Pelvic Floor Symptom
Chronic Constipation
By Dr. Anthony J. Gordon, Doctor of Acupuncture | Last reviewed September 2026
You have tried more fiber, more water, stool softeners and laxatives. Things improve a little, then go right back. When constipation does not respond to the usual fixes, the problem may not be the stool or the colon at all. It may be the pelvic floor muscles at the exit, and those need a different kind of treatment.
Prefer to talk it through? Call (516) 597-5400. Most new patients are seen within one to two weeks.
Overview
Understanding Chronic Constipation
Chronic constipation means infrequent, hard or difficult bowel movements for several months. There are broadly two kinds. In slow transit constipation, stool moves slowly through the colon. In outlet or evacuation constipation, stool reaches the rectum but has trouble leaving because the pelvic floor does not relax properly. Many people have some of both.
Outlet constipation is common and frequently missed. Fiber and laxatives soften stool and speed transit, but they cannot open a pelvic floor that stays tight. Signs include straining even with soft stool, feeling blocked, needing to change position or press to empty, and feeling incomplete afterward.
Your physician or gastroenterologist evaluates diet, medications, thyroid and colon health, and may order tests. Dr. Gordon focuses on the pelvic floor side, releasing tension so the exit can open.
Chronic Constipation at a Glance
Also called
Functional constipation, outlet or evacuation constipation
Two main types
Slow transit in the colon, or outlet problems at the pelvic floor
Common signs of outlet problems
Straining with soft stool, feeling blocked, incomplete emptying
Causes to rule out
Medications, thyroid, diet, colon disease
Main pelvic floor drivers
Pelvic floor tension, dyssynergia, straining habits, toilet posture
The Gap in Care
What Tests Check, and What They Can Miss
Constipation is usually treated as a diet or colon problem. When the pelvic floor is not relaxing, softer stool does not solve it.
What routine testing is looking for
- Diet and fluid intake
- Medication side effects
- Thyroid and metabolic causes
- Colon disease on colonoscopy
What often keeps symptoms going
- A pelvic floor that does not relax at the exit
- Dyssynergia, where muscles tighten while pushing
- Trigger points that make relaxing painful
- Toilet posture that closes the anorectal angle
- Years of straining and holding habits
These are assessed with a pelvic floor exam and, when needed, testing ordered by your GI specialist.
Signs & Symptoms
Does This Sound Like You?
Symptoms vary from person to person. These are the patterns Dr. Gordon sees most often.
Infrequent bowel movements
Fewer than three bowel movements a week.
Hard or lumpy stools
Stool that is hard to pass.
Straining even with soft stool
Pushing hard regardless of consistency.
Feeling blocked
A sense of a barrier at the exit.
Incomplete emptying
Feeling you are not finished.
Bloating and discomfort
Abdominal fullness and discomfort.
Root Causes
The Four Drivers Dr. Gordon Looks For
Most people have more than one of these in play. Finding which one leads makes treatment more efficient.
Pelvic floor tension
Tight pelvic floor muscles narrow the exit and resist emptying.
Dyssynergia
The pelvic floor tightens while you push instead of relaxing.
Toilet posture
Sitting upright keeps the anorectal angle closed. Raising the knees helps it open.
Straining and holding habits
Years of straining and ignoring urges reinforce tension.
Your First Visit
How Dr. Gordon Evaluates Chronic Constipation
The initial evaluation runs 60 to 75 minutes. You leave with a clear picture of what is driving your symptoms, a written plan, a realistic timeline, and in most cases your first treatment.
Records and history review
Dr. Gordon reviews your physician's findings, imaging, medications and past treatments so he knows what has been ruled out and what has already been tried.
Abdominal and breathing assessment
Dr. Gordon assesses the abdomen and how your breathing and pushing work together.
External pelvic floor assessment
The pelvic floor muscles are examined from the outside, with no internal exam. With you draped for comfort, gentle pressure around the perineum, sit bones, tailbone and inner thighs checks tone, tenderness and trigger points.
Bowel habits and posture review
Dr. Gordon reviews timing, diet, fluids, straining and toilet posture.
Plan and coordination
A clear plan, plus communication with your physician or pelvic floor PT when that helps your care.
When to see a physician first
- Blood in the stool or black, tarry stools
- A lasting change in bowel habits, especially after age 45
- Unexplained weight loss
- Severe abdominal pain with fever or vomiting
- Fever with a painful lump or swelling near the anus
- New numbness in the saddle area or loss of bladder or bowel control
If you have any of these, contact your doctor or go to the nearest emergency department.
Bring to your first visit
Records
Recent lab results, imaging reports and specialist notes. These can also be faxed ahead.
Treatment history
A short list of what you have tried and what did or did not help.
Clothing
Something comfortable and loose fitting.
Treatment
How Dr. Gordon Treats It
These are the tools Dr. Gordon uses most often for chronic constipation, chosen from your exam findings.
Primary approach
Intrapelvic & Extrapelvic Dry Needling
Dr. Gordon holds ASE certification in both intrapelvic and extrapelvic dry needling. Treatment releases pelvic floor tension at the exit so the muscles can open during bowel movements. The needles go in through the skin of the buttock, perineum or inner thigh, never through the vagina or rectum.
Learn about pelvic floor treatmentNerve focus
Neuro-Functional Acupuncture
Electro-acupuncture along sacral nerve pathways that help regulate bowel function.
See servicesBetween visits
Toilet Plan & Team Coordination
Toilet posture, breathing and routine guidance, coordinated with your GI specialist or biofeedback therapist.
Referring provider? Contact the clinicWhat to Expect
A Typical Recovery Arc
Visits 1 to 3
Find the main driver
Dr. Gordon confirms which muscles and nerves are behind your symptoms and starts calming the most reactive areas. Many people notice early changes between visits.
Visits 4 to 8
Lower the baseline
Day-to-day symptoms ease, flares become shorter and less frequent, and normal routines start to feel more manageable.
Visits 9 to 12 and beyond
Build resilience
Visits are spaced out as improvement holds. You leave with a maintenance and early-flare plan.
Most patients are seen weekly or every other week during active care. Individual results vary with how long symptoms have been present and how reactive they are. Progress is reassessed at every visit.
Not sure how to describe it? Put your pain or discomfort into words before your visit
"I have been to many acupuncturists over the past 15 years, and have suffered from digestion issues, migraines, lack of energy, and allergies, among other things, and I have often left my appointments with Integrative Family Wellness almost in tears at how much better I felt after 45 minutes."
Hounds Town USA, Google Review
Chronic Constipation Questions
Answers About Chronic Constipation
Still unsure whether this is the right fit? Reach out before you book and Dr. Gordon will talk through your history with you.
They soften stool and speed transit, but they do not relax a tight pelvic floor at the exit.
Straining with soft stool, feeling blocked and needing to press or change position suggest outlet problems.
Often yes. Raising your knees above your hips helps the pelvic floor open.
Your GI specialist may recommend anorectal manometry or other tests, especially if symptoms are severe.
Many people improve within six to ten sessions along with habit changes.
Yes, as directed by your physician, while Dr. Gordon works on the pelvic floor.
Before You Book
General Questions
The clinic is an out-of-network practice. The initial evaluation is $300 and follow-up visits are $250. After each visit you receive a detailed superbill to submit to your PPO plan for possible reimbursement. FSA and HSA cards are accepted, and the clinic can run a complimentary benefits check before your first appointment. The check is a courtesy, so please confirm your coverage with your plan. See Insurance & Fees for details.
The first evaluation is 60 to 75 minutes and usually includes treatment. Follow-up visits run 45 to 60 minutes.
Yes. Call (516) 597-5400 or send a message through the contact page. This is especially helpful if your case is complex and you want to understand the approach before committing to a full evaluation.
1508 Union Turnpike, Suite 133, North New Hyde Park, NY 11040, with free parking on site. The clinic is an easy drive from Manhasset, Great Neck, Garden City, Lake Success, Floral Park and Mineola. Early morning, evening and weekend hours are available.
Most people feel a quick muscle twitch or a deep ache that lasts a few seconds. That twitch is a normal sign the trigger point is releasing. Mild soreness for 24 to 48 hours afterward, similar to a hard workout, is common. Depth, angle and stimulation are adjusted to your comfort.
Both use the same fine, sterile, single-use needles. Dry needling targets specific trigger points and tight bands in muscle based on your exam. Neuro-functional acupuncture targets nerve pathways, often with gentle electrical stimulation, to calm nerve sensitivity. For chronic constipation, Dr. Gordon commonly uses both.
When performed by a trained, licensed provider with detailed knowledge of anatomy, it has a strong safety record. Tell Dr. Gordon if you take blood thinners, have a bleeding disorder, are pregnant or have a weakened immune system so he can plan accordingly.
It is a technique that reaches the internal pelvic floor muscles, including the levator ani, obturator internus and coccygeus, to release trigger points and restore normal muscle function. Dr. Gordon holds ASE certification in this technique, which few practitioners in New York have.
Yes. Your privacy and comfort come first. When undressing is needed for the area being treated, you are fully draped, and nothing internal is done without your clear consent. You can pause or stop at any time.
Yes. Chronic constipation can affect people of every gender, and Dr. Gordon treats adults of all genders and identities.
It helps to have had a medical workup so serious causes have been checked. If you have not seen a physician for your pelvic symptoms yet, call the clinic to talk through the best order of steps.
About Dr. Anthony J. Gordon
Dr. Anthony J. Gordon is a Doctor of Acupuncture licensed in New York and board certified. He holds ASE certification in intrapelvic and extrapelvic dry needling, along with advanced certifications in Functional Dry Needling and Neuro-Functional Acupuncture. With more than 18 years of clinical experience and over 3,000 complex cases treated, he focuses on pelvic, spinal and orthopedic conditions that have not responded to standard care, and works closely with each patient's physicians and physical therapists.
Read Dr. Gordon's full bioFurther Reading
What Your Pelvic Floor Has to Do With Constipation
From the blog: Some constipation comes from pelvic floor muscles that tighten when they should relax. How dyssynergia works, how a GI doctor tests for it, and what helps.
Book an Evaluation for Chronic Constipation
Book a full evaluation with Dr. Gordon and find out whether your pelvic floor is holding things back.
Early morning, evening and weekend appointments available. Free on-site parking.
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