Bowel Dysfunction is defined as difficulty with passing stools, known as constipation and/or inability to control your bowels, also known as incontinence. Bowel incontinence can range from occasional leakage of a small amount of stool to a complete loss of bowel control. Constipation is defined as less than three bowel movements per week or having a difficult time passing stools. Bowel dysfunction can affect people of all ages. It might be something that is uncomfortable to talk about, but bowel dysfunction can be manageable and treatable.
Bowel Dysfunction Causes
Normal bowel control depends on the proper function of the pelvic muscles, rectum, sphincter muscles, gastrointestinal system and the nervous system. Typically, bowel dysfunction is caused when one or more of these body parts stops working properly. There are many causes of bowel dysfunction including certain foods, fluid intake, medications, stress, childbirth, chronic laxative use, complications from bowel surgery, constipation, diarrhea, hemorrhoids, muscle/nerve damage, radiation treatment, tumors, diabetes, prolapse, and physical and/or mental disabilities.
Bowel Dysfunction Risk Factors
Factors that can increase your risk of having bowel dysfunction include diarrhea three or more times a day, constipation, difficulty with childbirth, disease of the nervous system and/or gastrointestinal system, poor overall health and a sense of urgency prior to a bowel movement.
Bowel Dysfunction Symptoms
Bowel dysfunction may happen only occasionally or multiple times a day. You should visit your doctor and discuss your symptoms if you are experiencing an inability to hold in gas, difficulty passing stools, reoccurring hemorrhoids or fissures, hard/dry stools and/or inability to reach the bathroom in time. Treatment is available and there is no need to suffer in silence.
What is considered normal bowel function?
Bowel movements should occur between three times a week and up to three times a day. Stools should come out easily without needing to push. It should not be painful or uncomfortable. Your bowels should feel like they are completely empty after each bowel movement. Try not to rush the process. The consistency of your stool should be soft, smooth and snakelike. When you feel the urge to defecate, you should head to the bathroom.
General good bowel habits
Here are some general guidelines for good bowel habits. Take your time as you defecate. You should not be straining or pushing to hurry up. Try to relax. If possible, use a step stool or squatty potty under your feet to raise your knees higher than your hips. Lean forward slightly and support your elbows on your thighs. Make sure this is a comfortable position and your legs are supported. This position can make it easier to defecate and fully empty your bowels. If you need to push to get your bowel movement to start or fully empty, take a deep breath and relax your pelvic floor muscles. On the exhale, try pushing out stool while making the noise, such as GRRRR, SSSHHH, or like you are blowing through a straw. Making these sounds or exhaling can help move the stool without placing stress on your pelvic floor. When you are finished with your bowel movement, do a couple pelvic floor contractions (close off rectum and try to lift it upward/inward). This can help signal to your brain and body that you are done.
How do you know when to seek care?
When bowel dysfunction is affecting your quality of life, it is time to seek medical help. Don’t hesitate to speak with your doctor regarding your bowel dysfunction. Your health care provider can help determine the cause of the bowel dysfunction and if appropriate, they can refer you to pelvic floor therapy. Treatment for bowel dysfunction may be as simple as making changes to your diet or lifestyle.
What to expect from pelvic floor therapy
Your therapist will perform an evaluation, which may include discussing your past and current symptoms, your medical history and an examination. The examination may include assessing how well your pelvic floor muscles are functioning. From the evaluation, we will determine the best course of action needed to treat your individual needs. The treatments may include one or more of the following:
- Educate you on how to improve your bowel function including modifications to your diet, fluid intake and changing your activities to help reduce episodes of bowel leakage and/or constipation.
- We will design a home exercise program that may include bowel emptying techniques and/or exercises that can strengthen the sphincter muscles and pelvic floor.
- Keeping a bathroom schedule can also be beneficial. Setting up a regular schedule for using the toilet can give you better control. This may include attempting to move your bowels at the same time every day.
- Often, we find that surrounding area (pelvis, back, hips) can impact how your bowels and pelvic floor muscles are functioning. We can address these areas if they are impacting your condition.
- We also have access to modalities that may help to better reduce your symptoms, including biofeedback, electrical stimulation, self-massage/trigger point release tools.