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  • Writer's pictureRobin R Varghese, PT.

"Can Physical Therapy be of help in case of constipation"?


Kindly check our previous post Titled "Do I really need to know about constipation"?. This is in continuation to it.


Treatment


While there are many methods to manage constipation medically, we will be focusing on the methods and techniques used in Physical therapy.


Treatment for constipation includes education, internal treatment, abdominal massages, relaxation techniques, biofeedback and home exercises.


Education.

  • Educating patients about diet and fluid intake, activity level, and other habits are a great step in preventing as well as treating constipation. Modifying these lifestyle factors has been shown to reduce the severity and symptoms of constipation.

How can water, fiber and physical activity help in relieving constipation?

  • Dehydration can lead to hard, lumpy, and difficult-to-pass stools.

  • Taking plenty of fluids will be a major step.

  • Fiber can help increase water absorption during the digestive process. It also can help in softening of stool and its movement throughout the digestive tract.

  • Exercise increases your heart rate and promotes blood flow throughout your body; it encourages movement throughout the bowels, too.


What major role do Physical therapy play to relieve constipation other than educate the patients?


  • In a 2020 study published in the journal Gastroenterology, researchers stated that pelvic floor dysfunction is one of the most recognized causes of constipation. The pelvic floor is a muscular bowl that encloses the rectum, bladder, and (for women) the uterus. There is a complex interaction among these different organs. In the act of defecating, or having a bowel movement, the anal sphincter (the group of muscles at the end of the rectum) has to relax, and the abdominal muscles must contract.

  • People with pelvic floor dyssynergia, undergoes a paradoxical muscle pattern where the pelvic floor muscles contracts, instead of relaxing while attempting to empty the bowels. This narrows the anorectal angle and increases the pressures of the anal canal so that evacuation is less effective. This may halt the pooping process and contribute to constipation. Pelvic floor physical therapy helps manage existing tightness in pelvic floor muscles, retraining them to function the right way so that the stool moves smoothly through the gut.

  • A combination of internal treatment to manage muscular tension, breathing and relaxation exercises to assist in decreasing muscular tone, cueing to teach how to relax those muscles and improve bowel movements is the right approach adopted by Physical Therapists.

Internal treatment

  • This can be done vaginally or rectally, with each of those options allowing for a closer examination of a different part of the pelvis and identifying the muscles that are weak, tight or spastic.

  • Different techniques are used to help the muscles that are tight to relax and function better to improve symptoms of constipation.


Abdominal massages and visceral mobilization

  • Your physical therapist may also teach you abdominal massages and Visceral mobilization with some simple movements of the pelvis and legs. This will help in:

  • Managing abdominal pain associated with constipation

  • Increase the frequency of bowel movements,

  • Prevent constipation,

  • Reduce the use of laxatives and

  • Improve quality of life.

Pelvic floor physical therapy

  • Pelvic floor physical therapy (PFPT), is a novel treatment for the treatment of chronic constipation with dyssynergic defecation in pediatric patients.

You may also find more information on pelvic floor Physical therapy here.

Relaxation

  • Diaphragmatic breathing could facilitate the activation of the parasympathetic system, which encourages the body to relax and stay in the “rest and digest” state

Biofeedback based Physical therapy for constipation

  • The physical therapist inserts a probe into the anal sphincter and places sticky pads on the abdomen in order to detect the movement of the anal sphincter and abdominal wall while defecation is simulated. By doing this, a feedback will be received (either visual or verbal) on how the abdominal wall muscles and anal sphincter acts during a bowel movement.

  • Your physical therapist will lead you through corrective exercises( includes pelvic floor exercises ) such as muscle strengthening or relaxation exercises and breathing exercises, in order to help you retrain the movement and coordination of your pelvic floor.

  • Three main techniques used are: sensory training, electromyographic feedback, and manometric feedback.

Home Exercises include Pelvic floor stretches and exercises as prescribed by you physical therapist, depending on the muscles that are weak or tight. Tools like rectal dilators can help with tension in the pelvic floor.


Have you heard of DPMDs?


  • Researchers call them Defecation Postural Modification Devices (DPMDs)

  • A 2019 study published in the Journal of Clinical Gastroenterology examined the use of devices that place one into a better position to poop.


How does DPMDs help?

  • It helps in decreasing the time spent pooping, produce less straining, and allows complete evacuation of the bowels compared to just simply sitting on the toilet

A few studies

  • In a 2020 study published in the journal Clinical and Experimental Gastroenterology, researchers found that chronic constipation causes people to miss work, pay for medical costs, and have a lower health-related quality of life.

  • Physical therapy incorporating abdominal massage appeared to be helpful in resolving this patient's constipation. Unlike medical management of constipation, no known side effects have been identified with abdominal massage.

  • physical therapists can confidently include biofeedback interventions into the plan of care for adults with functional constipation, as they are supported by strong evidence. Manual therapy also provided a degree of evidence suitable to recommend its use.


At Valley Healing Hands, Brownsville, Texas we provide the best physical therapy treatment for Constipation. Our highly qualified therapists will assist you with a programme well suited to get you know your bowels and its mechanism. They will teach you how to rectify the affected muscle and help you get back to having a happy and less stressful bowel. Our patients are very much satisfied with our services and you may learn about what they have to say about us here and get connected to us here. Our patients love us and you too, will!!!




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