Bowel
Bowel health doesn't get talked about enough but it matters more than most people realise.
Bowel symptoms are among the most commonly experienced and least commonly discussed pelvic health concerns. Whether you're dealing with constipation, urgency, difficulty emptying or loss of control, these symptoms affect quality of life significantly and they deserve proper attention and care.
At Fitt Physiotherapy we create a warm, open and non-judgmental space to talk about bowel health. Because no question is too embarrassing and no symptom is too small to mention.
What is normal bowel function?
Normal bowel function varies between individuals, but here's a general guide to what healthy looks like:
Passing a bowel motion once to twice per day, or anywhere between 3 times per week and 3 times per day
Stool that is soft and formed, not hard, lumpy or liquid
No straining required — if you need to strain, something needs addressing
Complete emptying — no feeling of residual stool after opening your bowels
No pain during or after a bowel motion
Adequate warning before needing to go, not rushing urgently to the toilet
Constipation
Constipation is one of the most significant threats to pelvic floor health and it is far more common than most people realise, particularly during pregnancy, postpartum and with increasing age.
Signs of constipation include:
Fewer than 3 bowel motions per week
Hard, dry or lumpy stools
Needing to strain or push excessively
A feeling of incomplete emptying
Needing to apply pressure to the perineum or vaginal wall to aid emptying
Why constipation matters for pelvic health:
Straining to open your bowels generates significant downward pressure on your pelvic floor, worsening prolapse, contributing to haemorrhoids and anal fissures, and delaying recovery after birth.
Pelvic floor dysfunction can also cause or worsen constipation. When the pelvic floor muscles contract rather than relax during a bowel motion, emptying becomes difficult and incomplete. This is called dyssynergia and is very responsive to pelvic floor physiotherapy.
Bowel urgency and Faecal Incontinence
Faecal urgency, a sudden, overwhelming urge to open the bowels that is difficult to control and faecal incontinence, involuntary loss of stool or wind, are conditions that cause significant distress and social isolation when left untreated.
They are also conditions that many people suffer with silently for years, assuming nothing can be done.
A great deal can be done.
Flatal incontinence, involuntary passing of wind, is the most common and most under-reported form of bowel incontinence. It is particularly common after vaginal birth involving perineal injury or anal sphincter trauma.
If you experience any difficulty controlling your bowel, please seek help. These conditions respond well to pelvic floor physiotherapy and bowel retraining, and the sooner they are assessed the better the outcomes.
How we assess and treat
Our bowel health assessments are thorough, respectful and always conducted in a private, comfortable environment.
Your assessment will include:
A detailed bowel history — frequency, consistency, urgency, control and any associated symptoms
Diet and fluid intake review
Pelvic floor muscle assessment, evaluating coordination and relaxation during bowel function
Toilet habits and positioning review
Treatment may include:
Pelvic floor retraining — addressing dyssynergia and improving coordination during defecation
Dietary and fluid guidance — fibre, hydration and bowel irritants
Toilet positioning advice — optimising position to reduce straining and improve emptying
Bowel retraining — establishing regular, healthy bowel habits
Manual therapy — for tight or restricted pelvic floor muscles contributing to constipation
Referral — to your GP, gastroenterologist or colorectal specialist where appropriate
Bowel health is pelvic health.
If something doesn't feel right, let's talk about it. That's what we're here for.