Bloated and constipated around the holidays? A pelvic floor perspective on better bowel movements from Thanksgiving to New Years
‘Tis the season for holiday hustle, occasionally tense dinner table conversations (and lots of laughter, too, I hope), overspending and overanalyzing which Black Friday deals to jump on, and yes - constipation.
And if you have a history of pelvic floor problems (like painful sex, bad periods, or leaking when you sneeze ), or even gut issues and anxiety, you might be more acquainted with the not-so-merry side of the holidays - constipation.
Did you know that constipation can be a cause or contributor to all KINDS of things like pelvic floor tension, painful intercourse, painful periods, hormonal imbalances, gut health problems, painful sex, anxiety, and much more?
Interestingly enough, constipation can also be a RESULT of all of the above conditions.
If you’re dreading Thanksgiving and the multitude of upcoming holiday parties and meals for fear of the uncomfortable bloating, discomfort, and even pain you experience during this season, trust me when I say, I have BEEN THERE!
How are bloating and constipation related to the pelvic floor?
Are you surprised at the connection between constipation and pelvic floor problems? Several years ago, I was too. May I tell you a bit of my story?
Through my years-long journey with chronic back, leg, and pelvic pain that was ultimately being driven by endometriosis, and I eventually made the decision to have endometriosis excision surgery to give myself the best chances of healing (PS - surgery is not for everyone, and if you suspect endo and are considering surgery, please schedule a call with me first!)
I had improved my gut health holistically for months prior to having surgery, but about 3-4 months after my surgery (right around Thanksgiving), I started to notice that EVERY time I ate even a small amount, my belly bloated so badly that I looked pregnant (and this was way before I started trying to conceive).
I remember being at my in-laws’ house, on my back, too uncomfortable to move because I was so bloated, and I hadn’t pooped in DAYS. I was like Regina George in Mean Girls… if you catch my reference.
When I finally did, it was a strained bowel movement that felt incomplete. And HURT!
Before I became a pelvic floor physical therapist, I had no idea that straining to poop was such a detrimental thing to the pelvic floor. And I also had no idea how much my other pelvic health issues, that stemmed from the endometriosis and 3 years of chronic pain, were impacting my gut health and bowel health.
Yall know there is no such thing as TMI in this corner of the internet, and I’m happy to tell you I overcame my severe constipation and bloating after several months of holistic gut care, hormone healing, and an integrative approach to treating the pelvic floor. I even have pain-free periods (and help others to do the same) and never experience more than a SMALL amount of bloating (which is normal to experience in the few days before your period because of the effects of progesterone and prostaglandins)
So if you’re dealing with constipation and bloating, know that it does NOT have to be your normal.
Why do I get bloated and constipated around the holidays?
Maybe you don’t experience chronic bloating, constipation, and other pelvic floor issues, but you do notice these issue creep up during the holiday season. Why is that?
There are a lot of reasons you may notice an increase in constipation around the holidays, including:
increased stress
dysregulated nervous system
eating meals and foods you don’t normally eat
more alcohol intake than usual
travel/excessive sitting
All of these can cause tension in the pelvic floor muscles, and when the pelvic floor muscles are tight or hypertonic, it makes it more difficult to relax them to allow a bowel movement to pass through easily.
In addition, the slower your bowels are, the more hard and dry your stools, which makes them much harder to pass. This leads to straining, which causes more pelvic floor tension, which causes more difficulty pooping.
Are you seeing this? Constipation can be tricky because it both CAUSES/CONTRIBUTES to pelvic floor tension, and it also is a RESULT of these things (in addition to things like anxiety, nervous system dysregulation, and stress) - so it can create a really vicious cycle of discomfort if left untreated for too long.
How does stress around the holidays cause constipation ?
The number one reason I see bowel problems like constipation and bloating increase during the holidays is due to holiday-related stress.
Things like:
Tension with family members (please tell me you have seen/loved/cringed at the Dinner table scene from Family Stone)
Travel stress (especially if you are traveling with kids!)
Financial pressure from consumerism culture
are just a few examples of stressors that can get your body’s normal functioning out of wack, and the result for many of us is bloating and constipation.
Without getting into the nitty gritty physiological details, Stress of ANY kind is perceived as a threat by the nervous system. This is because our stress-management system in the body is built into our neurobiology for survival. When we see a threat (like a bear), our nervous system gets ready for action- fight, flight, freeze, or fawn - so that we can survive this encounter. This is essentially the role of the sympathetic nervous system.
But we weren’t meant to be in a state of fight or flight for long - as soon as we reach safety, we are built to switch into a parasympathetic state, which is the steady state in which our body can prioritize normal functioning like rest, reproduction, and digestion.
Unfortunately, many of us have lived in a state of chronic stress - which puts us in a constant state of fight, flight, freeze, and fawn responses. Stress tells our brain, “hey!! brain! we are not safe!” to which the brain responds by prioritizing survival functions over our “safe-state” functions.
For those who have experienced trauma of any kind, it is an uphill climb to re-establish safety in our bodies so they can function properly, because they have been fighting so hard to protect us for so long.
(As a side note, this is another number one missing link I see in my clients struggling with fertility. The body will NOT prioritize fertility in a state of chronic stress- even the stress of trying to conceive.)
How stress impacts your pelvic floor and increases constipation
Now, another mechanism that occurs as a result of this phenomenon is an increase in pelvic floor muscle tension as a result of stress. Studies have shown that perceived threats increase activity of the pelvic floor muscles. Remember how we said that any type of stress is a perceived threat?
So now, not only is your digestion slower, your pelvic floor muscles are constantly “on.” When this happens for a long time, your pelvic floor muscles may have difficulty relaxing completely. In order for you to have a very good and satisfying bowel movement, you need your pelvic floor to relax and allow stool to move through. So chronic pelvic floor tension (as a result of stress) therefore increases the chances you will become constipated.
Stress during the holidays can lead to a tight pelvic floor, leading to pain, bloating, and constipation.
To recap: If you are in a state of stress, your body is working to protect you from perceived harm, and therefore, your digestion may slow (in some, the problem is more constipation than diarrhea, but the root cause is the same), which causes bowels to be harder and more difficult to pass. Your pelvic floor muscles also may become chronically overactivated and tight, making it difficult to relax. The combo of a tight pelvic floor and hard stools is not a recipe for juicy poops!!!
Also to recap: Sarah Jessica Parker DEFINITELY has to have the tightest pelvic floor of all time in Family Stone.
There is SO much more I could say here, but I hope this gives you a good background into why this may happen to you (or your friends - send them this blog post!), particularly around the holiday season.
So, What can I do to have better bowel movements and reduce bloating from Thanksgiving to New Year’s Day?
Fear not, because you don’t have to let bloating, discomfort, and pelvic pain steal your joy during this festive season! Here's a guide to keep your bowels as merry as the holiday spirit.
Stay super hydrated for juicy, easy-to-pass poops.
Aim for 1/2 your body weight in ounces of water per day, sipping throughout the day and ALWAYS having a glass of water that you can sip in between sips of your favorite holiday cocktails, eggnogg, and peppermint mochas. You may also want to add a hydration supplement to replenish minerals (which also take a hit in seasons of stress). I love Needed’s hydration support - it has electrolytes AND a daily dose of trace minerals.
2. Posture for pelvic floor relaxation and better poops
In order to decrease tension in the pelvic floor (particularly the puborectalis muscle, which creates a “clamp” around the rectum and can make it really hard to poop if it’s really tight), Position your knees above your hips with a stool, stack of books, or a Squatty Potty to help your pelvic floor relax. No straining necessary!
3. Use proper breathing mechanics for better poops
Inhale to expand your belly, then exhale as you tighten your belly while keeping your pelvic floor relaxed and open. GENTLY bear down only if necessary. This can take a while to get the hang of, and you may want to work with a pelvic floor PT if you are really struggling with this.
4. Take your time
As it turns out, all the men in your life who take 30+ minutes in the bathroom are on to something. This is actually something I will never understand, but I digress…
The important thing to know is that juicy poops happen when you’re fully relaxed, so don’t force it (and please never strain!) If you’re stopped up, give yourself 5-10 minutes (with those feet UP!) to allow your bowel reflexes to kick in. After 10 minutes, if nothing is coming, stress not, get up and move around, and try again later.
5. Move your body daily to move your bowels
Long car rides to see family and a change in your daily routine can slow your bowels (and just make you feel icky!). Now, please hear me say - you deserve rest and I hope you enjoy lots of cozy time on the couch watching your favorite Hallmark movies! Just make sure to include some movement every day to keep your nervous system stimulated, your body loose, and your bowels healthy and regular during your annual trip. Even a 5 minute walk or quick yoga flow can get things moving AND calm your nervous system for better poops this holiday season.
6. Keep calm and unclench your butt
Travel and family time over the holidays can be stressful (even if you love your family dearly!) , and for some it can be more stressful than others. As we discussed above, this contributes to pelvic floor tension and constipation. Take a few minutes every day for a walk to calm your nervous system, or to lay down, put your feet up and breathe intentionally for a few minutes.
Alright, that’s it! I hope this quick summary helped you understand that there’s SO much more to bowel health than meets the eye, and maybe cracked the Christmas Mystery of why you are always so stopped up in November and December.
Wishing you all the Juicy poops this holiday season!!!
Dr. Jackie Joy
PS. If you are struggling with more than seasonal constipation, and you are experiencing other symptoms like weeks of bloating (particularly before your period), severe PMS, and period pain that has you skipping work (and positively ruining Christmas if it happens to start around then), now is a great time to give yourself the gift of support, and I can help! Sign up for a complementary call with me so we can figure out the best next steps for you.
