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pelvic floor therapy for bowel urgency

Can pelvic floor therapy for bowel urgency and incontinence help you?

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 Surgery, 27(3), 99–105. https://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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I started seeing Heather in October 2014. For more than two years, I had been suffering from painful urinary tract infection type symptoms after my bartholins gland surgery which included constant burning and urinary frequency sensation that led to more and more painful intercourse. I had made multiple visits to internist, obgyn and urologist's offices, went through a range of treatment with UTI and bladder frequency medication that included antibiotics, vesicare, estrogen cream, but nothing worked.

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Heather is without exaggerating AMAZING! After years of trouble with a certain part of my body, in no time, she made everything change back to equilibrium and to what would be considered normal. She explains everything in detail and therefore gives you a better understanding of why things are the way they are, and how you can work towards turning things around. I would highly recommend Heather for any type of Physical Therapy. She has created her own "Method/Therapy" through years of studying (with some of the greatest practitioners), practice and breaking down the issues of her past patients, enabling her to fine tune her own system. I'm so thankful to have found her, and I'm especially grateful for the quick recovery I've achieved, after years of distress. If you cannot afford her, I recommend you purchase her book. Although it may not be Heather in person, it can still help you to get on the right path to recovery!

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Testimonial by R.M., Age 40

I can’t speak highly enough of the theapists at Femina Physical Therapy and how much they have helped me grow, discover, and love my body. I had had painful sex for my entire life, and didn’t know that there was anything that could be done about it. It was at the point where my husband and I were not having sex for MONTHs, because it was just too frustrating, and I hated feeling like I was the ONLY woman out there who had this problem, especially at my age. I finally brought it up to my doctor because I was turning 40 and my husband and I were barely having enough sex to conceive. And she brought up pelvic floor, PT. I didn’t even know this was a “thing”.

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I went to Heather after the birth of my third child. It was lucky, really, that I was referred to her, because my doctor had referred me to a surgeon for a possible hysterectomy or pelvic wall rebuild. Thankfully, I went to Heather before undergoing either surgery, she was able to fix the problem. She has studied extensively in women's health--even written a book about it--and was able to diagnose my problem, suggest a course of treatment (6 weeks), and then follow through with said treatment. By the end, as she said, I was as good as gold. Boy, was it worth it! Though uncomfortable to talk about, much less write about, it is worth getting the word out there. If you have painful intercourse, especially after birth or other trauma, the treatment may be as simple as Physical Therapy (with Heather, of course). I highly recommend her.

-- Fritzette H., 3/24/16 via Yelp!

Testimonial by Alexandra B.

Heather is without exaggerating AMAZING! After years of trouble with a certain part of my body, in no time, she made everything change back to equilibrium and to what would be considered normal. She explains everything in detail and therefore gives you a better understanding of why things are the way they are, and how you can work towards turning things around. I would highly recommend Heather for any type of Physical Therapy. She has created her own "Method/Therapy" through years of studying (with some of the greatest practitioners), practice and breaking down the issues of her past patients, enabling her to fine tune her own system. I'm so thankful to have found her, and I'm especially grateful for the quick recovery I've achieved, after years of distress. If you cannot afford her, I recommend you purchase her book. Although it may not be Heather in person, it can still help you to get on the right path to recovery!

-- Alexandra B., 5/20/2015 via Yelp!

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