Bowel Disorders And Conditions

 

Common Symptoms

• bowel frequency, retention, urgency and/or incomplete emptying

• difficulty initiating

• bloating, constipation, diarrhea,gas

• abdominal and/or rectal pain, pressure, spasms

   
Bowel Conditions
There are several types of bowel conditions and there are many medical reasons for bowel disorders.  Below are discussions of these conditions and how they may be helped by a physical therapist specifically relating to the musculoskeletal system.  Musculoskeletal problems developed by Irritable Bowel Syndrome (IBS), constipation and bowel incontinence result in trigger points of the surrounding musculoskeletal tissue, muscle imbalances and chemical changes of the surrounding tissue.  

Constipation: 
Constipation is a condition in which a person has fewer than 3 bowel movements a week.  It is usually associated with hard stools or difficulty passing stools.  Constipation is a result of muscle dysfunction.  Physical therapy can help with massaging the colon  resulting in bowel stimulation, behavioral modification and manual therapy techniques.  Constipation culprits include a low fiber diet, repeatedly ignoring the urge to go, lack of exercise and decreased water intake.  

Diarrhea:
To most people, diarrhea means an increased frequency or decreased consistency of bowel movements; however, the medical definition is more exact than this.  It is typically described as more than 5 bowel movements a day or liquid stools.  Chronic diarrhea is loose stools lasting more than 3 weeks and is a symptom of Irritable Bowel Syndrome (IBS).  Bowel leakage from weak pelvic floor muscles is seen with diarrhea.  Physical therapy assists in managing with pelvic floor muscle (PFM) up-training, behavioral modifications and diet modifications.

 

Inflammatory Bowel Disease (IBD):
Inflammatory bowel disease(IBD) involves chronic inflammation of all or part of your digestive tract.  IBD includes ulcerative colitis and Crohn's disease.  Symptoms typically include diarrhea, abdominal pain and cramping, blood in your stool, ulcers, reduced appetite and weight loss.  People with severe Crohn's disease may also experience fever, fatigue, eye inflammation, arthritis, skin disorders, inflammation of the liver or bile ducts and delayed growth or sexual development in children.

These diseases often result in shortening and spasms of the surrounding muscles which can be reduced with manual therapy, behavioral modifications and strengthening of the surrounding tissues.

Irritable Bowel Syndrome:
Also known as spastic colon is a symptom-based diagnosis characterized by chronic abdominal pain, discomfort, bloating, and alternation of stool function. Diagnostic tests may include a stool test, lower GI series and flexible sigmoidoscopy or colonoscopy. Colonoscopy may be recommended for people who are older than age 50 to screen for colon cancer.

Bowel Incontinence:
Unexpected leakage of stool from the rectum due to lack of control over defecation, leading to involuntary loss of bowel contents.  Bowel or faecal incontinence is a sign or a symptom, not a diagnosis.  

Hemorrhoid Pain

Rectal Prolapse:
Occurs when the rectum (the last section of the large intestine) falls from its normal position within the pelvic area.  Weak pelvic floor musculature or chronic straining and or lifting improperly can produce a feeling of pressure, fullness or “falling out”.  Often times a person does not realize they have a rectal prolapse unless specifically examined for a prolapse.  Men often suffer a prolapse of the rectum into the posterior pelvic wall.  This may result from chronic coughing, heavy lifting and obesity.  Typically, grade I-II rectal prolapse can be managed with pelvic floor physical therapy and sometimes pessaries for women.  Severe prolapses require surgery. 

 

Anal Fissure:
Small oval-shaped tear in skin that lines the opening of the anus.  Fissures typically cause severe pain and bleeding with bowel movements.  There are quite common in the general population, but are often confused with other causes of pain and bleeding, such as hemorrhoids. Tears often occur due to overstretching of the tissue which is a result of shortened and tight pelvic floor musculature.