Bowel

Introduction

Physiotherapy normally helps with one of the bowel conditions described below.

Faecal incontinence is the leakage of gas, solid or liquid from the back passage. Leakage can range from a smearing of underwear to the loss of a full bowel motion. Faecal urge incontinence happens when you are not able to get to a toilet quickly enough. Passive faecal incontinence is when you are unaware of any leakage. The most common causes of faecal incontinence are weak muscles, making it difficult to hold on, or having loose stools that are difficult to hold on to.

Constipation means having a bowel movement fewer than every three days and the bowel motion may be hard and difficult to pass. People may strain in their attempt to empty their bowels. Constipation is also associated with pain on having a bowel movement, bloating, or a sense that the bowel has not emptied properly. This may be due to diet, fluid intake, lifestyle and age.

Obstructed defecation describes difficulty emptying the bowel even with excessive straining. There is a sensation of blockage during defecation. This type of problem can be caused by poor muscle coordination when sitting on the toilet. The sphincter muscles can tense and close, instead of relaxing and opening. In women, the presence of a prolapse (a bulge in the rectum) can cause a bowel motion to become trapped.

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How Can I Help Myself?

You may want to try our self-management app getUBetter.

Our new Pelvic Health Module is designed to give you the knowledge and confidence to manage your symptoms and live a healthier life.

This module covers:

• Female pelvic pain
• Female pelvic prolapse
• Female bladder & bowel health (including incontinence)
• Cis-female biology & anatomy

Individuals vary but it is normal to open your bowels from between three times a day, to three times a week. A normal stool is soft and easy to pass (type 3 or 4 on the diagram below).

It is useful to think of bowel management in three parts: making your stool type normal, making lifestyle changes and normalising the activity of the anal sphincter.

Normalising Your Stool Type

Lifestyle Modification

Recommended Exercises

Pelvic Floor Exercises

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Help With Your Diagnosed Condition

Further Help

It may be useful to discuss medication with your GP or Pharmacist. There are several types of medications which act in different ways to help relieve bowel symptoms.

Ano-rectal Irrigation involves using warm water to stimulate more complete and effective evacuation by flushing out the lower bowel. This is something available on prescription and your physiotherapist will discuss this with you further if needed.

Specific devices are available which are designed to help you feel more confident with your bowel management. Containment products such as anal plugs/inserts can reduce the risk of faecal leakage and are sometimes the best option with severe ongoing leakage problems. Your physiotherapist will discuss this with you further if needed.

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