Pelvic Floor Disorders
Disorders of the pelvic floor function can present with a number of bowel symptoms and are common in both men and women of all ages. These include obstructed defaecation, which is often described as constipation, prolapse of the bowel and faecal incontinence. Often patients are embarrassed to talk about their symptoms and may have suffered for a number of years, before seeking medical advice.
Obstructed defaecation is when there is difficulty in emptying the bowel when visiting the toilet. It is often thought to be constipation but may present as a feeling of being unable to start defaecation, incomplete emptying requiring several visits to the toilet or needing to use a finger to apply pressure in or around the bottom to enable the bowel to empty.
Faecal Incontinence is the involuntary loss of wind, solid or liquid faeces.
It affects over 40 million adults in Europe and the United States and many will report symptoms that significantly impact their psychological wellbeing, social interactions and quality of life.
Rectal prolapse is when part of the rectum prolapses or drops down through the anal canal or back passage. Initially it only occurs when the bowels open and usually ‘goes back’ spontaneously. Over time, however, it may worsen and start to come down on standing or walking and only go back if it is pushed back up by hand. It will often cause a lot of watery or jelly like discharge from the back passage.
In assessing patients who present with pelvic floor problems, we always start with taking a thorough history of the symptoms. Included in this will also be questions about any bladder or urinary problems and in females, any vaginal prolapse symptoms, as some people will have pelvic floor problems that effect both the bowel and the bladder. An obstetric history with details or any childbirth injuries is also taken.
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