For people whose bowels are regular, we don’t give much thought to our poo. However, for those who have challenges – such as diarrhoea, constipation or difficulty controlling wind – this can be embarrassing and distressing. The normal frequency for opening your bowels is between 3 times per week and 3 times per day.
Conditions that pelvic floor physiotherapists see include:
1. Faecal incontinence: This is the involuntary loss of bowel matter. This can range from smudges to a full bowel movement. Anal sphincter injuries, nerve damage or IBS-related issues such as constipation or diarrhoea can be causes as to why someone has faecal incontinence. Depending on the causes for the incontinence, there are strategies such as muscle strengthening, dietary management of stool consistency and optimising toileting technique that are beneficial.
2. Flatus incontinence: This is the involuntary loss of control of wind. Control of wind requires more control than bowel matter and can be linked with similar causes to faecal incontinence. Strengthening the pelvic floor muscles can be beneficial. Additionally, dietary influences can also impact on the quantity of gas production which may lead to intermittent flatus control issues.
3. Constipation: Constipation is often thought of as ‘just hard stools’. However, the official definition is defined as experiencing two or more of the following for at least three months:
– Straining at least 25% of the time
– Firm, hard stools at least 25% of the time
– Sensation of incomplete defecation at least 25% of the time
– Sensation of a blockage of at least 25% of the time
– Needing to use manual facilitation at least 25% of the time
– Less than 3 spontaneous bowel movements per week
Chronic constipation and straining can cause other issues such as haemorrhoids, fissures and rectal prolapse. Pelvic floor physiotherapists often focus on optimising fluid and dietary intake, correct toileting technique and teaching you how to relax your muscles well if this is an issue for you.
4. Diarrhoea: This is loose or watery stools that are passed easily. Diarrhoea can be associated with gut issues such as Irritable Bowel Syndrome (IBS). Looser stools are harder to control so are often more associated with faecal incontinence than constipation is. Similar to faecal incontinence, optimising the stool consistency and improving the pelvic floor muscular control of the bowels are often starting points when treating diarrhoea.
Written by Hayley Runting
Senior Physiotherapist with Women’s & Men’s Health focus