Loss of bowel control may present as:
- Leakage of stool – symptoms involve staining in pants or leakage on way to toilet
- Leakage of mucus – passive leakage in pants without noticing
- Inability to control flatus – flatus escapes easily with movement
- Urgency of stool – having to run to toilet as soon as you feel the urge and sometimes without making it in time
- Difficulty cleaning – having to go back and wipe repeatedly
Further bowel disorders include defecation orders:
- Anismus – excessive tension in the sphincter muscle
- Chronic constipation
- Defecation dysfunction involving prolapse – where prolapse of rectal tissue plays a role in inability to pass a bowel motion
Rectal pain disorders include:
- Fissures / haemorrhoids
- Proctodynia – usually waking up at night with acutely painful rectal spasms
Control disorders may occur but are not always as a result of childbirth. An extensive tear at the time of childbirth may later in life lead to difficulty controlling stool without sufficient strengthening.
Separately, over-activity in the pelvic floor muscles can cause difficulty with passing bowel motions and motions can be inefficient. Symptoms can be inability to empty completely, lower abdominal discomfort and a feeling of loading and pressure on the pelvic floor muscles. These conditions are associated with dietary issues as well.
The bulk of pelvic floor muscle is centred around the back passage and the back of the rectum. This area is therefore very susceptible to developing taut bands, trigger points and holding patterns. It is easy for pain patterns to set themselves up in the anal sphincters, the rectum and even feeding into vulval pain and pudendal nerve conditions. The muscles through the anus should routinely be evaluated in all pelvic floor pain conditions.
In conditions of over-activity, tension and pain the muscles need to be released and in conditions of reduced control the muscles need to be strengthened to increase the control.
See FAQ for other ways of increasing muscle strength through the back passage with muscle stimulation.