Fecal Incontinence / Leakage
Fecal leakage can include inability to control a small amount of stool or gas.
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Contributors to Fecal Leakage
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Muscle weakness, tension or incoordination of the muscles surrounding the anus, specifically the puborectalis muscle
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Difficult vaginal delivery and/or perineal tears or episiotomy
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Some medications and/or supplements
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Dietary factors: some foods, lack of fiber
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Chronic diarrhea or chronic constipation
How Does Bowel Control Work? (Normally)
Bowel control relies on the muscles and nerves of the pelvic floor and anus to work together. First to “hold” the stool in the rectum, let us know when the rectum is full and then release the stool appropriately.
Intact/strong puborectalis muscle helps to hold the anorectal angle in a “kinked” position which makes it harder for the stool to move unintentionally through the anal opening. Without this angle, there would be a straight pipe pointing downwards allowing the stool to flow out easily.
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When the rectum is full, the puborectalis muscle has to relax, the angle becomes more straight and the feces flow outside the rectum.
How Can Physical Therapy Help?
Muscle Training
Physical therapists are experts in understanding and treating muscle problems.
The connection between physical therapy and bowel issues is the training of the muscles surrounding the anus to be strong enough to hold the angle at rest and be able to unkink/relax when appropriate to allow the passage of stool. We help you to train these muscles to gain strength, relax and work in a coordinated manner.
We use manual therapies, specific exercises tailored to your condition, perineal biofeedback, electrical stimulation or other means as needed.
Patient Education and Resources
Bowels like a schedule and are slow learners. We offer suggestions on dietary factors, optimal positions on the toilet, tips for anal hygiene and comfort, general exercise to encourage bowel activity.
Small changes in your lifestyle can make a big difference.
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