Login
Register

Home

About Us

Diagnoses

Treatments

Classes

Resources

Media

Testimonials

Blog

Account

Constipation & Dysynergic Defecation
Register
woman in bed suffering from Dysynergic Defecation

Pelvic Floor Dysynergia, Dysynergic Defecation, and Chronic Constipation

Can pelvic floor therapy help with the various forms of constipation?

It's National IBS Month! We are continuing our bowel health series to help you achieve optimal pelvic health. Having bowel movements is something everyone must do, and sometimes it is difficult to have a bowel movement. While the causes for constipation can vary, today we want to talk about a particular dysfunction that pelvic floor therapy can greatly help with: dysynergic defecation.

What is dysynergic defecation and how common is it?

Dysynergic Defecation is a muscle coordination issue where you think you are relaxing your anal sphincter to defecate, but in reality you are actually contracting your muscles and closing off the sphincter. In short, your pelvic floor muscles are doing the opposite of what your brain is telling them to do. Dysynergic defecation is common; an estimated 40% of patients with chronic constipation also have dysynergic defecation, according to this study.

But wouldn’t you be able to tell if you have it?

Dysynergic defecation, like other coordination issues, are hard to detect on your own. This is because your brain thinks that the muscles are doing the right action, when they are actually doing the opposite of what you want them to do. In this case, the pelvic floor muscles are firing incorrectly and it is often tied to poor coordination of the abdominal muscles, and sometimes decreased sensation of the rectum.

Dysynergic defecation is diagnosed typically by an anorectal examination, and anorectal manometry/defecography testing (like this, with an MRI), or by assessing muscle activity with EMG while the person attempts to expel a balloon, or other testing options)

What are the signs and symptoms?

The most common symptom of dysynergic defecation is constipation.

Constipation symptoms:

  • 3 bowel movements or fewer per week
  • Abdominal discomfort and pain
  • Abdominal bloating
  • Straining to have a bowel movement (holding your breath, pushing out the gut)
  • Sense of incomplete evacuation when you are done on the toilet
  • Bowel movements that are hard. Often pebbles, pebbles pushed together, or a log with lots of cracks.
  • Needing to use fingers to pull out stool or to push on surrounding tissues to evacuate

What happens when it goes untreated?

Constant straining and pushing bowel movements out of the body while holding your breath increases intra-abdominal pressure. This pressure can start forcing organs to move, usually down south, eventually creating or worsening a pelvic organ prolapse. That is if left untreated, constant straining with bowel movements will cause you to start pushing your organs. In some cases of prolapse, organs such as the bladder, uterus, vaginal wall, or rectal wall will begin to push on the pelvic floor, sometimes bulging or protruding. Constant strain will also cause the muscles of the pelvic floor to spasm or become weak.

How can pelvic floor therapy help?

A licensed pelvic floor therapist can conduct a thorough evaluation of the pelvic floor and help you come up with strategies to have a bowel movement without straining.

Examination may include an internal exam via the vagina or rectum, observing the movement of the pelvic floor muscles, as well as palpation of the structures of the belly and pelvic area.

The ultimate goal of our treatment plans at Femina Physical Therapy is to help you fully relax the pelvic floor and to be able to have a complete bowel movement without strain or pain. This might include manual therapy to treat tight and guarding pelvic floor muscles that may be preventing healthy bowel movements. Other treatments will help with neuromuscular retraining, helping your brain and muscles coordinate correctly so that you are actually relaxing your muscles when you think you are relaxing them. Your therapist will also work with you to create healthy bowel habits, problem solve positioning on the toilet, the time you are spending on the toilet, and other habits that can help create regularity.

 

Resources

1. Rao, S. S. C., & Patcharatrakul, T. (2016). Diagnosis and Treatment of Dysynergic Defecation. Journal of Neurogastroenterology and Motility, 22(3), 423–435. https://doi.org/10.5056/jnm16060

2. Rao SSC. Biofeedback Therapy for Constipation in Adults. Best practice & research Clinical gastroenterology. 2011;25(1):159-166. doi:10.1016/j.bpg.2011.01.004.

What Our Patients Have to Say

Prev
Next

Testimonial by Lauren B.

Femina PT (née Fusion Wellness & Physical Therapy) has been such an answer to prayer, i'm so glad I found them! I've been struggling with vaginismus my whole life, but didn't have a name for it until about 6 or 7 months ago. Even once I did have a name for it though, I didn't know where to begin in getting help. My OB/GYN had me get a set of dilators, but I couldn't even insert the smallest one by myself. Most times I tried I just ended up frustrated and in tears. I felt really alone, like I was broken and didn't have the energy to keep trying. When I got engaged a few months ago though, I realized I needed to get answers so i wasn't dreading my honeymoon.

Read more: Testimonial by Lauren B.

Testimonial by Ann V.

I wish i could give this place 10 stars!! 
I have been suffering from vaginismus for 5 years and never found the cure to it. I had seen an ob/gyn and he diagnosed me with vaginismus and told me i needed a surgery to cure my condition, which i refused to do. He also referred me to a PT that he works with, i had given them multiple calls and they never responded back to me, so i started searching yelp for another PT. I am SO HAPPY I found Heather's office! I was working with Laureen, and with her guidance and techniques i was able to be cured from vaginismus in only 2 1/2 short months!!! I couldn't believe how quickly their program worked for me! I am forever grateful and thankful from Heather, and Laureen! They are the absolute best at what they do!

Read more: Testimonial by Ann V.

Testimonial by Julie T.

Femina PT (née Fusion Wellness & Physical Therapy) has honestly changed my life. Before receiving treatment at Femina, I was going doctor to doctor to try and find the answer to my pelvic pain. It has taken me YEARS to find someone that can help fix this. It wasn't until my gynecologist recommended your clinic that I finally felt relief. My pelvic pain is almost gone, and granted I still have a lot more to work on with Laureen (my PT), my original problem is nearly cured. I am so grateful to her.

What is even better is she gave me practical exercises to do at home that were not tedious and provided instant (and lasting) relief. Although I mainly work with Laureen, my interaction with the owner (Heather) has been great. She is very generous, kind, and committed to her business.

It hurts to know there are women out there suffering who will never know or have the opportunity to work with women like Laureen and Heather because this issue is hardly talked about and this field is so rare. I hope more doctors and physical therapists see the value in this work and can relieve more woman of their pain.

-- Julie T., 12/4/16 via Yelp!

Testimonial by A.B.

Before I was referred to Heather Jeffcoat I was living in a nightmare. I had been married to my husband for three years and I was suffering from Vaginismus. That all changed when I visited my OBGYN and she said she knew of someone with a great success rate. To be honest I was hesitant at first because my first doctor had already told me that all I needed to do was order dilators from the internet and I should overcome my problem. She was wrong because I had followed the book on how to use the dilators with absolutely no advancements in my condition. However, that all changed when I went in for my first visit and Heather took the time to explain my condition and how we were going to work together to overcome it.

I remember leaving her office with a glimmer of hope that I could live a normal life. As my sessions continued I began to see immediate results. With only four sessions and a strict dedication to my home programs I was cured of Vaginismus. In the beginning of this process I was made aware that my health insurance company might not cover the costs, which was disappointing but today I can say one hundred percent that it was the best money I ever spent. Now thanks to Heather I am finally enjoying my life to the fullest with my husband. Thank you Heather, I can’t begin to tell you how much I appreciate all that you have done for me. I will never forget it. Those who are suffering from these types of conditions don’t be afraid because she makes you feel so comfortable and the end result is worth it. Good luck to you all and I hope you experience the success I have.
-- A.B.

Testimonial by R.H.

No one could tell me why I was having pain during sex--sharp pain, not just uncomfortable, pain. I was referred to Heather Jeffcoat after researching several different options. I had seen a specialist who told me physical therapy would not help and my only option was surgery. I really didn't want to go that route, so when we got a referral, I decided to try it--it can't hurt, I thought. I am so glad I did. She diagnosed the problem right away, which was a relief in itself.

To know why I was having pain eased my mind immensely. And to hear that she could fix it without surgery was another relief. She said she could fix the problem in 6 weeks. I think it was actually 4 for me. She was very methodical, and treated me as an intelligent human being capable of participating in my own recovery. I would absolutely recommend her to anyone. She did not try to prolong my session numbers, she worked hard to accommodate my schedule (and the fact that I had to bring a baby to sessions), and she was completely honest the entire time. It is so hard to find someone with these characteristics, much less a professional who is so good at what she does. She has my highest respect.

-- R.H.

Testimonial by R.D., age 38

"I had a severe tear during childbirth that was not stitched together correctly and therefore healed poorly. Even after having a surgery a year later to remove the scar tissue, I was still having pain, and no one could explain why -- there was no overt 'reason' to explain the pain. I had tried other 'specialists' and even saw another physical therapist who had me do hip / leg stretches -- what a joke! I was about to give up and just 'live with it' until thankfully I kept searching online and found Heather.

Read more: Testimonial by R.D., age 38

Subscribe To Our Newsletter

Get access to our free downloads and a 15% discount on Heather's book "Sex Without Pain"!
captcha 
I agree with the Terms and Conditions and the Privacy policy