Does a Prolapse Cause Constipation? Exploring the Link
The relationship between a prolapse and constipation is complex. While a prolapse doesn’t always cause constipation, it frequently contributes due to the impact on surrounding structures and bowel function; therefore, the short answer is: Yes, a prolapse can cause constipation, and often does, depending on its severity and location.
Understanding Pelvic Organ Prolapse (POP)
Pelvic Organ Prolapse (POP) occurs when the muscles and tissues supporting the pelvic organs – the bladder, uterus, and rectum – weaken. This weakening allows one or more of these organs to descend from their normal position and bulge into the vagina. Several factors contribute to POP, including:
- Pregnancy and childbirth
- Aging and menopause
- Chronic coughing or straining
- Obesity
- Genetics
- Heavy lifting
Different types of POP exist, including:
- Cystocele: Bladder prolapse
- Rectocele: Rectum prolapse
- Uterine Prolapse: Uterus prolapse
- Vaginal Vault Prolapse: Top of the vagina prolapse
The symptoms vary based on the type and severity of the prolapse, but common symptoms include:
- Feeling a bulge or pressure in the vagina
- Difficulty emptying the bladder or bowel
- Urinary or bowel incontinence
- Lower back pain
- Painful intercourse
The Link Between Prolapse and Constipation
Does a Prolapse Cause Constipation? The answer lies in the anatomy and functionality of the pelvic floor. A rectocele, specifically, directly impacts bowel function. When the rectum prolapses into the vagina, it creates a pouch where stool can collect. This pouching effect makes it difficult to completely evacuate the bowels, leading to constipation and a feeling of incomplete emptying.
Other types of prolapse can also contribute to constipation. A cystocele (bladder prolapse) can indirectly affect bowel function by putting pressure on the rectum or interfering with the normal muscle contractions needed for defecation. Uterine prolapse can similarly impact the rectum’s position and function.
The pelvic floor muscles play a crucial role in both urinary and bowel control. When these muscles are weakened due to prolapse, they may not effectively support the rectum, making it more difficult to have a bowel movement.
How Prolapse Contributes to Constipation: A Closer Look
Here’s a breakdown of the mechanisms by which prolapse can lead to constipation:
- Mechanical Obstruction: The prolapsed organ directly obstructs the rectum, making it difficult for stool to pass. This is most common with rectoceles.
- Altered Bowel Motility: Prolapse can disrupt the normal contractions of the bowel muscles, slowing down the movement of stool.
- Incomplete Evacuation: The prolapse creates a pouch where stool collects, leading to a feeling of incomplete emptying and the need to strain, further weakening the pelvic floor.
- Nerve Damage: In severe cases, prolapse can compress or damage nerves that control bowel function.
- Pelvic Floor Dysfunction: Weakened pelvic floor muscles contribute to both prolapse and difficulty with bowel movements.
Managing Constipation Related to Prolapse
Managing constipation when you have a prolapse often involves a multifaceted approach:
- Dietary Changes: Increase fiber intake by eating plenty of fruits, vegetables, and whole grains. Fiber adds bulk to stool, making it easier to pass.
- Hydration: Drink plenty of water to keep stool soft and prevent dehydration, which can worsen constipation.
- Exercise: Regular exercise can help stimulate bowel movements. Focus on pelvic floor exercises (Kegels) to strengthen the supporting muscles.
- Bowel Training: Establish a regular bowel routine. Try to have a bowel movement at the same time each day. Respond to the urge to defecate promptly.
- Stool Softeners: Over-the-counter stool softeners can help make stool easier to pass.
- Laxatives: Use laxatives sparingly and under the guidance of a healthcare professional.
- Pessary: A pessary is a device inserted into the vagina to support the prolapsed organs. This can sometimes alleviate constipation by restoring the rectum to a more normal position.
- Surgery: In severe cases, surgery may be necessary to repair the prolapse.
Common Mistakes When Dealing with Prolapse and Constipation
- Ignoring the problem: Many women are embarrassed to discuss prolapse and constipation with their doctor. Early diagnosis and treatment are crucial.
- Straining during bowel movements: Straining can worsen both prolapse and constipation.
- Relying solely on laxatives: Laxatives can provide temporary relief, but they don’t address the underlying cause of constipation and can lead to dependency.
- Not seeking professional help: A healthcare professional can provide a proper diagnosis, recommend appropriate treatment options, and rule out other potential causes of constipation.
Prevention of Prolapse and Associated Constipation
While prolapse is not always preventable, certain measures can reduce the risk:
- Pelvic floor exercises (Kegels): Strengthening the pelvic floor muscles can help support the pelvic organs.
- Maintaining a healthy weight: Obesity puts extra pressure on the pelvic floor.
- Avoiding heavy lifting: Lift properly and avoid straining.
- Managing chronic cough: Treat chronic coughs promptly.
- Preventing constipation: A high-fiber diet and adequate hydration are essential.
Frequently Asked Questions (FAQs)
Is it normal to be constipated with a prolapse?
Yes, it is relatively common to experience constipation with a prolapse, especially a rectocele. The altered anatomy and weakened pelvic floor muscles contribute to difficulty in passing stool.
How does a rectocele specifically cause constipation?
A rectocele creates a pouch in the rectum where stool can collect. This makes it difficult to completely empty the bowels, leading to constipation, a sensation of incomplete evacuation, and often, the need to strain.
Can a pessary help with prolapse-related constipation?
Yes, a pessary can sometimes alleviate constipation associated with prolapse. By supporting the prolapsed organs, a pessary can restore the rectum to a more normal position, facilitating bowel movements.
Are there specific pelvic floor exercises that can help with both prolapse and constipation?
Kegel exercises are the primary pelvic floor exercises that can help. Focus on contracting and relaxing the pelvic floor muscles as instructed by a physical therapist. Stronger pelvic floor muscles can support the rectum and improve bowel function.
What kind of diet is best for managing constipation with a prolapse?
A high-fiber diet is essential. Focus on consuming plenty of fruits, vegetables, whole grains, and legumes. Adequate hydration is also crucial for softening stool.
When should I see a doctor about prolapse and constipation?
You should see a doctor if you experience persistent constipation, a bulge or pressure in the vagina, difficulty emptying your bowels, or any other symptoms of prolapse. Early diagnosis is important for effective management.
Does a hysterectomy increase the risk of prolapse and subsequent constipation?
A hysterectomy can sometimes increase the risk of vaginal vault prolapse, which might indirectly contribute to constipation. It’s essential to discuss this potential risk with your doctor before undergoing a hysterectomy.
Can straining during bowel movements worsen a prolapse?
Yes, straining during bowel movements can definitely worsen a prolapse. It puts extra pressure on the pelvic floor muscles and ligaments, contributing to weakening.
Are there any medications that can help with prolapse-related constipation?
Stool softeners and gentle bulk-forming laxatives like psyllium can be helpful. However, avoid using stimulant laxatives regularly without consulting with a healthcare professional.
What are the surgical options for treating prolapse and constipation?
Surgery can be used to repair the prolapsed organ and restore it to its normal position. Different surgical approaches exist, and the best option will depend on the type and severity of the prolapse.
Can prolapse affect my ability to have normal bowel movements even after surgery?
Even after surgery, some women may still experience bowel issues. This can be due to underlying pelvic floor dysfunction or nerve damage. Pelvic floor physical therapy may be beneficial after surgery.
Does a Prolapse Cause Constipation? Is there any link between stress and prolapse-related constipation?
Yes, stress can exacerbate prolapse-related constipation. Stress can tighten the pelvic floor muscles, making it more difficult to have a bowel movement. Stress management techniques, such as yoga or meditation, can be beneficial.