A healthy bowel allows a soft, sausage shaped stool to easily without discomfort or difficulty making it to the toilet. The pelvic floor plays a major role in bowel dysfunction as it is the sole muscle responsible for holding s stool in the rectum, and the aloo wing it to pass on command.  Any change in bowel motions, bowel control or ease of opening the bowel with no obvious explanation should be investigated.

Types of bowel dysfunction:

  • Faecal or flatal incontinence (involuntary leaking of faeces or wind)

  • Haemorrhoid or anal fissures

  • Anismus, anal pain or proctalgia fugax

  • Prolapse (rectocele) – where poor fascial support cause the bowel to bulge forward and into the back vaginal wall causing problems with obstructed defecation (difficulty completely emptying the bowel)

  • Rectal prolapse – where part of the rectum protrudes from the anus.

  • Over distended rectum or megacolon

  • Lack of rectal sensation

  • Constipation – when stools are hard, dry, difficult or painful to pass.

  • Diarrhoea – loose bowel motions

  • Irritable bowel syndrome (IBS) – where the muscle wall of the bowel becomes overly sensitive resulting in pain and bloating

Risk factors commonly linked with bowel dysfunction:

  • Pregnancy

  • Vaginal deliveries – assisted deliveries / 3 / 4th degree tears

  • Ageing/Menopause

  • Endometriosis/IBS (chronic pelvic conditions)

  • Pelvic surgery

  • Poor diet or bowel habits or fluid intake

  • History of eating disorders

  • History of straining

  • Medications

  • Coccyx or sacral injury


At Women in Focus our physiotherapists will take a detailed history about both your bladder and bowel habits as well as complete a thorough assessment to determine the contributing factors to your bowel dysfunction.  This may include a vaginal, or rectal examination, and you will most likely be required to track your bowel habits with a bowel diary. Your treatment plan will then be individualised to address these findings but may include the following treatment options:

  • Lifestyle and diet advice

  • Education and strategies for correct defecation dynamics

  • Pelvic floor muscle down training and teaching relaxation strategies for optimal evacuation

  • Pelvic floor release

  • Education and building awareness of pelvic floor muscle strengthening

Physiotherapy for bowel dysfunction can be highly effective and make a huge difference to a woman’s quality of life. We will usually work in with other health practitioners such as colorectal surgeon, Nutrition. Dietician , naturopath, and refer for further testing where necessary.

In Australia fecal incontinence affects up to 12.9% of women is unfortunately one of the three major reasons for admittance to a residential aged care facility This is one of the major reasons we encourage anyone with any bowel issues to  come in for a pelvic health check, so that we can help you before it progresses to far along.

Please note if you experience blood in your stool or blood upon wiping please go to your GP before coming to Physiotherapy for stool testing. 

(Australian Institute of Health and Welfare report, 2006, Norton et al: Incontinence: Basics and Evaluation, 2002).