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Can pelvic floor therapy help with bowel (fecal) urgency and incontinence?

It's National IBS Month and our series on bowel health continues. Today’s article is for those with irritable bowel syndrome that tends towards softer stools and diarrhea (IBS-D). Most people have experienced fecal urgency at least once in their lives- the experience of rushing to the bathroom to have a bowel movement or having an accident.

Although management of conditions like irritable bowel syndrome should be multidisciplinary, pelvic floor therapy can play a role in regaining control of your bowel movements instead of allowing them control you. 

Bowel incontinence (also referred to as fecal incontinence, or FI) is defined as the involuntary loss of liquid or solid stool that affects quality of life or hygiene. Between 2 to 24% of the adult population suffer from bowel incontinence in a year, with 1 to 2% experiencing significant impact on daily activities (Scott, 2014).

Pelvic Floor Muscles Are Involved in the Management of your Bowel Function

The pelvic floor muscles extend from the pubic bone all the way to the tailbone. One main function of the muscles is controlling the sphincters, including the anus. In other words, the pelvic floor muscles open and close the holes down there, keeping the things like stool in the body until you are in a good place to let them out (ideally on the toilet, and not on the floor). 

How Can Pelvic Floor Therapy Help?

The pelvic floor muscles are made of the same types of muscle tissue as other parts of the body, like the neck or shoulder.  Similarly, the pelvis is home to ligaments, nerves, fascia, and bones, just like other parts of the body. Pelvic floor therapists are specialists who have advanced training rehabbing the muscles and tissues in the area, just like a hand specialist has advanced education in the muscles and structures of the hand.

The primary goal of pelvic floor rehabilitation in the management of fecal incontinence is to strengthen the pelvic floor and anal sphincter muscles and to make sure they are coordinated and functioning. With increased muscle tone, endurance, and coordination, one should see a positive change in function in continence and function. Additional goals may include Additional goals include increasing muscle awareness, improving rectal sensitivity, and treating any tissue dysfunction that may be getting in the way of optimal pelvic floor muscle performance.

Pelvic floor therapy can provide clients with more control. In fact, according to Scott (2014), between 50 to 80% of clients who receive pelvic floor therapy for fecal incontinence gain function improvements.

What does pelvic floor therapy look like?

The treatment modalities you will receive in pelvic floor therapy depend on your body and the issues present.

Some of the modalities used at Femina Physical Therapy for the treatment of fecal incontinence can include (but are not limited to):

  • Bowel management education and retraining including lifestyle modifications like optimal fluid intake and dietary fiber intake
  • Therapeutic exercise to strengthen the pelvic floor
  • Biofeedback training with intra-rectal balloon catheters
  • Electrical stimulation using the InTone MV device
  • Manual therapy to treat connective tissue dysfunction and myofascial trigger points
  • Visceral mobilization (gentle massage techniques that loosen internal adhesions and restore movement to the organs including the intestine, bladder, uterus, and ovaries) to improve motility and GI organ function
  • Internal pelvic manual therapy to treat sensitive tissues, muscle spasms, trigger points, and muscle guarding that can cause pain with bowel movements
  • Training in self treatment techniques including abdominal lymphatic massage
  • Neuromuscular re-education and autogenic relaxation to reduce chronic muscle over-activity and improve parasympathetic nervous system function, including digestion

Patient Education and Empowerment

Fecal incontinence can greatly affect quality of life. Let the therapists at Femina Physical Therapy help you along the journey back to continence, wellness and function! Make an appointment today and let’s get started.

 

Resources

Bols E M, Berghmans B C, Hendriks E J. et al. A randomized physiotherapy trial in patients with fecal incontinence: design of the PhysioFIT-study. BMC Public Health. 2007;7:355. [PMC free article][PubMed]

Perry S, Shaw C, McGrother C. et al. Prevalence of faecal incontinence in adults aged 40 years or more living in the community. Gut. 2002;50(4):480–484. [PMC free article] [PubMed]

Scott, K. M. (2014). Pelvic Floor Rehabilitation in the Treatment of Fecal Incontinence. Clinics in Colon and Rectal Surgery27(3), 99–105. http://doi.org/10.1055/s-0034-1384662
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4174224/

Tan J J, Chan M, Tjandra J J. Evolving therapy for fecal incontinence. Dis Colon Rectum. 2007;50(11):1950–1967. [PubMed]

**This information is for educational purposes only and is not intended to replace the advice of your doctor.

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