Conditions Pelvic Floor Dysfunction

Pelvic floor dysfunction occurs when the muscles at the bottom of the pelvis do not work properly. These muscles support the bladder and bowel and help control bowel movements and urination. When they do not relax or contract correctly, they can cause problems with bowel movements and other pelvic functions.

What Causes Pelvic Floor Dysfunction?

Pelvic floor dysfunction can have several causes, and sometimes there is no clear cause. Contributing factors may include:

Pregnancy or vaginal delivery
Injury to the pelvic area
Being overweight
Aging
Surgery or radiation to the pelvic area
Long-term constipation or diarrhea
Chronic coughing or heavy lifting

Signs and Symptoms

Pelvic floor dysfunction can cause a variety of bowel-related symptoms, including:

Constipation or difficulty passing stool
Feeling like you have not completely emptied your bowels
Feeling the need to have a bowel movement but being unable to go
Bloating, abdominal cramps, or pain
Stool leakage (fecal incontinence)
Needing to change your position to have a bowel movement
Using a finger to press on the rectum or vagina to help pass stool
Rectal prolapse, when part of the rectum pushes out through the anus

How Is Pelvic Floor Dysfunction Diagnosed?

Your doctor will begin with a medical history and physical exam, which may include a rectal or pelvic exam. Additional testing may be recommended to better understand how your pelvic floor muscles are working.

Tests may include:

Anorectal manometry: Measures the strength and coordination of the pelvic floor muscles and how well you sense stool in the rectum.
Balloon expulsion test: Checks how well you can pass a small balloon from the rectum.
Defecography: Uses X-ray or MRI imaging to evaluate how the pelvic floor moves during a bowel movement and identify structural problems.
Electromyography (EMG): Measures how the nerves and muscles of the pelvic floor work together.

How Is Pelvic Floor Dysfunction Treated?

Treatment depends on the cause and symptoms. Options may include:

Biofeedback therapy: Helps you learn to control and retrain your pelvic floor muscles. This is often the first treatment recommended and can be effective for many people.
Medications: Depending on your symptoms, medications may help soften stool, control diarrhea, relax muscles, or improve nerve function.
Botox injections: Botox may be used to relax tight pelvic floor muscles temporarily. The effects typically last about three months.
Surgery: In some cases, surgery may be recommended when other treatments are not effective.

When Should You See a Doctor?

Talk with your doctor if you have ongoing problems with bowel movements or symptoms that are not improving. You should also talk with your doctor if you experience: