Bowel Dysfunction & Incontinence
Can vary from the inability to hold or to pass stool or gas.
Common Causes of Bowel Leakage
Bowel incontinence, also known as fecal incontinence, is the involuntary loss of stool or gas. It can range from minor leakage when passing gas to a complete inability to control bowel movements. This condition can affect people of all ages and significantly impact daily life, causing physical discomfort, emotional distress, and social embarrassment.
Several factors can contribute to bowel leakage. Some of the most common causes include:
Pelvic Floor Muscle Weakness
The pelvic floor muscles provide support to the rectum and help maintain continence. Weakness in these muscles, often due to childbirth, aging, or surgery, can lead to poor bowel control.
Chronic Diarrhea or Constipation
If stools are watery it takes much more muscle control to hold the stool safely in the rectum, and it becomes even more of a problem if the pelvic floor or anal sphincter muscles are weak. Surprisingly, constipation can also result in bowel leakage. If there is a large accumulation of stool sitting in the rectum, mucus can seep around the stool and escape through the anus, often accompanied by small pieces of stool.
Rectal Prolapse
With rectal prolapse the rectum protrudes through the anus, weakening the sphincter muscles and contributing to incontinence.
Sphincter Damage
Injury to the anal sphincters, which are responsible for keeping the anus closed, can occur during childbirth, surgery, or trauma, leading to leakage.
Nerve Damage
The nerves that control the muscles of the rectum and anus may become damaged due to conditions such as diabetes, stroke, spinal cord injuries, multiple sclerosis or trauma.
How Can Pelvic Floor Physiotherapy Help?
Pelvic floor physiotherapy is a highly effective, non-invasive treatment that focuses on strengthening the muscles of the pelvic region. A physiotherapist specializing in pelvic health can work with you to restore bowel control and improve quality of life.
Here's how it can help:
Pelvic Floor Muscle Training
Strengthening the pelvic floor muscles through targeted exercises can improve the support they provide to the rectum and anus. A physiotherapist will guide you through exercises like Kegels, which help rebuild muscle strength and endurance.
Biofeedback Therapy
Biofeedback helps patients become more aware of their pelvic floor muscles. Sensors are placed to monitor muscle activity, and real-time feedback is provided, allowing you to learn how to control these muscles more effectively.
Electrical Stimulation
In some cases, gentle electrical stimulation may be used to activate and strengthen weak pelvic floor muscles. This therapy can help improve muscle tone and control.
Behavioral Retraining and Positioning
Bowel retraining programs help patients regain control over their bowel habits by establishing a more regular pattern of elimination. Positioning and techniques such as timed bathroom visits can be part of this program.
Difficulty Passing Stool or Gas?
Dyssynergic defecation refers to the difficulty of passing stool due to the pelvic muscles not relaxing or contracting in the correct sequence.
Pelvic floor physiotherapy can address these issues by retraining the muscles to coordinate properly, easing symptoms of constipation and straining.
A rectocele occurs when the wall between the rectum and the vagina weakens, causing the rectum to bulge into the vagina. This can lead to difficulties in the normal passage of bowel movements, leading to incomplete evacuation or straining.
Pelvic floor physiotherapy can help by strengthening the muscles that support the pelvic organs, including the rectum, to improve bowel control and reduce the symptoms associated with a rectocele.