Bowel Archives - Pelvic Rehab

Inflammatory bowel disease (IBD) affects 1.6 million Americans¹, with as many as 70,000 new diagnoses each year. The cause is relatively unknown, though it is certainly related to an immune system deficiency. There are two conditions that are included in the IBD diagnosis; Crohn’s Disease and Ulcerative Colitis. Each condition impacts the body in different ways, and both can be treated by a well-trained pelvic rehabilitation practitioner. Andrea Wood, PT, DPT, WCS, PRPC explains more in her recent post on The Pelvic Rehab Report.

Source: Wikimedia — A colon affected by ulcerative colitis

What are the symptoms of Inflammatory Bowel Disease?

According to Dr. Wood, “common complications experienced by patients with IBD include fecal incontinence, fecal urgency, night time soiling, urinary incontinence, abdominal pain, hip and core weakness, pelvic pain, fatigue, osteoporosis, and sarcopenia.”

What is the difference between Crohn’s Disease and Ulcerative Colitis?

While either condition is considered Inflammatory Bowel Disease, there are some differences between the two. Ulcerative Colitis affects the innermost lining of the colon exclusively, and it produces internal ulcers and open sores. Patients with Ulcerative Colitis will have inflammation and tissue damage throughout the inner lining of the colon.

Crohn’s Disease is a chronic inflammation anywhere in the digestive tract, though it most commonly impacts the bowel and colon. The bowel wall will be affected, and patients may experience patches of inflamed intestine interspersed with healthy areas of the intestine.

Both conditions can be life-altering for patients who suffer from them.

Can Inflammatory Bowel Disease be treated?

The cause of IBD may not be known, but the symptoms certainly are. A skilled pelvic rehabilitation practitioner, like a Pelvic Floor Physical Therapist, can help patients overcome symptoms like fecal incontinence, urinary urgency, sarcopenia, fatigue, or pelvic pain. According to Dr. Wood, these are some of the treatments that an IBD patient might be offered in her clinic:

Fecal Incontinence	– Identify primary cause – Apply manual therapy – Biofeedback training to improve rectal pelvic floor muscle endurance and strength – Instruct in proper toileting posture and techniques – Rectal balloon training to better understand fecal urgency
Urinary Incontinence	– Urge suppression techniques – Bladder diaries and voiding intervals – Decrease usage of bladder irritants
Sarcopenia	– Weight training – Abdominal training that doesn’t increase intra-abdominal pressure
Fatigue	– Short bursts of cardiovascular exercise – Training in proper bowel movement timing to improve sleep – Diet and nutrition recommendations to improve sleep
Pelvic Pain	– Manual therapy externally and internally if needed – Home yoga program instruction – Meditation instruction

Where can I find help?

Our directory of pelvic rehabilitation professionals can help you find a pelvic floor specialist today. Visit www.pelvicrehab.com to find a pelvic health practitioner near you, and get treatment for conditions like Inflammatory Bowel Disease.

^{1. Crohn’s and Colitis Foundation. 2019. What is Crohn’s Disease. Retrieved from: http://www.crohnscolitisfoundation.org/what-are-crohns-and-colitis/what-is-crohns-disease/}

When it comes to wetting the bed, it can be hard for parents to know when they should consult a pelvic rehab professional. Most of us have dealt with bedwetting one way or another, so it can be hard to identify when it goes from being a part of growing up to something more serious. Here are some quick facts:

Bedwetting affects 15% of girls and 22% of boys, or 5 – 7 Million US children
Boys are 50% more likely than girls to wet the bed
10% of 6 year olds continue to wet
Spontaneous cure rate 15% per year thereafter
1-3% of 18 year olds still wet their beds
The majority of bedwetting children also experience daytime “accidents” or constipation.
Bedwetting is genetic – if one parent was a bed wetter the child has a 40% chance of wetting the bed and if both parents were bedwetters the percentile goes up to 77%

It’s important to know that bedwetting is not behavioral; your kid isn’t lazy and they aren’t just trying to get attention. Sometimes it can be caused by hormone deficiency, sleep apnea, or issues with bowel incontinence. Let’s dive into that a bit.

The Effects of Anxiety and Stress

In a 2016 study, Salehi et al. found that children who wet the bed have a high frequency of generalized anxiety disorder as well as panic disorder, school phobia, social and separation anxieties, maternal anxiety, and a high body mass index.

Impacts of Bowel Difficulties

Dr. Steven Hodges has researched and written extensively on the topic of constipation causing pressure from the rectum against the bladder making it irritable during sleep. His research indicates that emptying the bowels regularly will reduce bedwetting. His book, “See It’s No Accident” is an excellent resource for parents looking for practical advice on children’s toileting issues.

Sleep Troubles

Dr. Neveus and colleagues reported that 43.5% of bedwetting children who also snore or have obstructive sleep apnea became dry after having their tonsils and adenoids removed (this operation is called an adenotonsillectomy).

Hormone Deficiency

Our bladders empty about every 2-3 hours during the day however at night we can hold for over 8 hours! This happens because our bodies produce an antidiuretic hormone when we sleep to slow kidney function and produce less urine to empty into the bladder. If this hormone is not being produced, the kidneys produce as much urine at night as they do during the day. In this case, it’s good that the bladder empties out in our sleep, otherwise our bladders would be dangerously large and possibly reflux urine backward into the kidneys. A synthetic hormone has been created, called Desmopressin acetate (DDAVP), that can be used to slow kidney function while we sleep. Bedwetting is a condition that affects millions of children throughout the world, and there is help available.

If your child is still wetting the bed by the age of 6, it’s time to consult a pediatric pelvic rehabilitation practitioner.

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Tag Archives: Bowel

How Physical Therapy Can Help with Inflammatory Bowel Disease