Bowel Dysfunction

Bowel dysfunction is a catch-all term for problems involving the anus and rectum regions. This includes disorders such as incontinence, constipation and hemorrhoids. At the centre of these disorders is pelvic floor dysfunction. That’s why retraining the pelvic muscles to work better for your body can help improve bowel function. Keep reading to learn more.

What is Bowel Dysfunction?

The bowel, commonly referred to as the intestine, is the long, tube-shaped organ in the abdomen that completes the process of digestion. The bowel has two parts, the small bowel and the large bowel. When functioning normally, the bowel allows you to regularly pass soft, formed stools. This is necessary to eliminate toxins from the body. Sometimes, however, the bowel behaves abnormally. This can lead to issues, such as:

• Fecal or Anal Incontinence: The involuntary loss of liquid or solid stool or the inability to control gas.

• Constipation: Bowel movements that are infrequent and difficult to pass. This may involve symptoms of bloating, abdominal pain, and the inability to completely empty the bowels (called dysfunctional defecation). Everyone has constipation from time to time – but when it is regular or very painful, consult a health professional.

• Hemorrhoids and Anal Fissures: These are often complications of constipation and dysfunctional defecation. When the body doesn’t have proper pelvic floor coordination, using excessive pressure or straining the body during bowel movements can result in swollen veins in the anorectal canal (hemorrhoids) or painful tearing in the anal canal (anal fissures).

Irritable Bowel Syndrome (IBS) is a term that has become used more and more in everyday language. But, what is it exactly? IBS is a chronic (long-term) condition involving significant abdominal pain and discomfort. It may also cause bowel dysfunction, including infrequent stools, straining during a bowel movement, and being unable to completely empty the bowel. IBS is categorized based on whether it is accompanied by constipation (IBS-C), diarrhea (IBS-D) or a mix of these two symptoms (IBS-M). If you think you may have the symptoms of IBS, contact your doctor. They’ll do specific tests to make a diagnosis.

Who Is At Risk of Bowel Dysfunction?

Certain conditions, such as constipation, is more common in young children , the elderly, and women. Nutrition and lifestyle factors can also impact the risk of developing a condition linked to bowel dysfunction, including:

• Low fibre intake

• Low water intake

• Low activity level

• Stress and/or anxiety

• Certain medications (e.g., narcotics, anti-depressants, iron supplements may all contribute to constipation)

However, anyone can develop bowel dysfunction. Issues related to the bowel are closely connected to the pelvic floor muscles – which can start working improperly in any individual.

What Is The Role of The Pelvic Floor in Bowel Dysfunction?

The pelvic floor is a group of muscles, ligaments, and connective tissue that are located at the bottom of the pelvic bones. The pelvic floor is our body’s foundation, providing critical support for the bowel, amongst other functions. When “in sync”, the pelvic floor muscles are able to dynamically relax and contract to allow the passage of stools. But, when the pelvic muscles are too tense and unable to relax, they can weaken and lose the power and endurance needed to maintain a tight closure around the anal opening. This may lead to a strong urgency to have a bowel movement and an inability to control it.

How Can Pelvic Health Physiotherapy Help Me?

It can be hard sharing a personal challenge as intimate as bowel dysfunction. Know that you are not alone – and help is available. Reaching out to a Pelvic Health Physiotherapist [[LINK TO: https://proactiveph.janeapp.com]], who is trained and experienced in these issues, is a good place to start. They will work with you to understand your specific issue(s), and come up with a customized treatment plan to help you regain control and confidence.

Pelvic Health Physiotherapy is increasingly being used in clinical practice to improve bowel function. The goal is essentially to retrain the pelvic floor muscles to work as they should: where you are in the “driver’s seat” to control them in your bowel movements. A Pelvic Health Physiotherapist works closely with you to help you:

• Learn how to release your pelvic floor muscles. The physiotherapist may gently massage the abdominal wall can help to trigger the bowel’s own reflexes to initiate rhythmic contractions of the bowel muscles to propel stool. Helping to release the anal sphincters and rectal muscles manually can also be a huge relief for those with sphincter pain, fissures, and tailbone pain (coccydynia). They’ll also teach you techniques for breathing and relaxation to help you relax the pelvic floor muscles.

• Optimize your posture so that evacuation is more efficient and less painful. This can include changing posture on the toilet to get the hips fully flexed, which helps relax the pelvic floor muscles.

• Breathe more effectively using your whole ribcage, abdominal wall and pelvic floor muscles, to help lessen pain and release tight pelvic muscles.

• Exercise and nutrition tracking. There are several strategies a Pelvic Health Physiotherapist can suggest to those dealing with bowel issues that may be related to nutrition, such as constipation. A fibre diary and/or bladder diary can help inform any diet-related changes that may help ease symptoms. Certain exercises, such as yoga-based stretches, can also in promote proper bowel function.

Another technique that may be used (after manual therapy) is called biofeedback, which involves insertion of an electrode probe into the anus. The probes are about the size of an index finger with a slightly enlarged tip. It has wires connected to a biofeedback unit and the electrical impulses are shown on a screen as images. It can help patients visualize muscle contraction and relaxation to help them retrain themselves to do this with more control

How Do We Approach Treatment For Incontinence?

At Proactive Pelvic Health Centre, we’re dedicated to helping destigmatize issues related to pelvic health, and empowering people to take control of their bodies. No more pushing these issues to the sidelines! We will work with you to release any shame you may feel, and arm you with an effective toolkit for bettering your pelvic health.

Firstly, your Pelvic Health Physiotherapist will take your full medical history and thoroughly discuss your current symptoms. With informed consent, they will perform a complete physical assessment of the joints and tissues affecting this area to identify the affected tissues that may be contributing to your bowel dysfunction. Based on your examination, your Pelvic Health Physiotherapist will work with you to put together a treatment plan specific to your symptoms.

We will use a variety of proven techniques, from manual therapy to biofeedback, to help improve the strength of your pelvic floor to better support your bowel muscles, as well as reviewing your nutrition patterns and voiding posture to ensure optimal bowel movements. It does NOT have to be painful or uncontrollable! With treatment and some hard work healthier bowel function is within reach.

Book an appointment to learn more about how we can help.

What Other Treatments Are Available?

IIn addition to Pelvic Health Physiotherapy, we may recommend a referral to a naturopathic doctor, nutritionist, and/or general practitioner. Physiotherapy can also be effective in helping you manage your symptoms better and reduce discomfort.