Bladder and Bowel Dysfunction

Stress Urinary Incontinence

This is a common problem that affects women more than men. It is leaking of urine when you cough, sneeze, run or laugh or during any other activity that increases the abdominal pressure and therefore puts pressure on the bladder. It is mainly caused by weakness of the pelvic floor muscles. This can occur due to pregnancy and childbirth (especially following a forceps or vacuum delivery), chronic constipation, or a chronic cough.

Overactive Bladder

This occurs when the bladder muscles squeeze even if the bladder is not that full and you get a strong urge to go to the toilet. It is often associated with frequency i.e. going to the toilet more than seven times a day.

Bowel Incontinence

This can include leakage of stool, gas or mucous from the bowel or staining and can be very distressing. Weakness of the pelvic floor, specifically the anal sphincter muscle, is the main cause and damage to the sphincter during surgery or childbirth can be present. Chronic straining due to poor defecation mechanics can play a part as the bowel may not be emptying completely.

Constipation

There are many reasons for constipation but poor bowel mechanics can be a major cause of chronic constipation. If there is poor muscle coordination between the abdominal and pelvic floor muscles, this can cause difficulty in emptying the bowels.

Physiotherapy for bladder and bowel problems involves rehabilitating the pelvic floor muscles through either release or strengthening, retraining the reflexes of the bladder and bowel, and learning correct voiding and defecation techniques.