A Deeper Look at Constipation &

Visceral Manipulation

Constipation is common, affecting roughly 15% of Americans as of 2023, with that number projected to rise (NIH). Diet and hydration can play a role, but you can eat well, drink plenty of water, and still struggle with constipation.

Constipation is generally described as infrequent or difficult to pass bowel movements. What counts as "infrequent" can vary. Some sources define it as fewer than one bowel movement per day, while others consider daily bowel movements to be within a normal range.

But frequency isn't the only factor worth paying attention to. At Invincible Physical Therapy, we look at the whole picture: how easily you're able to go, and how the digestive, nervous, and musculoskeletal systems, along with movement, stress, and daily habits, may be influencing bowel function.

Visceral manipulation is a hands on approach that focuses on the mobility of the organs and the tissues surrounding them.

When working with someone experiencing constipation, a practitioner may assess the abdomen and large intestine for areas of restriction that may be affecting bowel function. Gentle manual techniques can then be used to work with these tissues and support mobility and circulation within the digestive system.

Visceral manipulation can play an important role in supporting individuals struggling with constipation, particularly when multiple factors or systems may be contributing to their symptoms. You can read more on Barral Institute research on visceral manipulation and constipation.

The large intestine plays an important role in moving waste through the body and toward the rectum for elimination. When assessing constipation, we look at the colon as a whole, paying attention to areas where tension or restricted movement may be affecting how things move through the bowel.

One area we may pay particular attention to is the cecum, located in the lower right side of the abdomen where the large intestine begins. We also assess the rest of the colon, since different areas can have different levels of tension and mobility.

As we work through the large intestine, we pay attention to how the tissues move and respond. Differences in tension, mobility, or the pulse we feel in an area can provide additional information about what may be happening within the bowel.

The Cannon-Bohm region is a specific area of the large intestine where sympathetic and parasympathetic nerve inputs converge. This makes it a key landmark for assessing nervous system regulation of the bowel.

During treatment, gentle manual techniques may be used to work with the tissues here, following their natural movement rather than forcing the bowel to move, in order to support the mobility of the large intestine.

Working with this region offers insight into how the large intestine and autonomic nervous system interact, and whether that interaction is playing a role in someone's symptoms.

The digestive and nervous systems are closely linked. Nerves running to the digestive tract help coordinate movement through the intestines and support digestion and elimination. Stress can throw this off, sometimes slowing or altering bowel function.

Beyond the Cannon-Bohm region, we may also assess the L5 nerve root and sacral plexus, which connect to the pelvic and rectal areas. Here too, we may work with these structures while monitoring the rectal region for changes.

Together, these findings help build a fuller picture of how the nervous system is communicating with the digestive tract, and where that communication may be breaking down.

Sometimes constipation has roots in experiences that began in childhood. A child who regularly held bowel movements at school out of fear of using the bathroom, for example, may carry that habit into adulthood. Being teased or made to feel uncomfortable about spending "too long" in the bathroom can have a similar effect.

Over time, this kind of holding can become a learned response. Because the brain and gut are so closely connected, these early experiences can become tied to how the nervous system responds around digestion and elimination.

Understanding this history can be genuinely helpful when working with long-standing constipation. At Invincible, we may work with the head and abdomen together when these connections appear relevant to someone's symptoms.

That said, we aren't psychologists or counselors. When emotional or behavioral concerns go beyond what physical therapy can address, we may recommend working with a qualified mental health professional as well.

There are several simple strategies that may help support healthy bowel movements and digestive function.

Footstool

Using a footstool, such as a Squatty Potty, will relax the muscles and provide a more supportive position for passing a bowel movement.

Humming & Breathing

Gentle belly breathing or humming can help you connect with your abdomen and encourage relaxation. Try taking slow, comfortable breaths rather than holding your breath or straining.

Movement

Regular movement is another important part of supporting digestive function. Walking, exercising, and sweating can all be incorporated into your daily routine.

Hydration

Staying hydrated is important for supporting healthy bowel function.

Eating Habits

How you eat can matter just as much as what you eat. Give yourself time to eat rather than rushing through meals, and focus on chewing your food thoroughly.

Self-Massage

Gentle abdominal techniques can also be incorporated into your self-care routine. Here are some techniques that can be helpful:

Consider Castor Oil

If tolerated, castor oil packs are another option some people use as part of their self-care routine. Queen of Thrones castor oil packs are available in the Invincible office or online.

Nutrition

Nutrition can also play an important role in digestive health. Because dietary needs vary from person to person, working with an appropriate nutrition professional can help create a plan that supports regular digestion.

Chronic constipation is rarely caused by just one factor. The digestive system, nervous system, movement patterns, stress, and long-standing habits can all play a part, sometimes several at once.

Visceral manipulation can be especially helpful here, since it looks at the mobility of the organs and their connection to the nervous system together, rather than focusing on just one piece.

At Invincible Physical Therapy in Lakewood, Colorado, we use visceral manipulation and manual therapy to assess these systems, identify what may be interfering with normal bowel function, and address the root causes rather than just the symptom.