Constipation

Constipation is not just about how frequently you go. Are your bowel movements complete, regular, comfortable, and easy? It is a multifactorial problem, where your PT will assess all aspects and discuss medical referrals if needed. Symptoms include but are not limited to: decreased frequency, hemorrhoids, straining, finger splinting, hard/fragment stool, incomplete emptying.

Your physical therapists will assess:

• Transit/motility
• Pelvic floor function/ overactivity
• Breathing
• Nervous system dysregulation
• Hydration and Habits
• External influences (ex: medications)

Depending on the assessment done by your PT, treatment can look like retraining pelvic floor coordination and relaxation, biofeedback training, proper toilet posturing and defecation strategy, abdominal wall control, visceral mobility and more. Is it your pelvic floor that is making you constipated?

Pelvic Floor Dyssynergia

Pelvic Floor Dyssynergia is when your pelvic floor contracts instead of relaxing during a bowel movement. Think about someone stepping on a hose. Even when all other things are right- stool consistency, motility, digestion- it is very difficult to empty through a small outlet. Symptoms can include rectal pressure, hemorrhoids, straining with soft stool, or feeling blocked/ incomplete emptying. Treatment is mostly coordination training: biofeedback, mechanics training and education, pelvic floor relaxation techniques, breath retraining, behavioral strategies.

Other GI Disorders 

Many chronic GI disorders and conditions (such as IBS, SIBO, SIFO, Crohn’s, Ulcerative Colitis and more) coexist with pelvic floor dysfunction. Pelvic floor physical therapy can not promise to treat the overgrowth or inflammation of your gut, but it can help you manage the symptoms that come with it and break adaptive habits formed by it.

Symptoms and treatments can include:

• Constipation and hemorrhoid management
• Manual therapy to an overactive pelvic floor
• Urgency pattern or increased visceral sensitivity retraining
• Abdominal guarding/tension release techniques
• Diaphragm breathing and nervous system retraining

GI care is collaborative! Solstice takes pride in coordinating closely with patients’ doctors to achieve all medical and patient-oriented goals.

Bloating

Persistent bloating is not always gas! Abdominophrenic Dyssynergia (APD) can occur when your diaphragm contracts downwards, prompting the abdominal wall to inappropriately relax outward. This can be in response to gas or visceral sensation and can create visible distention of someone’s abdomen.

Just because bloating is not always gas does not mean it is never gas. Improper bowel habits, such as constipation, can create a trapped gas environment. Maybe you go every day, but maybe it is not complete, does not have the right stool consistency, or maybe you need help with diet modification and education.

Pelvic floor physical therapy approaches bloating with multiple treatment options:

• Constipation management
• Food/ fluid management
• Education on habits (ex: small meals, no straws)
• Rib cage tension
• Diaphragm excursion and breath coordination
• Abdominal wall coordination and core control
• Postural correction
• Nervous system regulation

“I have been to two different PT’s before Solstice and once I got there I felt like this is when my recovery really started. They really take the time to help you understand the Pelvic Floor and how to recover.”