Constipation and Prolapse – 10 Expert Tips for Better Bowel Movements

Are you sick and tired to of constipation and prolapse problems?

Constipation and prolapse is often the result of a cycle of straining, incomplete emptying and progressive worsening of prolapse symptoms.

These simple steps for diet, timing and prolapse constipationbowel emptying technique can help you to break the cycle of constipation and prolapse worsening.

Read on now to learn:

  • Symptoms of constipation and prolapse; and
  • 10 expert tips for better bowel movements.

Constipation and Prolapse Symptoms

Constipation with a prolapse may be characterized by:

  • Hard and/or lumpy pellet-like stool consistency;
  • Long-term straining to empty the bowel;
  • Sense of incomplete bowel emptying;
  • Sense of rectal blockage and/or obstruction;
  • Needing to manually support (using fingers) to empty; and
  • Emptying the bowels less than 3 times per week.

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10 Expert Tips for Better Bowel Movements

1. Correct Stool Consistency

Managing your stool consistency is the first and vital step for improving bowel movements with a prolapse. If your stool if too hard, it will be very difficult to pass. Good stool consistency requires adequate fibre intake (30 grams/day). Some women with constipation and prolapse make the mistake of consuming too much fibre. Too much fibre can overload the gut, a little like blocking the pipes causing constipation to worsen.

Foods that soften the stool include: fresh fruit with skins on, garlic, red capsicum, nuts, popcorn, greens (broccoli, spinach, green beans and cabbage) and spicy foods. Caffeine is a bowel stimulant and prune juice contains naturally occurring laxative.

Fibre supplements can improve stool consistency if your fibre intake is inadequate. Speak with your pharmacist or doctor about stool softeners if you are unable to achieve the correct stool consistency through diet alone.

2. Adequate Fluid Intake

Ensure that your fluid consumption is adequate. Fluid consumption of 2 litres per day is usually recommended for most individuals. Be mindful of the fact that insoluble fibre (in skins and grains) and some of the bulk forming laxatives commonly available (e.g. Metamucil and psyllium husks) require adequate fluid intake to avoid these obstructing the bowel and worsening constipation and prolapse problems. Fluid intake can be increased simply by including soups, jelly and fruits high in water content into your diet.

Prolapse and constipation3. Eat Breakfast

Eating stimulates bowel motility. Skipping breakfast is a missed opportunity to stimulate your bowels at the start of the day. Some women find that a warm drink and walking around helps to promote the urge to empty their bowels.

4. Obey the Urge to Empty

When you first sense the urge to empty your bowels, do so at the earliest convenient time. Never defer the urge to empty your bowels. Some women with constipation and prolapse lose the ability to sense when they need to empty owing to stretching of the rectum. When this happens routine emptying is most important to avoid overstretching the rectum and losing rectal sensation.

5. Take Sufficient Time

Allow sufficient time to empty your bowels, try not to rush. Sometimes the simple action of taking 5-6 slow deep breaths can help to relax the pelvic floor and facilitate bowel emptying. If you find that after a minute or two of relaxed breathing and sitting on the toilet that your bowels don’t move then get up and return to your daily activities. Plan your return when you next feel the urge to empty. Sitting on the toilet for long periods of time durations without an urge increases the likelihood of straining the pelvic floor.

6. Correct Bowel Movement Position

Position for bowel movements with a prolapse:

  • Sit on the toilet seat, never hover above the seat;
  • Knees should be higher than hips (use a wide stool or a toilet roll under each foot);
  • Lean forwards at your hips; and
  • Maintain the normal inward curve in your back.

7. Correct Bowel Movement Technique

Technique for bowel movements with a prolapse:

  • Make your waist wide and bulge your abdomen forwards (i.e. barrel shape);
  • Hold the breath you have, don’t take a new breath. This technique relaxes and opens the anal sphincter to allow the bowel movement to pass as shown in How to Empty Your Bowels online video; then
  • Lift and squeeze your pelvic floor muscles when finished.

8. Pelvic Floor Exercises

Perform regular daily pelvic floor exercises to improve pelvic floor support. During bowel emptying the pelvic floor muscles provide a firm platform of support for the passage of the stool from the body. Strengthening your pelvic floor muscles can improve the firmness of the pelvic floor and enhance bowel emptying. This is particularly important for women who have a long history of straining as their pelvic floor supports are likely to be stretched and weakened.

Manual support can also assist emptying with a prolapse. Some women find that simple hand pressure against the perineum (between the vagina and anus) can provide pelvic support where it is naturally lacking. This technique does not harm the pelvic floor and can be most useful to avoid straining.

9. Pelvic Floor Relaxation

Inadequate pelvic floor relaxation and release with bowel emptying is one major cause of constipation and prolapse. The action of straining and drawing the abdomen inwards strongly increases downward pressure on the pelvic floor and actually increases tightening of pelvic floor muscles and closing of the anus. This is the direct opposite to the desired effect of releasing the anal sphincter. Pelvic floor release is promoted by bulging the low abdomen forwards and with relaxed deep breathing.

10. General Exercise

General exercise helps to stimulate bowel motility. Research has demonstrated that moderate intensity exercise such as cycling increases the movement of wastes through the gut regardless of fluid and dietary input. Try to include regular low impact exercise such as walking or cycling as part of your daily routine. Be mindful of avoiding exercises with the potential to overload and strain the pelvic floor.

If you consistently incorporate these 10 simple steps for better bowel movements into your everyday life, you be more likely to avoid worsening of your constipation and prolapse problems. You may even find that your bowel movements actually improve despite your prolapse!

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We Welcome Your Comments


  1. Is there a safe laxative I can take sometimes to help with my constipation

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      Yes June, the osmotic laxatives are usually quite a safe option for most poeple. These are the laxatives like Movicol or Gavilax that soften the stool and improve motility by drawing fluid into the bowel (rather than irritating the bowel lining). Always check with your doctor or pharmacist first before taking for suitability however these laxatives are usually quite safe and don’t make the bowel lazy.

  2. Hi yhooo i just called chronic constipation because its more than 5 yrr .I tried different types of meds to help constipation but still struggling. I bought last wk Prep it help just for 2days.Then i was better but now ifeel not good at all.Doctor book me for scope.Advice plz what can i use? Anema laxatives Lacson Prunes i tried a lot but no luck.

  3. Hi – I have an internal rectal prolapse that I had under control with kegels and PT ordered by Colorectal surgeon – caused by extremely hypothyroid a couple of years back (had RAI for Graves) and since then have been on constipated side.(Put on Levoxyl but still hypo symptoms) plus have IBS. Have done OK for the most part but lately became more hard BMs and did some heavy straining in December. This caused the prolapse to come out again and is about the size of a cherry I think.. Unfortunately sometimes do not realize it is out and wipe and also wash it in the shower which makes it sore. I tried making my BMs soft with Colace and diet which worked but now have narrow stool come out which leads me to believe if the stool is harder it is larger but pushes out the prolapse and if it is softer it doesn’t push it out as much but is much narrower than normal. Just wondering if this makes any sense and could be the reason for my narrow stool. Only happened since stool is soft. Of course I overdid and caused some near diarrhea which also irritated the prolapse.I am busy kegeling and back doing my exercises since the prolapse comes out easier now again but in the meantime could the prolapse possibly cause narrow stool if it only happened since I made it very soft?? Thank you.

  4. Hi me again I forgot to mention she also has a prolapsed uterus what can we do for her. Thanks

  5. My girlfriend cannot do the exercises on the ground because of her disability. What else do you suggest for us to do to help her with her bowel functions. Thanks

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Johnathan
      Thank you for your email. Johnathan which exercise is your girlfriend unable to do? Maybe I can suggest an alternative – let me know.

  6. I recently delivered my daughter via vaginal delivery, which included 5 hrs of pushing and 1 hr of crowning. She is almost 4 months now. I have extreme difficulty eliminating. It seems to me that my rectum has bulged very close to the anal sphincter ( into the vagina,( is this rectocele?)), making it extremely hard to get the waste out because it’s too big for the opening. ( ewww… Sorry) I have had to use my hands, to press on my bottom, and also to support the perinium. What should I do? Will exercises help? Is this something I should see a pelvic floor therapist for? A doctor? Could surgery be necessary? Does it help anyway?
    Thank you.

    • Michelle Kenway Physiotherapist says

      Hi Ruth
      The symptoms you describe are similar to those of rectocoele also known as posterior vaginal wall prolapse. You need to see your medical practitioner or pelvic floor physiotherapist for an accurate diagnosis. It is quite common for women with rectocoele to need to use manual support to empty and this issue is usually made worse when the stool is very firm. Your Physio will provide you with assistance to help you manage now and in the long-term and this would be a good place for you to start.

      All the best

  7. Dear Michelle,

    Firstly, i would like to thank you for this helpful website on understanding what the pelvic floor is and how important is it to our body. i gladly appreciate the time you put in for all the helpful information.

    I am reaching out to you because Im currently struggling with incomplete bowel movements. It all started when I had constipation due to my poor diet during school. Once i notice that it became a daily problem, i went on a fiber diet. It improved my bowel movement but the only problem is the sense of feeling like i don’t empty completely. I feel that the problem came from when i was constipated and strained myself during bowel movements. Also along with that problem, i have uncontrollable gas, where i unexpectedly pass gas. I set up an appointment with my doctor on November for January but she cancelled it due to an emergency she had so i had to reschedule for Feb 16. Im going back to school soon and i hope to find a remedy before then. Im a little confused on weather it would be helpful to do Kegel exercises or relaxtion exercise for my pelvic floor. Any advice you have will be greatly appreciated. I hope to hear from you soon

    • Michelle Kenway Physiotherapist says

      Hi Karen

      Unless for some reason you think you might have increased pelvic floor muscle tension, then pelvic floor exercises can be very helpful for improving bowel emptying. It is important to relax the pelvic floor muscles during emptying by bulging the abdomen forwards as you can see in this bowel movement technique video. Pelvic floor exercises can also help with the control of gas too along with decreasing consumption of gas producing foods.

      Hope this helps you get started Karen

  8. Dear Michelle,

    here I am with my back with my feedback. Eventually I concluded that the keggel exercise will not solve my enema dependency. I was practicing them for a few days but I was not motivated to continue.

    But the posture for BM is great. I keep it in my mind and use it quite often. The water with stool goes out faster and quite smoothly.

    All my best,


    • Michelle Kenway says

      Great to hear Dalibor.

      Kegels are important for almost all of us lifelong to maintain a strong healthy pelvic floor and this is important with bowel movement problems too so doing them regularly can only benefit.

      All the best

  9. Dear Michelle,

    Thank you for your amazingly quick response.

    I have read both of the articles that you have mentioned.

    I started to put both the kegel excercise and the bowel movement technique in practice. And verily, I was able to use less water to evacuate my bowels in the last three days. However, it is still too early to give a proper feedback. I will come back to you once I will have somethink more substantial.

    And againe, thank you for the time you have devoted to my question.


  10. Hi Michelle.

    Thank you for you wonderful and informative articles and videos.

    I am a male 36 and have recently became dependent on water enemas. Now I have to use every morning 3 x 0,5l of filtered water to evacuate my bowels. Only after the third 0,5l infusion does my bowel completaly evacuate. If I do only 2 x 0,5l it evacuates only partially.

    Do you have any special tips for this type of situation?

    I exercise, have enough fibre and liquids and yesterday I even started to do the kegel exercise.

    Thank you.


    • Michelle Kenway says

      Hi Dalibor

      Thanks for your question – great to hear from a man on site!

      Incomplete bowel emptying can be caused by many different factors so it is difficult for me to know about the causes of your constipation. It may be due to your emptying technique, your stool consistency which is influenced by fibre intake (remember that it is very possible to have too much insoluble fibre whuch makes things worse), medications that you may take, your pelvic floor support and ability to relax your pelvic floor to empty your bowels.

      I would suggest you start by watching this bowel movement technique video to learn how to relax the anal sphincter when emptying by bulging your abdomen forwards and reading this article on foods for ideal stool consistency. I will be interested to hear back from you with further information you can provide having read and watched this material.

      All the best

  11. You write about how to sit on the toilet seat. Well in some parts of the world ,specially in Asia,not everybody has a western style toilet with seat. We can`t sit but have to squat down,which is probably not too god for pelvic floor problems.I would appreciate it very much if you could you give some advise how to make the best of this style of toilet. Thanking you

    • Michelle Kenway says

      Hi Fujiko
      This is an excellent point to make thank you! I believe that squatting to empty the bladder may more effectively empty the bladder than sitting on a seat to void so this position does have its advantages – this is how nature intended us to void.

      To reduce pressure on the pelvic floor with squatting to empty the bladder there are a couple of modifications that may be made:
      – avoid squatting for extended periods of time
      – never strain to empty in a squatting position
      – maintain the inward curve in the lower back while squatting and avoid slumping forwards – this will keep the upper torso a little higher than slumped forwards and in so doing help to reduce the pressure on the pelvic floor

      I am always keen to hear feedback, feel most welcome to let me know how this goes
      KIndest regards

  12. My good friend who suffers from similar prolapse problems to me, suggested I start eating one dried fig per day until I noticed a difference in my stools. This has helped enormously, and I am currently recovering after a hysterectomy and prolapse surgery, and eating 3 dried figs each morning with my muesli. I haven’t had to strain once since doing this. It’s great and has made a big difference! I find them very sweet, though, and so I cut them up into little bits and ‘hide’ them in the muesli. I’ve been able to save my sister-in-law some agonies as well after her AP prolapse surgery. I can highly recommend the figs, but take it easy in the beginning as they will affect each person differently and you don’t need the runs.

    • Michelle Kenway says

      Hi Veronica
      Thank you great tip about the dried figs! Yes I too have heard about their positive effect and yes good suggestion about starting gradually as you are right every one is different.
      Thanks so much for this input!

      • concerning dried figs,if you don`t like the very sweet version from Iran or America,then try dried figs from Turkey which are much less sweet.I eat them myself. Making bread with some figs and nuts inside is also delicious!

  13. I have rectal prolapse. Would you suggest the Inside Out DVD or the book?

    Also, I live in Los Angeles, can you suggest a doctor who I can see about this – preferably a Holistic Doctor who believes in natural remedies and that we have the ability to heal ourselves.

    I look forward to your feedback.

    • Michelle Kenway says

      Hi Rebecca

      Thank you for your enquiry. The whole Inside Out program of book and DVD is designed for women with prolapse, to help them exercise to know what to do and what to avoid. Inside Out Strength is a strength exercise DVD to help women seeking pelvic floor safe strength training exercises, whereas the Inside Out book is an overview of many different forms of exercise, with a focus on pelvic floor safe strength and abdominal exercise.

      I suggest that you seek an appointment with a Physical Therapist who specialises in Pelvic Floor treatment, perhaps one of our readers can recommend some LA-based Pelvic Floor Physios, I wish I could assist you more in this regard. A Physical Therapist will be able to assess your pelvic floor, and help you strengthen your pelvic floor prolapse supports, plus avoid lifestyle factors that may be impacting upon your prolapse. I do hope this gives you some useful direction.

      Best wishes