Struggling with bloating, constipation, or pelvic pain in eating disorder recovery? Learn how pelvic floor therapy supports gut health and healing.
Bloating that won’t go away. Constipation that feels confusing. Pelvic pain, urgency, or discomfort that no one has quite explained.
For many individuals navigating eating disorder recovery, these symptoms are often dismissed as “just part of the process.” But that’s not the full picture.
There’s an often-overlooked piece of the puzzle: the pelvic floor.
In this post, we explore the intersection of pelvic floor dysfunction, eating disorders, and gastrointestinal (GI) health and why a whole-person, interdisciplinary approach is essential for healing.
What Is the Pelvic Floor?
We recently sat down with Dr. Trudy Pacifico, a pelvic floor PT expert, on the Eat Kale and Cupcakes podcast. Catch up on the episodes wherever you listen to podcasts.
As Dr. Pacifico explains in Episode 5: What is the Pelvic Floor and Why Should We Care?, the pelvic floor is a group of muscles that sit at the base of the pelvis, supporting organs like the bladder, bowel, and reproductive system.
These muscles play a key role in:
- Bowel movements
- Bladder control
- Core stability
- Sexual function
Importantly, the pelvic floor must be able to both contract and relax. Did you know the diaphragm (your breathing muscle) and pelvic floor coordinate and work together? When this coordination is disrupted, symptoms can emerge.
What Is Pelvic Floor Dysfunction?
Pelvic floor dysfunction occurs when these muscles are not working optimally, often due to tension, weakness, or poor coordination.
Some common symptoms may include:
- Constipation or difficulty passing stool
- Bloating and abdominal discomfort
- Incomplete bowel movements
- Pelvic pain or pressure
- Pain during sex
- Urinary urgency or leakage
These symptoms are frequently misattributed to “just GI issues,” when in reality, the pelvic floor is deeply involved.
How Eating Disorders Impact Gut Health
Eating disorders, whether restrictive, binge/purge, or otherwise, can significantly affect the gastrointestinal system.
Some common GI impacts include:
- Slowed gastric motility (delayed stomach emptying)
- Constipation
- Bloating and gas
- Altered hunger and fullness cues
These changes are not just behavioral, they are physiological adaptations to inconsistent or inadequate nourishment. The digestive tract is a muscle and over time the muscles can weaken if they are being underfueled or underworked.
The Missing Link: Pelvic Floor + Eating Disorders
Here’s where things get more nuanced.
Individuals with eating disorders often experience:
1. Chronic Muscle Tension
“Stomach holding,” bracing, or body checking can lead to overactive (tight) pelvic floor muscles, making it difficult to relax during bowel movements.
2. Dysregulated Nervous System
The gut and pelvic floor are closely tied to the nervous system. Chronic stress, anxiety, or trauma can contribute to both GI and pelvic floor dysfunction. The gut is often called the second brain. Our vagus nerve, which is the longest cranial nerve, is an information highway connecting the brain and gut.
3. Disrupted Bowel Patterns
Periods of restriction, bingeing, or purging can alter natural bowel rhythms, further complicating pelvic floor coordination.
4. Learned Avoidance or Fear
Painful or difficult bowel movements can lead to avoidance patterns, reinforcing dysfunction over time.
Why GI Symptoms Don’t Always Resolve with Nutrition Alone
Nutrition is foundational, but sometimes, it’s not the only piece.
If someone is:
- Adequately nourished
- Eating consistently
- Still experiencing constipation, bloating, or discomfort
…it may be a sign that pelvic floor function needs to be assessed.
This is especially important in recovery, where lingering symptoms can:
- Increase distress
- Reinforce disordered eating thoughts
- Undermine trust in the body
What Is Pelvic Floor Therapy?
Pelvic floor physical therapy is a specialized form of care that focuses on restoring proper muscle function.
A trained pelvic floor PT may work on:
- Muscle relaxation and coordination
- Breathing mechanics
- Posture and core integration
- Bowel movement mechanics
This work is often gentle, individualized, and highly effective, especially when integrated with nutrition and mental health support.
When to Consider Pelvic Floor Therapy
You might benefit from pelvic floor therapy if you’re experiencing:
- Ongoing constipation despite adequate nutrition and nutritional modifications
- Pain or difficulty with bowel movements
- Chronic bloating that doesn’t resolve
- A sense of incomplete evacuation
- A history of eating disorders with persistent GI symptoms
- You are pregnant, postpartum, or in perimenopause or menopause (yes, hormones affect the pelvic floor – Dr. Pacifico breaks it down in Episode 7)
Final Thoughts
If you’ve been told your symptoms are “just part of recovery,” it’s worth pausing.
Your experience is valid and there may be more layers to explore.
The connection between pelvic floor therapy, eating disorders, and gut health highlights something we see again and again:
Healing doesn’t happen in isolated systems. It happens when we zoom out, get curious, and support the whole person.
If you’re navigating eating disorder recovery and ongoing GI symptoms, you don’t have to figure it out alone.
- 💬 Work with our team for whole-person, individualized care
- 🎧 Listen to our podcast for more conversations on gut health and recovery. In particular episodes 5, 6, and 7 go deep into the pelvic floor and GI health with Dr. Trudy Pacifico.
- 📩 Reach out to see if pelvic floor therapy could be a helpful addition to your care team.
- Learn more about Dr. Pacifico at her website.
