Constipation and lower urinary tract symptoms…
By: Anna Myers, MSN, WHNP-BC, FNP-BC, CUNP, RN
Often times ladies come into our office and are surprised during the initial and follow up appointments by questions we ask about their usual bowel habits. They say things like “I’m not here to talk about my bowels, I came to talk about my bladder!” While yes that is true, these two parts of your body may very well be influencing each other. This is a summary of some interesting facts regarding constipation and lower urinary tract symptoms such as urgency, frequency and burning.
- The bladder and rectum share a common embryo-logical origin. The motor nerve supply of each comes from the pelvic parasympathetic outflow (Sacral nerves 2-4). Additionally, the external anal sphincter and external urethral striated sphincter are both innervated by the pudendal nerve. Meaning, these parts of our body share similar neurological pathways.
- Lower urinary tract symptoms can be divided in three phases: storage, urination, and post urination. Storage symptoms are believed to be related to underlying bladder overactivity including increased urinary frequency, night time voiding, urinary urgency and urinary incontinence. Urination symptoms include impaired bladder contraction with slow or weak stream, urinary hesitancy and terminal dribble. Post urination symptoms include the sensation of not emptying and post urination dribble.
- Lower urinary tract symptoms have been found to be more frequently reported in women with constipation. This relationship may be explained by the close proximity of these organs, by the common neural pathways, and/or by the autonomic reflex interaction between the bladder and lower rectum. A full rectum can press the bladder wall causing either increased spasm or outflow obstruction. Also, overactivity of the pelvic muscles can result in dysfunctional elimination of stool and urine and actually source from bladder overactivity or bowel dysfunction. Meaning if your pelvic floor is all tied in knots related to overactivity or lack of activity in one of these two areas, it will just perpetually get worse.
These are just a few thoughts to help us see how dysfunction such as constipation can be possibly related to bladder issues. Treatment of constipation can be as conservative as increasing fruits, vegetables, water and fiber to more aggressively treating with over the counter and prescription medications. However, it should start with evaluation by your primary care and regular screenings such as a colonoscopy as indicated by age and family history by your gastroenterologist. If you have any questions or desire to further discuss your urological concerns, please call our office at (440) 202-1515. Thank you!
Anna Myers is a women’s health, urology and family board certified nurse practitioner working in our office here in Richfield, Ohio.