R.D., age 38

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 Julie T.

Femina PT (née Fusion Wellness & Physical Therapy) has honestly changed my life. Before receiving treatment at Femina, I was going doctor to doctor to try and find the answer to my pelvic pain. It has taken me YEARS to find someone that can help fix this. It wasn't until my gynecologist recommended your clinic that I finally felt relief. My pelvic pain is almost gone, and granted I still have a lot more to work on with Laureen (my PT), my original problem is nearly cured. I am so grateful to her.

What is even better is she gave me practical exercises to do at home that were not tedious and provided instant (and lasting) relief. Although I mainly work with Laureen, my interaction with the owner (Heather) has been great. She is very generous, kind, and committed to her business.

It hurts to know there are women out there suffering who will never know or have the opportunity to work with women like Laureen and Heather because this issue is hardly talked about and this field is so rare. I hope more doctors and physical therapists see the value in this work and can relieve more woman of their pain.

-- Julie T., 12/4/16 via Yelp!

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