Pelvic floor therapy for constipation in Bangladesh

Pelvic floor constipation treatment in Bangladesh

There are lots of reasons you might get constipation. In some patients, stool passes slowly through the colon. In others, the rectum fails to empty properly. Pelvic floor dyssynergia or dyssynergic defecation, can cause a blocked or incomplete feeling. This occurs when the pelvic floor muscles tighten instead of relaxing when you have a bowel movement.

The first step in treatment is to determine the cause of the problem. The plan is then individualized to the patient’s symptoms, bowel habits, examination findings and any investigations needed.

• Pelvic floor muscle coordination training
• Biofeedback therapy
• Bowel retraining
• Correct defecation techniques
• Breathing and abdominal pressure training
• Stool consistency management
• Dietary and lifestyle guidance
• Medication when clinically appropriate
• Further colorectal investigation when required

Who needs pelvic floor therapy for constipation?

Pelvic floor therapy may be considered when constipation appears to involve difficulty emptying the rectum rather than only hard stool. You may benefit from an assessment if you regularly experience:

• Straining too much to have a bowel movement
• Stool stuck feeling
• Partial evacuation of the bowels
• Long periods of sitting on the toilet
• Repeated unsuccessful attempts to defecate
• Difficulty in passing stool even if it is soft
• Reliance on laxatives, suppositories or enemas
• The need to use fingers or external pressure to assist in emptying the bowels
• Occasional constipation despite changes in diet
• A feeling of fullness or pressure in or around the rectum or anus

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Diagnostic tests for pelvic floor dysfunction

Not every patient requires the same investigations. Depending on your symptoms and examination findings, we may recommend further tests.

• Anorectal manometry: Anorectal manometry measures pressure within the rectum and anal canal. It can help evaluate whether the muscles relax and coordinate correctly during attempted defecation. This test can be particularly useful when dyssynergic defecation is suspected.
• Balloon expulsion test: A balloon expulsion test can assess how effectively a patient is able to evacuate from the rectum. Difficulty performing the test may support the diagnosis of an evacuation disorder when interpreted together with other findings.
• Defecography: In selected cases, defecography may be recommended to examine how the rectum and pelvic floor behave during bowel evacuation. It may also help identify structural problems associated with difficult defecation.
• Other colorectal investigations: Colonoscopy or additional investigations may be recommended when symptoms suggest another colorectal condition or when clinically indicated based on age, history, bleeding, changes in bowel habits, or other risk factors.

Pelvic floor therapy and biofeedback for constipation

For patients diagnosed with pelvic floor dyssynergia, therapy may focus on retraining the muscles involved in bowel emptying.

Biofeedback therapy for constipation

Biofeedback therapy for constipation helps patients understand how their anal and pelvic floor muscles behave during attempted bowel movements. Using feedback from muscle activity or pressure measurements, patients can learn to:

• Relax the anal and pelvic floor muscles
• Coordinate relaxation with abdominal pressure
• Improve rectal evacuation
• Reduce unnecessary straining
• Develop a more effective bowel movement technique

Pelvic floor muscle retraining

Pelvic floor therapy for constipation is different from simply performing pelvic strengthening exercises. For some patients with constipation, the pelvic floor is already too tight or contracts at the wrong time. The goal of treatment may therefore be to improve:

• Pelvic floor relaxation
• Muscle coordination
• Awareness of pelvic muscle activity
• Correct abdominal pressure
• Timing during defecation

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Why choose a colorectal specialist for chronic constipation?

Long-term constipation is not always a simple dietary problem. A colorectal specialist can assess both functional and structural causes of difficult bowel movements. Prof. Dr. Tariq Akhtar Khan provides evaluation and management for conditions including:

• Chronic constipation
• Dyssynergic defecation
• Pelvic floor dysfunction
• Obstructed defecation
• Rectal prolapse
• Rectocele-related bowel problems
• Anal and rectal conditions
• Other colorectal disorders

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