Pelvic floor muscles support abdominal organs including the rectum. Any problem with the pelvic muscles can interfere with the functions of the rectum and other organs such as the bladder and the vagina. In fact, pelvic floor dysfunction (PFD) is a leading cause of constipation.

How PFD causes constipation?
PFD includes all the problems related to the proper abdominal and pelvic muscle movement during an evacuation. PFD consists of many disorders that cause problems with proper bowel functions.

• When pelvic muscles do not coordinate muscle movement (relaxation and contraction), the condition is called dyssynergia. When pelvic muscles lose the ability to relax during the bowel movement, the condition is termed as anismus. Both dyssynergia and anismus can be a cause of constipation.
• When pelvic muscles become weak due to any other medical condition, it can affect normal bowel functions and cause difficulty in elimination.

Diagnosis
If all anatomic, disease-related and dietary reasons for your constipation have been eliminated, your doctor may suggest diagnostic tests for PFD.

• Endoanal/endorectal ultrasound: This is used to create images of the anus and nearby muscles through an ultrasound probe.
• Anorectal manometry testing: This is used to check the health and functions of various anal and rectal muscles.
• Balloon expulsion: This is used to test the time and efficacy of the rectum to expel a water-filled balloon, which is placed inside the organ.

Treatment
Treatment of PFD is possible through non-surgical methods.

• Biofeedback training: This uses audio and visual aids to retrain patients to use their pelvic and anal sphincter muscles (muscles surrounding the anal canal).
• Kegel exercises: This can help strengthen pelvic muscles. To do these exercises, you need to consciously relax and contract your pelvic muscles a few times every day. If weak pelvic muscles are a cause of constipation, practicing Kegel exercises can be very beneficial in treating the condition.

When you have severe constipation, it helps to rule out all possible causes. When PFD is the cause of constipation, your doctor may guide you to the right treatment plan depending on the seriousness of your condition. Without treatment for PFD, your colon, rectum, and anus can suffer damage and worsen your constipation.