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.

Within 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.