Believe it or not, the muscles in the pelvic floor directly impact bowel function and health. In involuntary and voluntary ways, these muscles can impact the health and function of your gastrointestinal system. Typically, pelvic floor muscles let us control when we release gas and stool, allowing the bowel to relax at the correct time. The anal sphincter is a sophisticated neuromuscular structure, as it can 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 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 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
  • Three bowel movements per day to 3 bowel movements per week is considered normal; less than three bowel movements per week are considered abnormal
  • 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 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
  • Three bowel movements per day to 3 bowel movements per week is considered normal; less than three bowel movements per week are considered abnormal

Symptoms

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

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

Some of the many diagnoses associated with pelvic floor dysfunction include hemorrhoids, anal fissures, irritable bowl syndrome (IBS), Small Intestinal Bacterial Overgrowth (SIBO), H. Pylori, Proctalgia Fugax, Endometriosis, Ulcerative Colitis, Crohn’s disease, transit along with transit and mobility disorders.

Associated Diagnoses

Some of the many diagnoses associated with pelvic floor dysfunction include hemorrhoids, anal fissures, irritable bowl syndrome (IBS), Small Intestinal Bacterial Overgrowth (SIBO), H. Pylori, Proctalgia Fugax, Endometriosis, Ulcerative Colitis, Crohn’s disease, transit along with transit and mobility disorders.

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

Bowel disorders and gastrointestinal symptoms affect millions of Americans each year, yet pelvic floor physical therapy is typically never considered. Because of this gap in healthcare, patients cannot find effective treatment. Various factors, including diet, medications, environment, and the gastrointestinal/musculoskeletal system play a part in proper bowel function, which means a coordinated effort is needed to properly treat symptoms in many situations. Our Ventura County pelvic floor physical therapists are well-positioned to work with integrative health providers and doctors to ensure our patients have the most comprehensive care possible.

Diagnostic Challenges

Treatment:

How We Can Help You

Your gastrointestinal system and bowel health are reliant on the pelvic floor muscles. If you are experiencing gastrointestinal distress or difficulty with bowel movements, a pelvic floor examination may be necessary. Bowel dysfunction may be caused by pelvic floor muscles that are too tight and/or weak, or the pelvic muscles might be uncoordinated and dysfunctional themselves. It is helpful 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 make your symptoms worse. That’s 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.

Treatment:

How We Can Help You

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 that 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 complement 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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