Pelvic Pain With Bowel Movements: What to Know
Pelvic pain during a bowel movement is more common than many people realize, and it can stem from a range of causes including constipation, endometriosis, hemorrhoids, pelvic organ prolapse, or an overactive pelvic floor. Understanding which structures are involved is the first step toward finding relief.
The pelvic floor plays a central role in bowel function by controlling when muscles engage and relax. When straining or breath holding becomes a habit during bowel movements, it can weaken the pelvic floor over time and contribute to dysfunction.
Pelvic floor physical therapy addresses painful bowel movements through habit changes, nutrition guidance, breathing retraining, manual techniques, and pelvic floor relaxation work. I work with patients to identify the root cause and build a treatment plan specific to their needs.
Pelvic pain is considered to be any pain in the pelvic region, including organs and soft tissue that lie between the pelvic bones. Some of those structures include the intestines, uterus, bladder, rectum, urethra, vagina, and anus. Pelvic pain can also encompass musculoskeletal tissue in the hips, low back, and pelvic floor.
In this blog, I am going to discuss some of the reasons that you may experience pelvic pain during a bowel movement.
Common Causes of Pelvic Pain during a Bowel Movement
There are many different causes of pelvic pain during a bowel movement. I have listed some common causes below:
Constipation- This can cause abdominal pain associated with poor intestinal motility, stool consistency of stool, gas, and pelvic floor tension.
Endometriosis- This is when the lining of the uterus (endometrium) grows outside of the uterus causing inflammation and scar tissue. When the intestines are affected, this can especially cause pain during a bowel movement.
Hemorrhoids- These are swollen blood vessels around the anus and in the rectum that are caused by increased pressure/straining and can get irritated by firm stool and wiping.
Pelvic organ prolapse (POP)- When you strain to have a bowel movement this adds more pressure to the pelvic floor making POP symptoms worse.
An overactive pelvic floor- If your pelvic floor is chronically tight, it can be hard for your pelvic floor to relax when you are pooping.
The Role of the Pelvic Floor in Bowel Function
The roles of the pelvic floor include giving us core stability, continence, and sexual function.
The pelvic floor gives us continence by sphincteric control. When we don’t want anything to come out, our pelvic floor stays engaged, and when we want to go to the bathroom our pelvic floor relaxes to let things out.
Because of the pelvic floor’s connection to the core, it is also connected to breathing. When we breathe in, the pelvic floor lengthens, and when we breathe out the pelvic floor shortens.
How Constipation and Straining Affect the Pelvic Floor
When we relax the pelvic floor, it lengthens.
If we strain when going to the bathroom, the pelvic floor shortens and engages.
When we strain, our pelvic floor engages, and we are often holding our breath.
If the pelvic floor is engaged while we are trying to go to the bathroom, that can cause extra stress on the pelvic floor muscles weakening them, and teaches them that they can let things out when the muscles are engaged, putting you at risk of developing incontinence or pelvic organ prolapse.
How Pelvic Floor PT can Help
Pelvic floor PT can often start with more identification of habits and routine changes that need to be made. The first thing we look at with painful bowel movements is fluid intake and nutrition.
This is the first line defense to pain with bowel movement especially if your symptoms are linked to constipation. By optimizing fluid intake and ensuring you are hitting daily recommendations for fiber we can get your stool to the right consistency.
A soft but formed stool is easiest on the pelvic floor. If your poop is too firm you may have been straining or spending too long on the toilet to void.
Another treatment technique for pain with bowel movements is a gut massage to help with stool mobility in the intestines. This is a gentle manual technique where you or your PT massages gas and/or stool in the direction it moves in the body to help stimulate a bowel movement.
Working on relaxing tight muscles with stretching and learning how to breathe with your diaphragm is also important.
It is very important not to strain or hold your breath when pooping for the reasons I discussed above. We can also use a poop stool or “squally potty” to position the rectum in an optimal position.
When Pelvic Pain With Bowel Movements is a Red Flag
When pain with bowel movements is not explained by the above characteristics, it is important to seek out medical help or go to the emergency room. Some important red flags not to ignore with painful bowel movements include:
Unexplained weight loss
Fever and/or chills
Severe abdominal that does not change or gets worse
Rectal bleeding and/or blood in stool
A distended stomach
Inability to pass stool and/or gas
These symptoms can be indicative of something more serious going on.
Where to Find Pelvic Floor Therapy for Pelvic Pain with Bowel Movements in Meredith, NH
Are you local to the Lakes Region of New Hampshire and interested in working together? Book a discovery call or an evaluation to see how we can get to the bottom of your pelvic pain- pun intended! ;)
I would love to be a part of your pelvic health journey!
My office is conveniently located in downtown Meredith, and I offer individualized pelvic therapy for women who want to stay healthy and active without leaking.
Next on your reading list:
**The information provided on this blog is intended for general wellness education purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physical therapist, physician, or other qualified health provider with any questions you may have regarding a medical condition.