According to National Institute of Health, constipation is a health problem that impacts over 4 million people in the United States. Most people associate constipation with diet and disregard the uprising cause of constipation which has to do with poor posture. This blog is about constipation, pelvic floor dysfunction, and pelvic stability and how the instability in the pelvis creates havoc with the stability of the pelvis which houses the pelvic floor with the end result of constipation.

What Is Constipation?

Constipation is infrequent or difficult bowel movements. While diet and activity play a big role in the function of bowel movement, there are plenty of people who eat fairly well and go to the gym or work out and still experience constipation. While many wonder if constipation will go away by itself, if the cause is not due to medication that can be discontinued or due to surgery that causes constipation, it is worth further investigation.

What Does Constipation Feel Like?

Recently I read an article about a recent discovery of the cause of death in Elvis Presley and how he did not die of a drug overdose but from constipation! It made me look into it further to find out the autopsy revealed that he had fecal matter as old as 4 months! Was it pain from constipation that killed him or something else? No one will actually know but they suspected that as he was about to sit on the toilet, the pressure from the fecal matter in his intestine and the obvious increase in intra-abdominal pressure put excess pressure on the aorta and killed the man!

Now, while that is off the charts and unusual in most constipation cases, let’s not forget how this excess pressure feels like when imposing pressure on the internal organs and how each organ under stress can have its own series of symptoms. Cramping, bloating, nausea, or pain in the rectum from straining are commonly reported symptoms.

Are Constipation and Indigestion Linked?

While not all cases of constipation cause indigestion and not all indigestion is accompanied by constipation, it is possible for indigestion to occur as a result of chronic constipation. The relationship has to do with the gastrointestinal reflex. Have you noticed how after you eat, you go to the bathroom? It is the reflex that is doing its job and when constipated, the work of this reflex simply does not push the fecal material out. This compromises the digestive flow and becomes the reason why food sits in the stomach longer than usual. The stagnation of food leads to the spoiling of food in the stomach sac and the production of acid. It is this acid that causes indigestion and complications that are caused as a result of it.

Can Constipation Cause Back Pain?

Constipation can cause back pain through the following mechanisms:

  • Accumulation of fecal matter pressing on the nerves from the lower back spine, causing lower back pain.
  • Accumulation of fecal matter increasing intra-abdominal pressure, which disallows the subtle natural movement between the vertebrae which in turn creates tension in the muscles of the lower back and causing pain.
  • Constipation impacts posture which then can lead to lower back pain among other issues.

What Causes Constipation?

The cause of constipation can be simple or complex and the following is a list of some of them.

  • Diet not eating enough fiber, such as fruit, vegetables, and cereals
  • Not drinking enough water and fluids
  • A change in the routine or lifestyle
  • Limiting or avoiding the use of the bathroom
  • Immobility or lack of exercise
  • Poor posture and pelvic floor dysfunction
  • Medication
  • Complications from surgery
  • Medical conditions such as Parkinson’s, Diabetes, or Celiac disease
  • Spinal injuries
  • Pregnancy¬†

How Do Pelvic Instability and Posture Cause Constipation?

The pelvis is the house to your intestines, bladder, and uterus/ovaries/prostate. With pelvic instability, the ‘house’s’ integrity is compromised and with an unstable pelvis, every single movement, and position you hold while awake and sleeping accentuates this instability.

All of the muscles, tendons, nerves, connective tissues, blood vessels, and the soft tissues that reside or go through the pelvis will be at the mercy of the pelvic stability and positioning in posture. When these structures are compromised, their functions are altered.

The following factors directly impact the chances of constipation:

  • Position of the intestine, specifically the colon, within the pelvis can be changed if the pelvis is tilted forward or backward
  • Amount of pressure imposed on the intestine as a result of poor posture or enlargement of the neighboring internal organ
  • Nerves that signal the internal and external sphincter muscles to contract or relax
  • Stability of the pelvis in relation to the hips and the spine
  • Presence or absence of pelvic floor dysfunction
  • Functional vs dysfunctional movement patterns that impact the stability of the pelvis
  • Puborectalis muscle which loops around the colon and has to relax for the fecal material to go through


Sling around the colon

Puborectalis sling courtesy of futurelearn.com

If you suffer from chronic constipation and wonder if your constipation is due to pelvic instability and your posture, contact me and put an end to your constipation.

Dr. Shakib


Recommended Reading:

Pelvic Floor, Deep Groin Pain, and Deep Hip Pain

What is Pelvic Pain and Who Treats Pelvic Pain?