Constipation: Is It Fiber, Water, or Your Pelvic Floor? Understanding the Differences
Constipation is one of the most common digestive complaints, yet it doesn’t always come from the same root cause. In fact, three of the most frequent culprits are not enough fiber, not enough water, and tight pelvic floor muscles. Each one affects your body in a different way, and knowing the difference can help you find the right solution instead of guessing or trying every remedy at once.
Let’s break it down in simple terms.
Constipation From Too Little Fiber
Fiber is the part of plants your body can’t fully digest, and it plays a major role in creating soft, bulky, easy-to-pass stools.
What happens when fiber is low?
Stool becomes small, dry, and hard.
There’s not enough bulk to stimulate the colon to contract.
You may go days without a bowel movement.
When you finally go, you may strain or feel incomplete emptying.
Common signs it’s a fiber issue
You don’t eat many fruits, vegetables, whole grains, or legumes.
Stool looks like small pebbles or hard logs.
You feel better after adding high-fiber foods or supplements like psyllium.
What helps
Gradually increase high-fiber foods (aim for 25–30g/day for most adults).
Consider a soluble fiber supplement.
Pair fiber with water to avoid worsening constipation.
Constipation From Too Little Water
Hydration is what keeps stool soft and movable. Without enough water, the colon pulls extra fluid out of the stool, leaving it dry and difficult to pass.
What happens when water is low?
Stool moves slowly through the colon.
You may have infrequent bowel movements.
The act of passing stool may feel dry, scratchy, or painful.
Common signs it’s a hydration issue
You know you don’t drink much water.
You notice darker urine or signs of dehydration.
Stools are dry or crumbly.
Increasing water noticeably improves your bowel habits.
What helps
Drinking consistently throughout the day (not chugging once).
Adding water-rich foods (fruit, broth, smoothies).
Pairing increased fiber with increased water for best results.
Constipation From Tight Pelvic Floor Muscles
This cause surprises many people, but it’s extremely common, especially in people with pelvic pain, a history of holding in bowel movements, chronic prostatitis, or stress.
The pelvic floor muscles are supposed to relax during a bowel movement. When they stay tight, stool can’t move out even if it’s soft, bulky, and you’re well hydrated.
What happens when the pelvic floor is too tight?
You feel the urge to go but can’t.
You strain or push without success.
Stool gets “stuck” low in the rectum.
You may experience pain in the tailbone, hips, low back, or anus.
You may feel like you can’t fully empty.
Common signs it’s a pelvic floor issue
You frequently strain without results.
You get constipation even when your diet and water intake are good.
You feel a blockage or “not opening” sensation.
You have pelvic pain, pain with sex, urinary hesitancy, or a history of chronic stress.
Squatting or using a footstool helps more than diet changes.
What helps
Pelvic floor physical therapy.
Learning to coordinate breathing and relaxation during bowel movements.
Avoiding excessive straining.
Using positions that help open the pelvic outlet (like knees-above-hips).
How to Tell Which Type You Have
It may be a fiber problem if…
Your diet is low in plant foods.
Stools are small or pebble-like.
It may be a hydration problem if…
Your urine is often dark yellow.
Stools are dry or hard to push out.
It may be a pelvic floor tension problem if…
You feel the urge to go but can’t relax to let it out.
You strain a lot with little progress.
You have pelvic discomfort or other pelvic floor symptoms.
Many people actually have a combination of these factors. For example, someone might start with mild constipation from low fiber, then develop tight pelvic floor muscles after months of straining.
When to Seek Help
If constipation is new, persistent, painful, accompanied by rectal bleeding, or not improving with basic changes, reach out to a healthcare professional. A pelvic floor physical therapist can be especially helpful if you suspect tension plays a role.
The Bottom Line
Constipation isn’t one-size-fits-all.
Fiber gives stool bulk.
Water gives stool softness.
Your pelvic floor gives stool an exit.
Understanding which system needs support is the key to finally getting lasting relief.
Looking to optimize your well being with pelvic floor physical therapy? Reach out to us at Pelvic Health Center in Madison, NJ to set up an evaluation and treatment! Feel free to call us at 908-443-9880 or email us at receptionmadison@pelvichealthnj.com.