The pelvic floor muscles support the rectum and are voluntarily and involuntarily involved with bowel function. Under normal circumstances the pelvic floor muscles keep us from leaking gas and stool and we have the ability to relax the muscles voluntarily to evacuate stool. The anal sphincter is a sophisticated neuromuscular structure, as it has the ability to detect air, liquid, and stool and the pelvic floor muscles respond accordingly, involuntarily. Unfortunately, gastrointestinal distress is common in the United States. Ongoing gastrointestinal pain and dysfunction have somatic consequences on the pelvic floor muscles, which in turn exacerbate the gastrointestinal distress.  When this system becomes dysfunctional people suffer, but pelvic floor physical therapy and a coordinated interdisciplinary treatment plan can help.

The Facts

  • Constipation affects up to 28% of the population
  • Over 25% of all Americans suffer from gastrointestinal distress
  • Anal incontinence and fecal urgency is reported by up to 40% of postpartum women
  • Constipation is three times more common in women than in men and increases in women over the age of 65
  • Irritable Bowel Syndrome affects up to 30% of the population
  • Small Intestinal Bacterial Overgrowth (SIBO) affects 38% of the population
  • Chronic constipation is a leading cause of pelvic pain and pudendal neuralgia
  • Constipation exacerbates bladder and pelvic pain symptoms
  • 3 bowel movements per day to 3 bowel movements per week is considered normal, less than 3 bowel movements per week is considered abnormal

The Facts

  • Constipation affects up to 28% of the population
  • Over 25% of all Americans suffer from gastrointestinal distress
  • Anal incontinence and fecal urgency is reported by up to 40% of postpartum women
  • Constipation is three times more common in women than in men and increases in women over the age of 65
  • Irritable Bowel Syndrome affects up to 30% of the population
  • Small Intestinal Bacterial Overgrowth (SIBO) affects 38% of the population
  • Chronic constipation is a leading cause of pelvic pain and pudendal neuralgia
  • Constipation exacerbates bladder and pelvic pain symptoms
  • 3 bowel movements per day to 3 bowel movements per week is considered normal, less than 3 bowel movements per week is considered abnormal

Symptoms

  • Straining to evacuate stool
  • Constipation
  • Need for excessive toilet paper
  • Fecal or gas leakage and incontinence
  • Hemorrhoids and fissures
  • Pain before, during or after bowel movements
  • Anal/rectal pain, burning or itching

Symptoms

  • Straining to evacuate stool
  • Constipation
  • Need for excessive toilet paper
  • Fecal or gas leakage and incontinence
  • Hemorrhoids and fissures
  • Pain before, during or after bowel movements
  • Anal/rectal pain, burning or itching

Associated Diagnoses

Irritable Bowel Syndrome, Proctalgia Fugax, Small Intestinal Bacterial Overgrowth (SIBO), H. Pylori, Celiac Disease, Endometriosis, Crohn’s disease, Ulcerative Colitis, transit and motility disorders, anal fissures and hemmorhoids are associated with pelvic floor dysfunction.

Associated Diagnoses

Causes of Bowel Dysfunction

  • Medication induced constipation (opiates, mood stabilizers, oral contraceptives, etc)
  • Pelvic floor muscle dyssynergia, tightness, and/or weakness
  • Peripheral nerve injuries from childbirth, chronic straining, or surgical trauma
  • Visceral-somatic consequences from gastrointestinal distress (IBS, SIBO, Crohn’s disease, ulcerative colitis, etc)

Causes of Bowel Dysfunction

  • Medication induced constipation (opiates, mood stabilizers, oral contraceptives, etc)
  • Pelvic floor muscle dyssynergia, tightness, and/or weakness
  • Peripheral nerve injuries from childbirth, chronic straining, or surgical trauma
  • Visceral-somatic consequences from gastrointestinal distress (IBS, SIBO, Crohn’s disease, ulcerative colitis, etc)

Diagnostic Challenges

Millions of Americans are plagued by gastrointestinal symptoms and bowel disorders yet many are not referred to pelvic floor physical therapy; therefore, they continue to suffer. Our diets, various medications, environmental factors and our gastrointestinal and musculoskeletal systems all play a role in keeping our bowels functioning properly. When things go awry many people are offered bits and pieces of appropriate therapies but rarely in a coordinated effort. As pelvic floor physical therapists we are well positioned to work with doctors and integrative health providers to make sure all aspects of our patient’s health is being considered and appropriately treated.

Diagnostic Challenges

Treatment:

How We Can Help You

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The pelvic floor muscles are intimately tied to our gastrointestinal system and bowel health. In the presence of gastrointestinal symptoms or difficulty around bowel movements a pelvic floor physical therapy evaluation is warranted. Bowel dysfunction can be associated with pelvic floor muscles that are too tight, and/or too weak, or they can be discoordinated and do not function properly. It is important to understand that historically people were told to ‘do your kegels’ for bowel health. If your pelvic floor muscles are too tight, kegel exercises may actually make your symptoms worse, which is why we advise working with a pelvic floor physical therapist to ensure proper rehabilitation. The pelvic floor muscles may need to be lengthened before they are strengthened. During the evaluation, the physical therapist reviews your history and symptoms with you, what you have been diagnosed with in the past, the treatments you have undergone and how effective or not effective these treatments have been. Importantly, we understand what you have been going through and that most people are frustrated by the time they get to see us.

During the physical examination the physical therapist examines muscles, tissues, joints, nerves, and movement patterns. Once the examination is complete your therapist reviews your findings with you. The physical therapist creates an assessment which explains how you developed your symptoms and creates short and long-term goals for your treatment plan. Typically, the frequency of physical therapy treatment is one to two times per week for roughly 12 weeks. You are given a home exercise program to compliment your in-person sessions, and your physical therapist will help to coordinate your recovery with the other members of your treatment team. We are here to help you recover and live your best life! 

 

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Treatment:

How We Can Help You

162 Rancho Santa Fe F-45 Encinitas, CA 92024

Phone:    (760) 487-5118
Fax:         (760) 487-5118
Email:      [email protected]
Staff:        Jandra

PHRC expanded to Encinitas in 2019, spearheaded by Jandra when she moved from West LA to San Diego County. In addition to her doctorate degree in Physical Therapy, Jandra also has her Master’s Degree in Integrative Health and Nutrition. She offers in person and virtual services in these areas. There is free parking for our patients in the attached parking lot.

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162 Rancho Santa Fe F-45 Encinitas, CA 92024

Phone:    (760) 487-5118
Fax:         (760) 487-5118
Email:      [email protected]
Staff:        Jandra

PHRC expanded to Encinitas in 2019, spearheaded by Jandra when she moved from West LA to San Diego County. In addition to her doctorate degree in Physical Therapy, Jandra also has her Master’s Degree in Integrative Health and Nutrition. She offers in person and virtual services in these areas. There is free parking for our patients in the attached parking lot.

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