Most people don’t give a second thought to their pelvic floor. Until, that is, something goes wrong with it.
Your pelvic floor is the collection of muscles and connective tissue that support the organs in your pelvis. This structure protects and keeps those organs where they are supposed to be. They are also key to some of your body’s most important functions, helping you urinate and defecate.
Unfortunately, the pelvic floor tissues can weaken, often because of the strains of childbirth (for women) and aging (for both women and men). If that occurs, you can lose control of your bladder and bowel, among other problems.
This can create serious quality-of-life issues, making it difficult to take part in activities outside your home. But you don’t have to accept this as a normal part of aging. There are solutions available to help you retake control of your life.
Pelvic floor disorders are generally caused by a range of factors, rather than any one thing. Among the key risk factors:
- Childbirth: During pregnancy, your body undergoes many changes, some of which can contribute to pelvic floor dysfunction. Muscles, tendons and nerves are stretched, while hormonal changes can also cause weakening. Still, it’s not as simple as blaming these disorders on pregnancy. Some women can have multiple children without any impact, while a younger woman who has never been pregnant can have issues.
- Age: Muscles can weaken naturally as part of aging, both for women and men.
- Obesity: Anything that puts pressure on the pelvic floor can contribute.
- Chronic constipation/chronic straining for bowel movements: These also put pressure on the pelvic floor.
- Surgery: Hysterectomies can increase risk.
- Injury: Car accidents and other traumatic events can damage the pelvic area.
Pelvic floor disorders are most commonly seen in women, though men can be affected as well. Among the most common conditions:
- Stress incontinence: This includes urinating or letting a few drops out when coughing, sneezing or lifting a heavy item. It is more common after childbirth or prostate surgery.
- Urge incontinence: You may have an urgent need to urinate without being able to hold it.
- Fecal incontinence: You may struggle to control your bowel movements.
- Retention or constipation: Getting urine or fecal matter to exit the body can be difficult.
- Pelvic organ prolapse: An unsupported organ – such as the uterus, bladder or rectum – may protrude outside the body (like turning a sock inside out) or bulge into the vagina.
Bowel movements are largely automatic and a result of reflexes. Once a person sits on a toilet to have a bowel movement, the anus must relax, and muscles within the bowel wall that are not under conscious control take over. When people try to “squeeze” out the stool, they often actually squeeze the sphincter muscles, which then obstruct the stool from exiting. This causes a special kind of outlet obstruction constipation.
You don’t have to accept pelvic floor issues. Often, people with urinary incontinence will just deal with the consequences and continue with life. But fecal incontinence can be extremely debilitating -- physically, emotionally, and mentally. That’s why it is one of the top causes of nursing home admissions. It’s not easy to deal with – for the patient or their family.
Fortunately, there are ways to deal with fecal incontinence. Dietary changes can help to bulk or thicken the stool to make it easier to control. For some people, medications may be an option, particularly when it comes to bowel movements. In addition, specialized pelvic floor physical therapists can help patients with exercises, lifestyle and dietary modifications to improve bowel function.
Finally, for some patients, surgery can be added to the nonsurgical therapies to reestablish pelvic floor support or improve function. Other patients may benefit from special nerve stimulators which can help your bladder and bowel work better through simple outpatient procedures. If you have pelvic floor problems affecting your quality of life, ask your doctor to see a specialist who can help you enjoy life more again.
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