Mayo Clinic Connect
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.
Liked by elle1233
Yes, there are exercises. Can you set up appointments with a physical therapist to help you? There are therapists who are specially trained in pelvic floor dysfunctions. They use biofeedback techniques. I went to one who was very knowledgeable and helpful. Also, in the meantime, try to go to the bathroom at the same time each day. And as soon as you feel that you are going to need the bathroom, do not delay in heading for it! I know how stressful and embarrassing this problem can be.
Liked by Teresa, Volunteer Mentor, JK, Volunteer Mentor, neh213
Welcome to Connect, @neh213 As @jackiem95 said, there are exercises. I had pelvic floor PT and since I was having a lot of diarrhea that leaked at times I was given exercises to help with that too. The exercises are basically that when you do kegels you also tighten your anal sphincter. If you go to a Pelvic Floor physical therapist they will help you with that, and teach you how to do them correctly.
I discovered that I am lactose intolerant and that was causing the diarrhea/loose stools. When I eliminated dairy the problem went away.
Liked by neh213
Thank you . I will give this a try and if it doesnt help I will go to a specialist.
Liked by JK, Volunteer Mentor, elle1233
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@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.
I just had my second visit to the Pelvic Floor Physical Therapist, they not only do the bio feedback, but a lot of other valuable info. Such as using a stool when on the toilet to put you in a natural position for a BM. Also a massage treatment you can do yourself when your constipated to help move the stool along. I was given lists of foods with amounts of fiber per serving, and how to slowly increase it. They will answer many questions you may have. It’s all information that everyone should have for a healthy digestive system. They stress not straining to have a BM as it can cause other complications, I’m sure I’ll learn a lot more.
Liked by JK, Volunteer Mentor, neh213
@emyliander There is a stool made especially for that! It’s called “squatty potty”. It tucks in to the toilet. I saw it a few years ago on Shark Tank. I just googled it and amazon, sells it along with a number of other retailers.
The squatty potty is nice and aesthetically pleasing, however; if one is cheap (like me) you can achieve the same affect with a step stool. I have a couple of foldable ones that I can tuck behind the toilet when not using. I'm also pretty flexible and actually can even 'squat' right on the toilet seat, pulling my feet up onto the toilet. This puts pressure on my abdomen which sometimes helps things come out. I've been testing for pelvic floor dysfunction and apparently don't have a problem down there, however still find these things helpful.
I also did see a physical therapist for many months, and she was wonderful, did a lot of massage and myofascial release, which always made me feel better, but hasn't fixed anything long term. Since I stopped, however, I am not very good about doing other "homework". I think having the structure of the therapy helped, and it also was dedicated time to just lie down and relax.. something I've learned I am very bad at!
I was really impressed with how much the physical therapist knew. She gave me more diet advice than the dietician I saw. Her approach was a "bowel management program" – incorporating diet, routine, as well as the positioning, just like they do with spinal cord injured patients. They are able to "train" their bowels to evacuate. It is a lot more than most people think of with "physical therapy", I don't think the docs even are aware of all that they do. I think it could be used a lot more for people with chronic GI problems. She also functioned as a "therapist" also, really. There is something to be said for just having a person put their hands on you, listen to you, and care for you, and having someone follow you on a regular basis.
I know the Mayo clinic has a 2 weeks intensive pelvic floor therapy program that is supposed to be very good. I don't qualify because I don't have that diagnosis, but it sounds great for those that do.
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 🤔
I just want to echo the many comments on the benefits of seeing a physical therapist for this. I went to Mayo Scottsdale for this and I learned a lot. One really good tip was to eat your salad after your entree. Another possibility is that you might look at FODMAP diet, which must be medically supervised. I went to Mayo Scottsdale for this too. I avoid certain foods and have an alternate, tasty way to use garlic.
Liked by JK, Volunteer Mentor
I also am on the Low FODMAP Diet. Interesting that your dietician recommended eating salad after entree. I’ve not heard of that. Do you know what the reason is? Also, can you share your alternate way of using garlic? I use garlic infused olive oil which works well for me but if there is something else, would love to know! I really miss eating fresh garlic and onions!
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).
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.
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…….. 🙂
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.
@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.
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