Are you straining to open your bowels and thinking this is normal?
Opening your bowels should not feel like a full body workout, where you are holding your breath, straining, pushing so hard or rocking back and forth. You may even be spending what seems like forever on the toilet to just open your bowels. It is not normal to feel exhausted, sweaty, or like you’ve completed a gym session after opening your bowels. Or you may leave the toilet and feel you have not emptied your bowels completely.
An important point is you are not alone, as many people live with defecation dysfunction. This is a condition that affects the body’s ability to effectively empty their bowels.
The good news? There is help available and one of the most effective tools is Rectal Balloon Training (RBT). This training can be provided from a Pelvic Health Physiotherapist, who has a special interest in defecation dysfunction.
What is Defecation Dysfunction?
Defecation dysfunction refers to difficulty emptying the bowels, even when stool is present in the rectum and the urge to go exists.
Common symptoms include:
- Excessive straining
- A sensation of incomplete emptying
- Feeling blocked or obstructed
- Needing multiple attempts to empty
- Spending a long time on the toilet
- Needing to use your fingers to assist evacuation
- Reduced or absent urge to open your bowels
- Chronic constipation
For many people, the problem isn’t simply the stool itself, but rather how the muscles, nerves and rectum are working together.
The Role of Your Pelvic Floor in Bowel Function
Your pelvic floor muscles form a supportive sling at the base of your pelvis and play an important role in bowel control and emptying.
When everything is working well, the pelvic floor muscles relax and lengthen when you sit on the toilet. This relaxation allows the anal canal to open so stool can pass comfortably and efficiently.
However, sometimes these muscles don’t get the correct memo. So instead of relaxing, the muscles may tighten, brace or contract during attempts to empty the bowels. This is known as dyssynergic defecation or a defecation disorder.
Over time, this can lead to:
- Ongoing constipation
- Excessive straining
- Haemorrhoids
- Pelvic floor tension
- Pelvic organ prolapse
- Worsening bowel symptoms
Is it Just a Muscle Issue?
Your rectum also plays a crucial role.
The rectum acts as a storage reservoir and contains stretch receptors that help detect when stool is present. These receptors signal to the brain that’s its time to open your bowels.
Sometimes, particularly in people with longstanding constipation, the rectum can become stretched over time. As the rectum enlarges, it becomes less sensitive and requires larger volumes of stool before the urge to empty is triggered.
As a result, people may experience:
- Reduced bowel urges
- Missing the body’s signals to go
- Infrequent bowel motions
- Significant stool accumulation
This is where Rectal Balloon Training (RBT) can be particularly helpful.
What is Rectal Balloon Training?
Rectal Balloon Training (RBT) is a specialised assessment and treatment technique used by Pelvic Health Physiotherapists to improve bowel emptying and rectal sensation.
A small balloon attached to a catheter is gently inserted into the rectum and gradually inflated with air. This allows us to assess:
- Rectal sensation
- Awareness of bowel filling
- The urge to defecate
- Pelvic floor coordination during emptying
Depending on the test findings, your Pelvic Health Physiotherapist can use the balloon as a treatment tool to retrain the bowel-brain connection. For some people, the goal is improving awareness of rectal filling and restoring normal bowel urges. For others, the focus is learning how to relax the pelvic floor and coordinate effective bowel emptying,
Think of RBT as physiotherapy to train your bowel reflexes.
How can a Pelvic Health Physiotherapist Help You?
At Physiotherapy for Women, we take a comprehensive approach to bowel dysfunction. We firstly listen to your story and your symptoms. By working together with open discussion, we set a treatment plan, including achievable goals.
Treatment may include:
- Education about bowel function and anatomy
- Optimising toilet posture
- Breathing and pressure management strategies
- Pelvic floor muscle relaxation training
- Defecation training
- Rectal Balloon Training
- Stool consistency optimisation
- Fibre and fluid education
- Strategies to improve bowel urges
- Management of pelvic floor tension and pain
Our goal is simple: to help bowel motions feel effortless again.
You Should Not Have to Fight Your Bowels
Opening your bowels shouldn’t feel like a full-body workout!
If you are straining, pushing, spending excessive time on the toilet, or feel like you’re never completely empty, your body must be telling you that something isn’t functioning as efficiently as it could be.
The good news is that there are evidence-based treatments available to help you. Pelvic Health Physiotherapists are uniquely trained to assess and manage your bowel opening problems. If you are struggling with constipation, incomplete emptying, or bowel dysfunction, we’d love to help you.
Contact our clinic today to book an appointment with one of our Pelvic Health Physiotherapists. Congratulations for taking the first step towards better bowel health.