(646) 355-8777

Herman & Wallace Blog

Treating Fecal Urgency

Lila Abbate PT, DPT, OCS, WCS, PRPC is the creator and instructor of Bowel Pathology Function & Dysfunction and the Pelvic Floor, a course which instructs in comprehensive evaluation and treatment techniques for bowel pathologies and dysfunctions, including fecal incontinence, chronic constipation, and the relationship between constipation and rectal and/or abdominal pain. Join Dr. Abbate in one of five events taking place in 2020!

Bowel dysfunction can be very rewarding to treat. Most pelvic health physical therapists are nervous about diving into bowel treatment. When I was training with my mentor, Elise Stettner, PT she used to remind me that “any PT can treat urinary symptoms. The patients who are really suffering are those bowel dysfunctions.” That statement really stuck with me and mentoring with her and treating those patients created a passion for treating patients who suffer from bowel dysfunction.

Lila Abbate, PT, DPT, OCS, WCS, PRPC TeachingWithin the term bowel dysfunction, fecal urgency, is a common symptom and is under-researched. In 2019, Similis, et al published A Systemic Review and Network Meta-Analysis Comparing Treatments for Faecal Incontinence, doesn’t even mention physical therapy and pelvic floor muscle rehabilitation as an intervention for fecal incontinence and fecal urgency treatment.

Anecdotally, I have a lot of pelvic health patients and even generalized orthopedic patients who report that having bowel urgency is a more apparent symptom in their life after having a back or hip surgery. What started as a once-in-a-while problem, fecal urgency has crept up and become the new normal in their lives. They have subliminally re-routed their day to accommodate their bowel movements in order avoid incidences and accidents whether its waiting to eat breakfast until they get to work, waiting to drink a favorite drink until they are near a toilet or taking supplements before bed to empty their bowels before they start their day in order to avoid accidents during their day. Learning to treat bowel urgency can tremendously help patients regain control and abolish their symptoms.

Bowel urgency has many parallels to urinary urgency. The colon is giving the signal too soon, potentially at an inappropriate time, and the muscles need to be strong enough to hold the urge of defecation back in order to postpone. The failure occurs when one part of the continence mechanism fails. Bowel Pathology Function & Dysfunction and the Pelvic Floor course helps you to learn how to treat and guide your patients and conquer all types of bowel dysfunction.


Similis et al, A systematic review and network meta-analysis comparing treatments for faecal incontinence. Int J Surg. 2019 Jun;66:37-47. doi: 10.1016/j.ijsu.2019.04.007. Epub 2019 Apr 22.

Continue reading

Upcoming Continuing Education Courses

Mobilization of Visceral Fascia: The Gastrointestinal System - Arlington, VA (RESCHEDULED)

Jul 10, 2020 - Jul 12, 2020
Location: Virginia Hospital Center

Mobilization of Visceral Fascia: The Gastrointestinal System

Jul 10, 2020 - Jul 12, 2020
Location: Replacement Remote Course

Postpartum Rehabilitation - Remote Course (SOLD OUT)

Jul 11, 2020 - Jul 12, 2020
Location: Replacement Remote Course

Pelvic Floor Level 1 Part 1 - Remote Course (SOLD OUT)

Jul 11, 2020 - Jul 12, 2020
Location: Short Form Remote Course

Athletes & Pelvic Rehabilitation - Remote Course

Jul 11, 2020 - Jul 12, 2020
Location: Replacement Remote Course

Bowel Pathology and Function - Remote Course (SOLD OUT)

Jul 11, 2020 - Jul 12, 2020
Location: Replacement Remote Course

Pelvic Floor Level 1 - Newark, NJ (Rescheduled)

Jul 12, 2020 - Jul 14, 2020
Location: Rutgers University - Doctoral Programs in Physical Therapy

Pregnancy Rehabilitation - Remote Course

Jul 16, 2020 - Jul 17, 2020
Location: Replacement Remote Course

Postpartum Rehabilitation - Foothill Ranch, CA (RESCHEDULED)

Jul 18, 2020 - Jul 19, 2020
Location: Intercore Physical Therapy

Pelvic Floor Level 1 - Colorado Springs, CO (SOLD OUT)

Jul 18, 2020 - Jul 19, 2020
Location: Manual Edge Physiotherapy

Postpartum Rehabilitation - Remote Course

Jul 18, 2020 - Jul 19, 2020
Location: Replacement Remote Course

Pelvic Floor Level 1- Bangor, ME (Rescheduled)

Jul 18, 2020 - Jul 19, 2020
Location: Husson University

Pelvic Floor Level 1 - Columbus, OH

Jul 18, 2020 - Jul 19, 2020
Location: Fitness Matters

Pelvic Floor Level 1 Part 1 - Remote Course (SOLD OUT)

Jul 21, 2020 - Jul 22, 2020
Location: Short Form Remote Course

Nutrition Perspectives for the Pelvic Rehab Therapist - Columbia, MO (Rescheduled)

Jul 24, 2020 - Jul 26, 2020
Location: University of Missouri-Smiley Lane Therapy Services

Pelvic Floor Level 1 - Chicago, IL (RESCHEDULED)

Jul 25, 2020 - Jul 26, 2020
Location: Advocate Illinois Masonic Medical Center

Pelvic Floor Level 1 - Fayetteville, NC (SOLD OUT)

Jul 25, 2020 - Jul 26, 2020
Location: Methodist University School of Health Sciences

Nutrition Perspectives for the Pelvic Rehab Therapist - Remote Course

Jul 25, 2020 - Jul 26, 2020
Location: Replacement Remote Course

Pelvic Floor Level 2A - Glenwood Springs, CO (SOLD OUT)

Jul 25, 2020 - Jul 26, 2020
Location: Valley View Hospital

Pudendal Neuralgia and Nerve Entrapment - Maywood, IL (RESCHEDULED)

Jul 25, 2020 - Jul 26, 2020
Location: Loyola University Health System

Pelvic Floor Level 2B - Los Angeles, CA (RESCHEDULED)

Jul 25, 2020 - Jul 26, 2020
Location: Mount Saint Mary’s University

Manual Therapy for the Abdominal Wall - Remote Course

Jul 31, 2020
Location: Short Form Remote Course

Parkinson Disease and Pelvic Rehabilitation - Remote Course

Jul 31, 2020 - Aug 1, 2020
Location: Short Form Remote Course

Neurologic Conditions and Pelvic Floor Rehab - Washington, DC

Jul 31, 2020 - Aug 2, 2020
Location: George Washington University Hospital Outpatient Rehabilitation Center

Restorative Yoga for Physical Therapists - Remote Course

Aug 1, 2020 - Aug 2, 2020
Location: Replacement Remote Course

Pelvic Floor Level 2A - Chicago, IL (SOLD OUT)

Aug 1, 2020 - Aug 2, 2020
Location: Midwestern Regional Medical Center

Pelvic Floor Level 2A - Washington, DC (SOLD OUT)

Aug 1, 2020 - Aug 2, 2020
Location: The George Washington University

Pelvic Floor Level 1 - New York City, NY (RESCHEDULED)

Aug 2, 2020 - Aug 3, 2020
Location: Touro College

Pelvic Floor Level 1 - Birmingham, AL

Aug 8, 2020 - Aug 9, 2020
Location: Shelby Baptist Medical Center