One of our current patients is getting relief of a 30-year history of constipation. It takes this patient 3 hours to have a bowel movement in the morning. Yes, that means that this patient spends 3 hours per day in the morning trying to have a bowel movement and has tremendous pelvic pain and rectal pain associated with the bowel movement. This patient has undergone 3 treatments of physical therapy consisting of visceral manipulation, pelvic mobility exercises and movement re-education techniques, prescriptive pelvic floor muscle exercises, surface EMG biofeedback, and pelvic floor muscle rehabilitation. We have decreased his time in the bathroom by 1 hour so far and have reduced his pain by 50%. Other advice consisted of increasing his fiber intake to between 25 and 35 grams per day. That is the amount that the Harvard School of Public Health and the Mayo Clinic recommends. Instruction of proper toilet posture was also given. We expect to improve his bathroom time even further with continued care. Bowel movements should occur without straining, take no more than 5 minutes, and should be the consistency of a ripe banana!