What causes constipation?

Constipation can develop for a variety of reasons. Understanding the cause is key to managing it effectively.

• Diet and hydration: Low fibre and fluid intake make stools harder and therefore more difficult to pass. Learn how alcohol can impact the bladder and bowels.

• Lifestyle factors: Lack of physical activity slows intestinal activity, while regular movement stimulates bowel health.

• Ignoring the urge: Delaying bowel movements repeatedly can desensitise rectal nerves, making it harder to recognise when it’s time to go.

• Medications: Opioid painkillers, iron tablets, some antidepressants and certain antacids can cause constipation.

• Overuse of laxatives: Long-term use may weaken natural bowel function.

• Medical conditions: Irritable bowel syndrome (IBS), hypothyroidism, diabetes, Crohn's disease or neurological disorders such as Parkinson’s disease and MS can contribute.

• Pregnancy and childbirth: Hormonal changes and pelvic floor strain can slow bowel activity and trigger issues, such as incontinence after childbirth.
  

How does constipation affect bladder control?

People often notice their bladder symptoms worsen when they are constipated. Understanding the link between constipation and urinary incontinence is the first step towards managing both effectively.

Here’s how constipation affects bladder control:

• Bladder pressure: When stool builds up in the colon, it causes increased pressure against the bladder. This can result in increasing urgency, frequency and the risk of leaks.

• Weakened pelvic floor: Straining to pass stools puts extra pressure on pelvic floor muscles. Over time, this weakens the muscles that control both urine and faeces. Straining can also affect the sphincter muscles responsible for controlling the flow of urine and stool.

• Faecal overflow incontinence: Severe constipation can cause stool impaction in the rectum, which sometimes leads to leakage of watery stool around the blockage (this can often be mistaken for diarrhoea)
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Bladder and bowel dysfunction

Bladder and bowel dysfunction describes the overlap of bowel and bladder problems. Because the two systems share nerves, muscles and pelvic space, difficulties in one often trigger symptoms in the other. It’s particularly common among women and often presents with:

• Increased urgency.

• More frequent urination.

• Sudden, unexpected leaks.

Tackling both bowel and bladder health together is the most effective approach. 

Symptoms to watch out for

Signs that you may be dealing with a combined issue include:

• Having fewer than three bowel movements per week.

• Straining or pain when passing stools.

• A constant feeling of fullness, even after going to the toilet.

• Urinary leaks, especially when straining.

• Sudden urges to urinate, even with little urine in the bladder.

• Dehydration or poor bladder health can exacerbate overactive bladder symptoms, such as urinary urgency and frequency. 

Sudden changes in bowel habits, or blood in your stool, should always be checked by a healthcare professional, as this may indicate a new health condition. It is important to treat constipation early to prevent complications, as untreated constipation can lead to additional issues, such as haemorrhoids, as well as worsening urinary issues.

How to alleviate constipation and reduce incontinence

The good news is that constipation is usually treatable, and with the right strategies, you can improve both bowel and bladder health. It is important to treat constipation not only to alleviate discomfort but also to support overall urinary and digestive function. Some useful lifestyle strategies include:

• Stay hydrated: Aim for at least 6–8 glasses of water a day. Warm liquids such as herbal teas may also stimulate bowel activity.

• Eat more fibre: Wholegrains, beans, lentils, vegetables and fruits like pears, apples and prunes help soften stools and improve regularity.

• Add probiotics: Foods like yoghurt, kefir or sauerkraut support gut health.

• Exercise daily: Walking, swimming or light stretching encourages bowel movements.

• Go when you need to: Don’t ignore the urge to have a bowel movement – holding it in can make constipation worse.

Some bladder medications can have side effects that include constipation, so it is important to discuss treatment options with your healthcare provider.

The role of the pelvic floor muscles in constipation and incontinence

Your pelvic floor muscles play a vital role in controlling both bowel movements and bladder function. When these muscles are strong and healthy, they help you maintain control and prevent both bowel incontinence and urinary incontinence. However, if the pelvic floor muscles become weak – often due to chronic constipation, straining or nerve damage – bowel and bladder control is reduced, which increases the risk of leaks.

Pelvic floor exercises (also known as Kegels) are a simple and effective way to strengthen the pelvic floor muscles. By practising these exercises regularly, you can improve bladder and bowel control. For some people, working with a pelvic floor physiotherapist can help identify specific issues, such as muscle weakness or nerve problems, and create a tailored plan to restore pelvic floor health.

It’s best not to wait until symptoms appear. Starting pelvic floor exercises early is a proactive step to protect long-term bladder and bowel health.

Medical treatments and professional support

Sometimes lifestyle changes aren’t enough, and professional treatment is needed. Common treatments for constipation and incontinence include:

• Fibre supplements or laxatives to soften the stools or to improve regularity.

• Medications for urinary incontinence.

• Pelvic floor physiotherapy.

• Electrical stimulation or, in severe cases, surgery.

Toilet habits and posture

Adopting the right posture and routine can make bowel movements easier and reduce strain on the bladder and pelvic floor. 

Tips for a healthy posture:

• Place your feet on a small stool so your knees are higher than your hips.

• Lean forward slightly, resting your elbows on your knees.

• Relax your abdomen and breathe steadily.

• Push gently with your abdominal muscles – avoid straining.

• Try to establish a routine, often after meals.

Proper posture during bowel movements also helps support spinal cord and nervous system function, which is important for the effective nerve signalling that controls bladder and bowel function. Over time, these small adjustments can reduce constipation, protect the pelvic floor and lower the risk of leaks.
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Preventing constipation in the future

Prevention is key when managing constipation and incontinence. You can reduce the chances of problems recurring by:

• Eating a diet rich in fibre from fruits, vegetables, legumes and wholegrains.

• Drinking 6–8 glasses of water a day.

• Reducing caffeine and alcohol, which can dehydrate the body and irritate the bladder.

• Staying active with regular physical activity.

• Responding promptly to the urge to go to the toilet.

Living confidently with constipation and incontinence

Living with both conditions can feel overwhelming, but you are not alone. Millions of people experience these challenges, and effective support is available. In some cases, neurological conditions, such as multiple sclerosis, may contribute to both problems, which makes it important to identify and address the root cause. With the right support and management strategies, it is possible to reduce symptoms and maintain confidence in daily life.

Practical tips for everyday confidence:

• Plan bathroom access when you are away from home.

• Carry spare pads or pants discreetly, just in case.

• Use incontinence bed sheets at night for peace of mind.

• Stay active to support digestion and overall well-being.

• Talk openly with your GP or continence nurse about your symptoms and support options.

FAQs

Can constipation cause urinary incontinence?

Yes. When the bowel becomes blocked with stool, it presses against the bladder, which can lead to urgency and leaks. Straining to pass stool can also weaken pelvic floor muscles.

Is faecal incontinence always linked to constipation?

Not always. Chronic constipation can cause faecal overflow incontinence, but other causes include nerve damage, muscle weakness or bowel conditions.

Can constipation resolve on its own?

Yes, particularly if it is caused by temporary factors such as stress, short-term dehydration or dietary changes. However, persistent symptoms should always be assessed by a healthcare professional. It is important to address persistent constipation to rule out underlying causes and prevent further complications.