Common Symptoms
- Constipation
- Fecal Incontinence
- Bowel frequency, urgency, retention, and/or incomplete emptying
- Flatulence/gas
- Diarrhea
- Bloating
- Rectal and/or abdominal pain, pressure, or spasm
Definitions of Bowel Conditions:
The following information relates to various bowel disorders. While there can be many medical reasons for bowel disorders, specially trained physical therapists can evaluate and treat the musculoskeletal components of bowel dysfunction. Musculoskeletal dysfunction caused by IBS, constipation, and the other bowel disorders can be treated by physical therapists utilizing massage and myofascial release techniques to decrease muscle tightness and myofascial trigger points in the abdomen, back, gluteals, and pelvic floor. EMG/Biofeedback for re-education of these muscle groups is imperative in order to return to normal function.
Constipation: Delayed or abnormal colonic transport, constipation may result from tight and/or weakened pelvic floor and abdominal musculature or may be due to incoordination of these muscles. Constipation as a result of muscle dysfunction can be managed conservatively with physical therapy. Treatment consists of bowel stimulation through abdominal massage and trigger point release.
Fecal Incontinence: Unexpected leakage of any stool from the rectum. This can be due to pelvic floor muscle weakness.
Diarrhea: The passage of an increased amount of feces. Chronic diarrhea may be a symptom of irritable bowel syndrome, Crohn's disease, or ulcerative colitis. Diarrhea can be caused by some medications including laxatives, antacids, certain antimicrobial agents, diuretics, and alcohol. Weak pelvic floor muscles and the soft consistency of the fecal matter with diarrhea can contribute to fecal incontinent episodes.
Irritable Bowel Syndrome (IBS): Signs and symptoms of IBS may include abdominal pain or discomfort, bloating, gas, and such changes in bowel pattern as more frequent bowel movements, diarrhea, and/or constipation. IBS may result from tightening, weakening, and/or incoordination of the pelvic floor and abdominal musculature.
Hemorrhoid Pain: Painful, swollen, and inflamed veins around the anus and rectum. They occur usually due to straining with bowel movements. They can be seen with pregnancy, chronic constipation, and/or diarrhea. Hemorrhoids can be external (skin around the anus) or internal (inside the anal canal). If the muscles or tissues in the rectum and anal canal are restricted or in spasm, blood flow to the hemorrhoid is restricted. This decreased circulation can make healing more difficult. Physical therapy can help increase tissue mobility and reduce muscle spasms in the affected area.
Rectal Prolapse: Weak pelvic floor musculature or chronic straining can produce a feeling of "falling out" or fullness. Men may suffer a prolapse of the rectum into the posterior pelvic floor wall. The herniation of rectal tissue may occur with chronic constipation, chronic coughing, heavy lifting, and/or obesity. Symptoms may include constipation and/or pelvic pain. A rectal prolapse may be prevented through correct body mechanics with lifting, avoidance of straining, controlling and treating constipation, weight control, and kegels. A rectal prolapse can be managed with pelvic floor physical therapy, pessary (for women), or surgery (in severe cases).
Anal Fissure: A tear in the skin of the anal canal, commonly caused by overstretching of the tissue. This is typically due to tight pelvic floor musculature and hard stool.
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