How to Improve Constipation
Constipation is very common. It can feel discouraging, uncomfortable, and even a bit scary, especially after having a baby or surgery.
From a pelvic floor physical therapist’s perspective, we want you to hear this clearly: you’re not doing anything wrong. This post is designed to help you alleviate constipation, support your digestive health, and move toward more regular bowel movements.
Causes of Constipation
Your digestive tract depends on coordinated muscle contractions (motility), adequate hydration, and a regulated nervous system to move stool through your digestive system. Constipation can happen when any part of that process slows down or gets disrupted.
Common causes of constipation include:
Medications, especially certain pain medications and supplements
Changes in appetite or eating patterns (including nausea)
Not drinking enough fluids or losing more fluid than usual
Low activity levels or long periods of sitting/bed rest
Stress and nervous system overload, which can slow digestion
Hormonal changes, which can affect gut motility in many stages of life
Changes in routine, travel, or not responding to the urge to go
Certain medical conditions that impact bowel function
Constipation can also be closely tied to pelvic floor muscle coordination. To have a bowel movement, the pelvic floor needs to relax and lengthen while the abdominal muscles generate gentle pressure. If your pelvic floor is bracing, tight, or “guarding,” it can feel like a closed door when you’re trying to empty, leading to straining, incomplete evacuation, and worsening symptoms over time.
Symptoms of Constipation to Watch For
Constipation isn’t only “not going.” Common symptoms of constipation include:
Straining or holding your breath to poop
Hard, dry stools or pebble-like stools
Feeling like you can’t fully empty
Going less often than your normal
Rectal pressure or pelvic heaviness
Hemorrhoids or fissures
Bloating and gas (often overlooked, very common)
If you’re dealing with ongoing symptoms, you may be facing chronic constipation, and it’s absolutely worth getting support.
A Gentle Plan to Prevent Constipation
If your goal is to prevent constipation, think “small daily supports” instead of one big fix.
Toilet posture + breathing (pelvic floor-friendly): Use a stool or SquattyPotty. Place your feet on a stool so your knees are higher than your hips, then lean forward with your elbows resting on your knees. Exhale slowly like you’re fogging a mirror and picture your pelvic floor relaxing, which helps reduce straining and makes emptying easier.
Stay physically active: Being physically active helps stimulate gut motility. Even short walks, gentle stretching, or easy mobility breaks can support the bowel, especially after surgery.
Drink plenty of water: Hydration matters. If you’re increasing fiber (more below), it’s extra important to drink plenty of water, otherwise stool can become bulkier without moving well.
Choose high fiber foods : Fiber can help, but timing and pacing matte, especially postpartum or after surgery. High fiber foods include:
Fruits and vegetables (berries, kiwi, pears, leafy greens, cooked veggies)
Beans and lentils (start small if you’re sensitive)
Oats, chia, flax
Whole grains (as tolerated)
There are different types of fiber, and understanding them can make fiber feel a lot less frustrating:
Insoluble fiber adds bulk and helps move stool through the gut (think: wheat bran, many whole grains, veggie skins).
Soluble fiber helps soften stool by holding onto water (think: oats, chia, psyllium, apples).
If you’re prone to bloating and gas, adding fiber too quickly can backfire. Start low, increase gradually, and pair it with water.
At-Home Constipation Relief (Without Straining)
Abdominal massage to relieve constipation: Abdominal massage can support motility and help relax the belly wall, especially when you’re tense or guarding. A simple approach is the ILU massage:
Get Comfortable: Lie on your back with knees bent (or supported by pillows). Place one hand on your lower belly and take a few slow breaths.
I: Start on the left side of your abdomen, just below your ribcage. Slowly stroke downward toward your left hip bone 5–10 times.
L: Start on the right side just below your ribcage. Stroke across your upper belly from right to left (toward the left ribs) 5–10 times. Then stroke down the left side again (left ribs to left hip) 5–10 times.
U: Start at the right lower abdomen (near your right hip bone). Stroke up to the right ribs, then across to the left ribs, then down to the left hip, making a “U” shape, 5–10 times.
Helpful tips: Many people like doing this for 2–5 minutes once a day.
Safety note: If you’re pregnant, have a new or worsening abdominal pain, fever, recent abdominal surgery without clearance, a hernia, or a medical condition where abdominal massage is not advised, check with your medical provider first.
Foods that help relieve constipation: For some people, prune juice is a helpful option for constipation relief. Start small (a few ounces) and see how your body responds, especially if you’re sensitive.
Stretches to relieve constipation: Certain yoga poses may help stimulate the gut and calm the nervous system. Choose what feels safe for your body and healing stage:
Child’s pose
Supine knees-to-chest
Supine twist
Cat-cow
If a pose increases pressure, pain, or heaviness, skip it. Your body gets to lead.
When to Consider Pelvic Floor Physical Therapy
If constipation is persistent, painful, or paired with pelvic heaviness, leaking, or fear of straining, pelvic floor PT can help you build a plan that supports both the bowel and the pelvic floor.
In pelvic floor PT, we may work on:
Toileting posture + routines that support regular bowel movements
Pelvic floor relaxation and coordination (so you’re not “clenching against yourself”)
Breath and pressure management (especially postpartum and post-surgical)
Scar massage (when appropriate)
Visceral manipulation/mobilization techniques (when appropriate) to support mobility of the abdominal tissues and help the body move more freely
Strategies to alleviate constipation without force or fear
Important Note About Medical Conditions
Some medical conditions can contribute to constipation, including medication side effects, thyroid issues, neurological conditions, GI disorders, and more.
If constipation is new, severe, or worsening, or if you have red flags like vomiting, fever, severe abdominal pain, or significant bleeding, please contact your medical provider promptly.
A Kind Closing Thought
With the right strategies, including hydration, fiber that fits your body, gentle movement, pelvic floor coordination, and smart routines, you can find constipation relief and support long-term digestive health.
