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Sphincter exercises

Digestive Health | Last Active: Sep 2, 2019 | Replies (16)

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@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........ 🙂

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Replies to "I know some of you here know each other (I'm new), so I was wondering what..."

@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