Getting to the Bottom of the Matter
“I’m having issues related to sudden and uncontrollable bowel movements with intense abdominal pain. Despite multiple visits to medical specialists, there is no diagnosis and nothing has helped. Can physical therapy help me?”
This question was recently posed to me by a woman referred to physical therapy (PT) with a diagnosis of fecal incontinence. Despite seeing several medical doctors, she had no improvement related to control of her bowels or her abdominal pain.
Typically, the patients we see with fecal incontinence secondary to pelvic floor weakness present symptoms of leaking, passive loss or an inability to hold it long enough to get to a toilet. Her symptoms were different. She complained of sudden onset abdominal cramping and pain associated with uncontrollable bowel movements several times a month. The situation had progressively worsened during the past year.
After a thorough examination, including an evaluation of her pelvic floor and dietary assessment, I was able to differentially diagnose that her symptoms were, most likely, due to a dietary intolerance. The patient was instructed to keep a food diary for a week noting everything she ate, symptoms, and any episodes of fecal incontinence. Lactose intolerance emerged as the most likely culprit. For the next week, she eliminated all dairy from her diet. She returned to PT and reported no cramping, pain or uncontrollable bowel movements while on the dairy-free diet. I also gave her information about other foods that could provide the vitamins and minerals she would need to get from different dairy-free sources. With pelvic floor retraining, continued diet review and modification, timed voiding, and a home exercise program, my patient was discharged symptom free after a few visits!
In many cases of pelvic floor dysfunction, there is a dietary component to the problem. All patients require a comprehensive examination and evaluation to help identify the multiple factors that can cause pelvic floor dysfunction. This issue can negatively impact a person’s ability to participate in their daily activities. In this case, taking the time to thoroughly examine diet, symptoms, and provide individualized diet education to correct symptoms quickly restored my patient’s dignity and enabled her to return, worry-free, to her daily activities.
To learn more about women’s health issues, visit our website or call (877) 56-REHAB today to schedule an appointment with a specialist.