Sphincter exercises

Posted by neh213 @neh213, Aug 28, 2019

I occasionally have trouble making it to the bathroom on time and wondered of there were any exercises to strengthen my sphincter to help control this from happening.

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@emyliander

I knew about the squatty potty, my son and wife have one. I elected to get a folding step stool as elle1233 mentioned. We’ll see how it works. I’ve got to go and add up my fiber intake for today 🤔

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Both will do the same thing for you, as I'm sure your therapist explained, it's about getting yourself in a better posture to have your rectum/anus in the correct position. Both work, by raising your feet up, what you are trying to do is mimic a literal squatting position. Key thing is (whichever you are using) is to keep your back straight (don't slouch, i.e. round your back), or you are defeating the purpose. There are some good photos on line or perhaps your therapist has shown you one. That is one common reaction I see people having. A lot of people (I think - I haven't done any research, lol) tend to lean forward on the toilet. When your feet go up, it will lean you back, a natural counter to this is to slouch. Instead, back sure your butt is back as far as can be on the seat, sit up straight, if you can even try to keep the curve in the smaller of your back, you will get your "lean" there. If you feel you are falling back, lean slightly forward WITH YOUR BACK STRAIGHT. Your therapist can help you with this Also, with the stool, have your feet as wide apart as you can on the stool (it won't be very wide - that's okay, just not close together. Again, imagine an actual squat. You still get your "bottom" in the correct position.

Oh, by the way, I am a physical therapist, although not a specialist in this area professionally, I saw a pelvic floor/GI issues PT for 5 months, learned a LOT from her, and have studied a lot on my own. LOL, I'm explaining my emphasis on posture, posture, posture!

I suppose that is the one selling point of the squatting potty, it wraps around the toilet so you can put your feet wider apart, I'm not sure now much difference that makes though, in terms of getting "the job" done better, for lack of a better word! Maybe you could experiment, and try your son's and let us know!

I've never tried the squatty potty because the stool seems to do what needs to be done for me, or as I said, I literally squat on the toilet seat.

Of course the position is not a miracle, but I can feel how it helps get stool out sometimes, and I supposedly don't even have a pelvic floor problem (however, I don't want to go on too long here), I think it is more complicated than most docs understand. There can be a problems with the coordination of all of the muscles used in defecation, which I had, and only the PTs seem to understand/ address that (at least in my experience). Hence, my new opinion that just about anyone with constipation or altered bowel patterns should see a PT, at least for a consult, because they can teach people things that can really help that docs don't address (or are even aware of).

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@neh213

Thank you . I will give this a try and if it doesnt help I will go to a specialist.

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neh, I have so much to write to you, can I ask you if you have any specific diagnosis at this time? Also, you say "make it to the bathroom" - what happens when you get there? i.e. are you having stools, just not sensing the urge in time, are you having diarrhea? Or are you having more chronic leaking of stool? LOL, it always makes me laugh how in these GI forums, we can talk about things like this without thinking twice. I think most people are uncomfortable talking about these "bathroom issues", so don't, and suffer in silence.

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@contentandwell

@neh213. You might try a urogynecologist, it seems they deal with fecal incontinence as well as urinary incontinence. I presume proctologists also must deal with this but I think they may be more apt to suggest surgery, which for me would be an absolute last resort option. I could be wrong on that though, maybe they too would you refer to a specialized physical therapist.
JK

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I know some of you here know each other (I'm new), so I was wondering what kind of GI work-up @neh213 has had, ? diagnosis, etc. before going to someone like a urogynecologist, etc. Often as was your case, fixing/helping the incontinence is more about correcting an underlying problem, the lactose intolerance in your case. I don't know yet what kind of work up she's had. Interesting, about proctologists, you'd think so, but honestly, I don't think any doc deals well with the issue of incontinence. A doc can rule out some abnormalities that can have surgical fixes (there are some, and that is when they consider surgery), but other than that, they really don't have much to offer for incontinence. Geez, I can't remember what his title was, a guy I saw, some kind of rectal specialist, maybe he was a proctologist, LOL, he said my "muscles" down there were fine, and I didn't need physical therapy. Later, just on physical exam, a GI doc thought I had "low tone" and suggested the P.T., and it has been one of the things that helped me most. I learned so much! Their testing is more extensive, IMO. The "pelvic floor", contains your anus, your vagina, and your urethra, as well as being directly connected with your transverse abdominus muscle. The 'pelvic floor' tests docs do involve testing the innervation of your rectal sphincter, seeing if you can get a decent contraction of it, and if you can poop out a very full balloon. I could poop out the balloon, and contract enough, I guess, to be considered 'normal'. But, in real life, I don't have a very full balloon, in there, and was having trouble then. It's all so complicated.

I'm not knocking the testing that they do (mine was done by a nurse at Mayo, I'm not sure what dept she came from or who read the report), which was also "normal". I'm sure it identifies a lot of people who have pelvic floor problems. But, I think it may also miss some, which just goes back to how one can't always rely on "test results" alone. One reason I went to Mayo was to get into their 2 week intensive 'pelvic floor' program - which I assumed if was like my therapy experience, was a lot more than 'pelvic floor', but the doc won't order it because of my "normal' test. Arg. My PT here and I were very excited b/c we thought the intensity, i.e hours every day for 2 week might be good, vs her once a week.

Anyway, the journey continues........ 🙂

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@elle1233

Both will do the same thing for you, as I'm sure your therapist explained, it's about getting yourself in a better posture to have your rectum/anus in the correct position. Both work, by raising your feet up, what you are trying to do is mimic a literal squatting position. Key thing is (whichever you are using) is to keep your back straight (don't slouch, i.e. round your back), or you are defeating the purpose. There are some good photos on line or perhaps your therapist has shown you one. That is one common reaction I see people having. A lot of people (I think - I haven't done any research, lol) tend to lean forward on the toilet. When your feet go up, it will lean you back, a natural counter to this is to slouch. Instead, back sure your butt is back as far as can be on the seat, sit up straight, if you can even try to keep the curve in the smaller of your back, you will get your "lean" there. If you feel you are falling back, lean slightly forward WITH YOUR BACK STRAIGHT. Your therapist can help you with this Also, with the stool, have your feet as wide apart as you can on the stool (it won't be very wide - that's okay, just not close together. Again, imagine an actual squat. You still get your "bottom" in the correct position.

Oh, by the way, I am a physical therapist, although not a specialist in this area professionally, I saw a pelvic floor/GI issues PT for 5 months, learned a LOT from her, and have studied a lot on my own. LOL, I'm explaining my emphasis on posture, posture, posture!

I suppose that is the one selling point of the squatting potty, it wraps around the toilet so you can put your feet wider apart, I'm not sure now much difference that makes though, in terms of getting "the job" done better, for lack of a better word! Maybe you could experiment, and try your son's and let us know!

I've never tried the squatty potty because the stool seems to do what needs to be done for me, or as I said, I literally squat on the toilet seat.

Of course the position is not a miracle, but I can feel how it helps get stool out sometimes, and I supposedly don't even have a pelvic floor problem (however, I don't want to go on too long here), I think it is more complicated than most docs understand. There can be a problems with the coordination of all of the muscles used in defecation, which I had, and only the PTs seem to understand/ address that (at least in my experience). Hence, my new opinion that just about anyone with constipation or altered bowel patterns should see a PT, at least for a consult, because they can teach people things that can really help that docs don't address (or are even aware of).

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I agree with you that anyone can benefit from the info received in PT, even little children who get put on a toilet and their feet don’t even touch the ground.
I didn’t get the info to sit up straight, so thank you for that. I was told that you shouldn’t be pushing at all because it can cause other problems like a prolapsed bladder , which I’ve already had repaired a while ago.
Our life style makes it more difficult because we always have somewhere we need to be, and if we don’t go before we leave, we may not be able to use a BR. when we do need it. Therefore we try our hardest to relieve ourselves before we’re really ready.
If I hadn’t joined this discussion group I would not have known anything about Pelvic Floor rehab, so I’m thankful for all the info.

REPLY
@elle1233

I know some of you here know each other (I'm new), so I was wondering what kind of GI work-up @neh213 has had, ? diagnosis, etc. before going to someone like a urogynecologist, etc. Often as was your case, fixing/helping the incontinence is more about correcting an underlying problem, the lactose intolerance in your case. I don't know yet what kind of work up she's had. Interesting, about proctologists, you'd think so, but honestly, I don't think any doc deals well with the issue of incontinence. A doc can rule out some abnormalities that can have surgical fixes (there are some, and that is when they consider surgery), but other than that, they really don't have much to offer for incontinence. Geez, I can't remember what his title was, a guy I saw, some kind of rectal specialist, maybe he was a proctologist, LOL, he said my "muscles" down there were fine, and I didn't need physical therapy. Later, just on physical exam, a GI doc thought I had "low tone" and suggested the P.T., and it has been one of the things that helped me most. I learned so much! Their testing is more extensive, IMO. The "pelvic floor", contains your anus, your vagina, and your urethra, as well as being directly connected with your transverse abdominus muscle. The 'pelvic floor' tests docs do involve testing the innervation of your rectal sphincter, seeing if you can get a decent contraction of it, and if you can poop out a very full balloon. I could poop out the balloon, and contract enough, I guess, to be considered 'normal'. But, in real life, I don't have a very full balloon, in there, and was having trouble then. It's all so complicated.

I'm not knocking the testing that they do (mine was done by a nurse at Mayo, I'm not sure what dept she came from or who read the report), which was also "normal". I'm sure it identifies a lot of people who have pelvic floor problems. But, I think it may also miss some, which just goes back to how one can't always rely on "test results" alone. One reason I went to Mayo was to get into their 2 week intensive 'pelvic floor' program - which I assumed if was like my therapy experience, was a lot more than 'pelvic floor', but the doc won't order it because of my "normal' test. Arg. My PT here and I were very excited b/c we thought the intensity, i.e hours every day for 2 week might be good, vs her once a week.

Anyway, the journey continues........ 🙂

Jump to this post

@elle1233. My PCP and my gynecologist both knew I had incontinence problems, but we were just speaking about urinary incontinence. My gyno referred me to a urologist but in talking to my daughter’s sister-in-law who is a urogynecologist I decided I would go to one of them. I didn’t go to her because I just felt funny going to someone I knew, but as it turned out she mentored the one I went to!

No one ever brought up that lactose intolerance could be causing my soft stools which were what was basically causing leakage. I suspect though that if your anal sphincter is tight the way it should be that even then you would not leak. Both the physical therapist and the doctor felt that my son’s birth could have contributed to my problems, I tore through my anal sphincter — should have been a Caesarian but I had a substitute doctor and he was a jerk. He ended up being sued by a patient after that and I believe he left the area.

You know way more about this than I do. I did have some testing for my anal sphincter, I forget what it was called, but it did not involve a balloon. I really dreaded that testing but the technician made it as comfortable as possible, she was really good. The testing was done through the gastroenterology department but prescribed by the urogynecologist.

Just found the name of the test I had, it was MANOMETRY ANORECTAL HIGH RESOLUTION.
JK

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@elle1233

neh, I have so much to write to you, can I ask you if you have any specific diagnosis at this time? Also, you say "make it to the bathroom" - what happens when you get there? i.e. are you having stools, just not sensing the urge in time, are you having diarrhea? Or are you having more chronic leaking of stool? LOL, it always makes me laugh how in these GI forums, we can talk about things like this without thinking twice. I think most people are uncomfortable talking about these "bathroom issues", so don't, and suffer in silence.

Jump to this post

I was diagnosed many many years ago with spastic colon. That was way before IBS was a thing. The doctor just told me to try to deal with it. Over the years I have dramatically changed my diet by removing gluten, caffeine, cows milk, nuts, coconut, yeast, chocolate and a lot of other foods- which has helped tremendously as I used to have immediate diarrhea after eating. On the occasions that I have a bowel accident on the way to the bathroom, I feel it is because of something I ate the day before. While it is an improvement over the immediate diarrhea, it still isn’t acceptable. I am finding that squash of any variety needs to be added to my ever growing list of do not eat foods. I try to rotate my food choices and not eat the same foods for three days. I take a probiotic daily at the suggestion of my nutritionist. I have had lots of GI tests which all have been negative. My gynecologist recommended that I do more Kegels last year and will be going to my annual appointment in a couple of months to see if I have made progress. I head to the bathroom as soon as I feel the need but would like to have a little more control on those mornings when my body is a little out of whack.

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