Bowel incontinence FI
This is the passing of bowel motions or wind with poor, or no control. It is one of the most hidden problems and probably the condition that stops people socialising. Although it is often associated with older adults and dementia, it can affect younger women.
Patients who are chronically constipated and strain to open their bowels. Any patients with diarrhoea.
Patients with anal problems:
- Women with third- and fourth-degree tears from childbirth injury.
- Patients with rectal or pelvic organ prolapse.
- Patients with pelvic radiotherapy or colon surgery.
- Inflammatory Bowel Disease IBD
- Patients with Fistula or Haemorrhoids
- Patients with Irritable Bowel Syndrome IBS
Incontinence is common after the use of forceps, a large baby, occipito-posterior position and a long second stage of labour.
One in five women develop incontinence after vaginal delivery and 30% have structural damage that can be seen by anal endosonography. A systematic review reported that after repair anal incontinence persisted in 15-59% of women and anal urgency affected a further 6-28%.
This is the most common cause after obstetric trauma.
Incontinence may be inevitable after complex anal fistula surgery or may occur as an unexpected complication after haemorrhoidectomy or surgery for chronic anal fissure. The incidence is reducing with advances in surgical techniques.
Degeneration of the anal sphincter:
After structural damage, this is the most common cause of sphincter dysfunction. Most cases are due to primary isolated degeneration of the smooth muscle of the internal anal sphincter. The condition is most common in middle age and affects both men and women.
Endosonography is a useful investigation to identify surgically correctable sphincter defects. It often shows that the anal sphincter is fibrotic and thin and resting anal pressure is low.
Constipation is usually determined by the consistency of your motion. The regularity if passing bowel motions varies. Less than 3 bowel motions a week, together with hard, small, difficult to pass motions is typical of constipation.
Some people who are constipated find it painful to have a bowel movement and often experience straining, bloating and the sensation of a full bowel. When they do pass a motion, it may be accompanied by a small amount of blood. This is due to a small tear in the lining of the rectum.
These are not just symptoms of bowel problems but can be the result of other problems in the pelvis or gut. Digestive gut problems can really affect the bowel and the control of defaecation. A wholistic approach is the only way to tackle bowel problems…diet…exercise…lifestyle are vital components to helping you.
If you have problems with your bowels you must see your doctor to exclude serious underlying pathology. Again, people don’t really talk about these problems (even more so than bladder issues) because they are embarrassed. Believe me your doctor has heard it and seen it all before and you need to know that you don’t have serious bowel disease.
A Women’s Health Physiotherapist can help you to understand the complex connections between gut- digestive, bowel, reproductive/hormonal systems and how the symptoms you may be having are related to these system
Call today for an appointment with one of our experienced Pelvic Physios for a private, fully confidential assessment.