Bowel Health

There are many concerns around bowel function where a Pelvic Floor Physio can help. Unfortunately, a large part of the population don't disclose their concerns to Health Professionals (in fact only 1 in 3 are believed to mention pelvic health concerns or seek help). That is why Pelvic Health Physio's are here to help you regain control.

The key areas of bowel function which Pelvic Health Physio provides assessment and management for include;

- faecal incontinence

- chronic constipation

- difficulty with defecating and emptying (i.e. straining, paradoxical muscle coordination of pelvic floor muscles, overactive anal sphincter)

- flatal incontinence

- haemorrhoids and anal fissures

- obstretric anal sphincter injuries (read more HERE)

Please see below for more information of the types of conditions and treatment we provide.

What is classified as "normal" for bowel habits? Keep in mind everyone's "normal" will vary slightly, these are general guidelines and you can always discuss with your Physio, GP and Specialist any bowel concerns.

Bowel General Guidelines: "normal"

- emptying your bowels up to 3 times per day, or 3 times per week

- feeling completely emptied after opening your bowels

- Type 3-4 on Bristol Stool Chart

- <5 minutes to empty your bowels completely

- approximately <3-4 wipes to clean yourself

- not having to strain to empty you bowels

- no pain with opening your bowels

- no bleeding associated with bowel motions or within the stool

Medical Disclaimer: Remember if you ever notice a change in bowel motions or any of the above chat to your GP.

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Bowel Conditions

Chronic constipation is a common problem that affects many people. It is characterized by infrequent bowel movements and difficulty passing stools. This can lead to a range of symptoms such as abdominal pain, bloating, pain with defecation and often can result in straining, which sometimes leads to haemorrhoids .

One possible cause of chronic constipation is pelvic floor muscle paradoxical contraction. The pelvic floor muscles are a group of muscles that support the pelvic organs and control the sphincters that open and close the anus and urethra. These muscles need to relax in order for the bowel to empty and stool to pass. However, in some people, these muscles may contract instead of relax, which can make it difficult to empty the bowel.

Pelvic floor muscle paradoxical contraction can be caused by a variety of factors, such as chronic muscle tension, nerve damage, or previous surgery.

A Pelvic floor physiotherapist can help with pelvic floor muscle paradoxical contraction and chronic constipation. They can help you identify and correct any postural contributing factors, muscle imbalances or tension in the pelvic floor muscles. Through the use of exercises and manual therapy, a pelvic floor physiotherapist can teach you how to relax and coordinate the muscles of your pelvic floor, which can help to improve bowel function and reduce constipation.

Pelvic floor physiotherapy also incorporates biofeedback, which uses electronic sensors to monitor the activity of your pelvic floor muscles and balloon sensory retraining to provide real-time feedback to the rectum and muscles. This can help you to better understand how your muscles are working and identify areas that need to be improved.

Faecal incontinence is the inability to control bowel movements, leading to the unintentional passing of stool or gas. It can have a significant impact on a person's quality of life, causing embarrassment, social isolation, and depression.

There are many possible causes of faecal incontinence, including muscle or nerve damage, inflammatory bowel disease, and certain surgeries. In women, childbirth can damage the muscles and nerves of the anal sphincters, leading to weakened muscle tone and decreased control of the bowel motions.

Pelvic floor physiotherapy is method of conservative management for faecal incontinence, sometimes surgical options are required by your Colorectal Specialist. A pelvic floor physiotherapist will assess the strength and tone of the pelvic floor muscles and develop a specific treatment program to improve muscle tone and control. This may include strength or endurance exercises for anal sphincter and pelvic floor muscles, in addition to lifestyle or dietary modification and functional retraining of bowel habits.

It is important to note that pelvic floor physiotherapy may take several weeks or months to produce noticeable improvement and that it may not be a cure for the condition, depending on the cause of the faecal incontinence. We sometimes utilise electrical nerve stimulation to assist with retraining and strengthening anal sphincter muscles.