Constipation, bloating, and diarrhea aren’t always just microbiome or enzyme problems.
Even conditions like SIBO (small intestine bacterial overgrowth), SIFO (small intestine fungal overgrowth), or chronic gallbladder inflammation can have a hidden root cause: your pelvic floor and diaphragm.
Think of them like the engine of a car.
If the cylinders don’t fire in sync, the car won’t run.
Similarly, if your pelvic floor and diaphragm don’t contract and relax together, your gut motility suffers.
When the intestines can’t move in a piston-like rhythm with the diaphragm and pelvic floor, food flow is disrupted. This can lead to:
- Sluggish movement → bloating, pain, constipation
- Overactive motility → diarrhea
Because the nervous system is directly tied to digestion, stress also plays a role.
When you’re stuck in fight-or-flight mode, blood is shunted away from your gut and digestion shuts down.
Over time, chronic stress, trauma, or even posture changes can lead to:
- A tense diaphragm or pelvic floor
- Altered breathing mechanics
- Constipation, bloating, or incontinence
A tense pelvic floor is actually a weak one, which is one reason why urinary leakage often increases with age.
And if you’re sitting a lot, hunched forward, or dealing with back pain, chances are your diaphragm and abdominal muscles are tight too, which further impact your gut health.
Here’s what I’ve seen in practice:
Many chronic gut issues don’t fully resolve until the pelvic floor and diaphragm are addressed.
Supplements and protocols may help short-term, but without fixing this connection, progress stalls.
What Helps?
- Abdominal massage / visceral manipulation
- Acupuncture
- Abdominal lymphatic massage
- Pelvic floor therapy & exercises
I recommend seeing a pelvic floor specialist at least once in your life and if you can’t get into one there’s some amazing gals online who can help!
One of the is Kim Vopni with her Buff Muff app (she was a guest on my podcast, episode 481). It’s a great way to learn the basics of pelvic floor fitness.
You can also try:
- Abdominal massage before getting out of bed: trace an “upside-down U” from the right hip up to the ribs, across, and down to the left hip, repeat 12 times.
- Stimulate the ileocecal valve (1” down and right from the belly button) for 1 minute daily.
- Open the diaphragm by lying back over a foam roller or stability ball for 1–2 minutes.
As I’ve gotten older and worked with more clients my age and beyond I’ve seen how gut issues and incontinence often show up together.
That’s no coincidence.
They’re linked through the pelvic floor and shared nerves.
If you’ve been struggling with gut issues, don’t overlook the pelvic floor.
A little focused work here can be a total game-changer.
Here’s to a happy gut–pelvic floor connection,
Dr. J
