Sarton Physical Therapy

Hope and healing for pelvic floor dysfunction

Fecal Incontinence | Sarton Physical Therapy

FECAL INCONTINENCE

Physical Therapy, the first line of defense against Fecal Incontinence.

This embarrassing healthcare problem affects somewhere between 2 to 24% of the adult population. Because fecal incontinence is one of the most psychologically and socially embarrassing conditions found in an otherwise healthy individual, it is often unreported and therefore untreated. It can lead to social isolation, loss of self-esteem, self-confidence, and depression.

Sarton Physical Therapy is here to help.

Fecal continence is maintained by the structural and functional integrity of the anorectal unit. Normal anal sphincter function is a critical part of continence. The internal anal sphincter contributes approximately 70-80% of resting sphincter tone. This is reinforced during voluntary squeeze by the external anal sphincter. These are further augmented by the puborectalis muscle, which forms a sling around the rectum and creates forward pull to reinforce the anorectal angle. During voluntary squeeze, the angle becomes more acute, whereas during defecation, the angle becomes more obtuse. If evacuation of the rectum is not socially appropriate, sympathetically mediated inhibition of the smooth muscle of the rectum and voluntary contraction of EAS and puborectalis musculature occur. The anorectal angle becomes more acute and prevents the bolus of stool from descending further. The contents of the rectum are forced back into the compliant rectal reservoir above the levators, which allows the IAS to recover and contract again.

“I have now gone from up to ten episodes of fecal incontinence per day to approximately one to two per week. My life has completely changed for the better. After six weeks of physical therapy, my Urogynecologist recommended that I elect not to have surgery to repair my defect.”

S.P., female patient
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Continence requires the complex integration of signals among the smooth muscle of the colon and rectum, the puborectalis muscle, and the anal sphincters. In essence, any process that interferes with these mechanisms, including trauma from vaginal delivery or a neurological insult, can result in fecal incontinence (1).

Pelvic Floor Physical Therapy Can:

Improve functional strength and coordination of the pelvic floor musculature
Increase frequency of normal bowel movements
Increase functional activities without fecal incontinence
Eliminate diarrhea, fecal incontinence and/or constipation
Decrease paradoxical puborectalis contractions
A study by Rieger et. al. (1997) found that pelvic floor rehabilitation/physical therapy should be considered the initial treatment for patients with fecal incontinence with improvement expected in up to 67% of patients (2). Initial good results can predict the overall outcome.

Our highly trained therapists will conduct a comprehensive evaluation to identify the root causes of the patient’s fecal incontinence. We will then develop an individualized treatment plan that may include: manual therapy such as myofascial release, nerve gliding/tension release, and visceral manipulation; biofeedback - which results in a 90% reduction in episodes of incontinence in over 60% of patients (3); as well as therapeutic and core strengthening exercises, which may include one on one sessions with our pelvic floor Pilates trained instructors. To insure the best results, the therapists at Sarton Physical Therapy always spend an hour with each patient during every appointment.

Let our expert Physical Therapists with advanced board certification in pelvic floor physical therapy help. For more information, please visit our website or contact us with any questions or to have your patients schedule an appointment.

714-770-8222
714-770-8228 (fax)

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1) Ranganath, Sonia, and T. R. Ferzandi. "Fecal incontinence." (2009).
2) Rieger, N. A., et al. "Prospective trial of pelvic floor retraining in patients with fecal incontinence." Diseases of the colon & rectum 40.7 (1997): 821-826.
3) Jorge, J. Marcio N., and Steven D. Wexner. "Etiology and management of fecal incontinence." Diseases of the colon & rectum 36.1 (1993): 77-97.