Understanding Bowel Problems and How Pelvic Floor Physiotherapy Can Help

Bowel problems are far more common than most people realise.

Constipation, faecal urgency with or without leakage, or that uncomfortable feeling of not being able to completely empty your bowel are things many people live with quietly, often feeling too embarrassed to talk about them. These problems are three times more common in women, particularly after childbirth, during menopause, or following pelvic surgery and yet many women don’t seek help due to embarrassment.

These concerns are not only manageable, but in many cases, they can be improved naturally, without relying solely on medications. One of the most effective and gentle approaches is pelvic floor physiotherapy.

Reasons Why These Bowel Problems Occur:

1) The pelvic floor muscles may have become stretched or weakened after childbirth or surgery.

2) For others, the issue is the opposite! Sometimes the pelvic floor muscles can become overactive or have difficulty relaxing, making bowel emptying more difficult and sometimes painful, often contributing to straining.

3) Conditions such as irritable bowel syndrome, prolapse, or even spinal issues can also play a role.

So How Does Pelvic Floor Physiotherapy Help?

Unlike medications or quick fixes, pelvic floor physiotherapy focuses on understanding the underlying problem and working with you to restore normal function.

Pelvic Floor Muscle Retraining:

For someone with weak muscles, this may involve training the pelvic floor to contract more strongly so it can better support continence. For someone with overactive or tight muscles, the focus might be on teaching relaxation and release, so that the bowel can empty more easily.

Correct Toilet Posture and Timing:

Another important part of treatment is learning better toileting techniques. Simple changes, like adjusting your posture on the toilet or using your breath instead of straining, can make bowel emptying far smoother. Sometimes, something as simple as using a footstool to bring your knees up slightly can help position the rectum more naturally for easier emptying.

Correct Breathing Techniques:

Breathing and pressure management strategies can help improve coordination between the diaphragm, abdominal muscles and pelvic floor. This may include diaphragmatic breathing and the use of sound cues such as "Mmmm" or "Ooooo" to reduce unnecessary straining during bowel emptying.

Lifestyle & Dietary Strategies:

Physiotherapists also look at the bigger picture. Food, fluids, physical activity, posture, abdominal strength, and even scar tissue from previous surgeries can all influence how the bowel works. Rather than focusing on one small piece, pelvic floor physiotherapy takes a whole-body, holistic approach. And when necessary, your physio can coordinate with your GP, gastroenterologist, or dietitian to make sure all aspects of your care are addressed.

Who May Benefit From Pelvic Floor Physiotherapy?

This care is ideal for women dealing with:

• Ongoing constipation despite dietary changes

• Straining or pain when passing stools

• Feeling of incomplete evacuation

• Sudden or uncontrolled bowel leakage

• Pelvic or anal pressure with bowel motions

Looking for Help With Bowel Problems?

If you are experiencing constipation, bowel leakage, urgency or difficulty emptying your bowels, pelvic floor physiotherapy may help identify contributing factors and support better bowel function.

Appointments are available at Signal Health Tusmore or you can book online through Praxis Rehab Physiotherapy.

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