Constipation:
Constipation is one of the most common gastrointestinal complaints in the US. Although diet and lifestyle factors play a significant role in constipation management, it is equally important to consider the function of the muscles and nerves in the pelvis, as they can also play a pivotal role in proper bowel function. Constipation can include increased time between bowel movements, decreased urge to have a bowel movement, feelings of incomplete emptying, large, dry, and difficult to pass stools. It is not uncommon for a client to experience diarrhea at times in response to chronic or extreme constipation.
How physical therapy can help:
Physical therapy can address the function of the nerves and muscles of the pelvis and assess and improve the mechanics used to pass stool. Oftentimes patients are using compensatory strategies, sub optimal breathing strategies, and holding patterns which have been exacerbated by pain in the past. Dyssynergia of the pelvic floor muscles can lead to and contribute to constipation. Physical therapy can train the muscles to work in the correct way once again.
Painful Bowel Movements:
For patients experiencing bowel issues, it's important to note that pain during or after a bowel movement is not normal. Pain can lead to or exacerbate constipation and other impairments within the pelvic bowl.
How Physical Therapy Can Help:
Physical therapy can help by restoring balance to the muscles, nerves and surrounding structures within the abdomen and the pelvis. As with any pain condition retraining the nervous system is an integral part of the treatment process.
Fecal Incontinence:
Just like urinary incontinence, fecal incontinence—or the involuntary leakage of stool—is more common than you may think and can occur at any point during the life cycle. In fact, this condition often goes unrecognized or unaddressed due to stigma or lack of awareness. Moreover, various factors can contribute to fecal leakage, including activity-related issues, structural or neurological problems, behavioral patterns, gastrointestinal conditions, or, most commonly, a combination of these.
How Physical Therapy Can Help:
A physical therapist can assess each of these factors separately, conclude how they are all working together, and restore balance to improve control and decrease episodes of fecal incontinence.
Incomplete Bowel Movements:
Incomplete evacuation of stool. Common symptoms include feeling like the “door closes too fast,” which limits complete evacuation, along with fecal smearing and excessive wiping. Furthermore, many patients experience feelings of pressure and discomfort that persist until another bowel movement occurs. Clinicians often diagnose pelvic floor dyssynergia or dyssynergic defecation in patients who experience incomplete bowel movements
How physical therapy Can help:
The physical therapist will look at the pelvic floor muscles, nerves, and mechanics of defecation. Physical therapists can often address incomplete evacuation by targeting tension patterns, suboptimal breathing, and ineffective evacuation strategies through intervention and biofeedback