Inflammatory bowel disease, which is also referred to as IBD, is a chronic and relapsing inflammatory condition affecting the digestive tract. Inflammatory bowel diseases include two kinds of intestinal diseases that may be characterized by their location in the intestinal tract and depth of involvement. These are Ulcerative Colitis and Crohn's disease.
Ulcerative Colitis is characterized by an inflammation of the lining and mucous of the colon. The part of the intestine that is mainly affected by Ulcerative Colitis is the rectum; however, this may also spread higher up the large intestine to the cecum. On the other hand, Crohn's disease causes ulceration of the terminal ileum and colon. On the basis of severity, these may be classified as mild, moderate and severe. (1) (2) (3)
Pelvic Floor Muscles And Inflammatory Bowel Disease
The primary function of the pelvic floor muscles is to assist in the maintainence of bowel movements, control continence, and defecation of stool. (4) A dysfunction in the pelvic muscles can occur due to unpleasant symptoms associated with Inflammatory Bowel Disease such as chronic abdominal cramping, anorectal pain, a sensation of incomplete emptying, and fecal urgency (5) An impairment of these muscles may also lead to problems in defecation as the anal sphincter muscles fail to coordinate appropriately.
Pelvic Physiotherapy For Inflammatory Bowel Disease
The treatment for inflammatory bowel disease typically includes drug therapy, modifications of diet, and psychological therapy. Although these treatments are effective at temporarily easing the uncomfortable symptoms, they may not be effective at actually targeting the pelvic floor dysfunction associated with Inflammatory Bowel Disease. (6) This is why Pelvic therapy is now being recommended for such cases and has gained popularity over the past few years.
Pelvic Health Physiotherapists are specialized in assessing and treating pelvic floor dysfunction, helping the muscles to function optimally. The treatment and rehabillitation plan recommended by your Pelvic Health Physiotherapist can help with symptoms including anorectal pain, continence and dyssynergic (uncoordinated) defecation.
What to Expect?
Before starting Pelvic Health Physiotherapy, the health professional may first begin by evaluating the symptoms and checking the coordination and strength of the pelvic muscles in the rectal region. The patient may also be asked to undergo different movements and
activities to check the pelvic floor muscle coordination. After a thorough assessment, a plan will be designed for patients suited to their unique needs. This plan may include internal and external manual therapy, exercises, and lifestyle modification. The goal of therapy is to ease the symptoms and improve your quality of life.
1. Maaser, C., Sturm, A., Vavricka, S. R., Kucharzik, T., Fiorino, G., Annese, V., Calabrese, E., Baumgart, D. C., Bettenworth, D., Borralho Nunes, P., Burisch, J., Castiglione, F., Eliakim, R., Ellul, P., González-Lama, Y., Gordon, H., Halligan, S., Katsanos, K., Kopylov, U., Kotze, P. G., … European Crohn’s and Colitis Organisation [ECCO] and the European Society of Gastrointestinal and Abdominal Radiology [ESGAR] (2019). ECCO-ESGAR Guideline for Diagnostic Assessment in IBD Part 1: Initial diagnosis, monitoring of known IBD, detection of complications. Journal of Crohn's & Colitis, 13(2), 144–164. https://doi.org/10.1093/ecco-jcc/jjy113
2. Dmochowska, N., Wardill, H. R., & Hughes, P. A. (2018). Advances in Imaging Specific Mediators of Inflammatory Bowel Disease. International journal of molecular sciences, 19(9), 2471. https://doi.org/10.3390/ijms19092471
3. Colombel, J. F., Shin, A., & Gibson, P. R. (2019). AGA Clinical Practice Update on Functional Gastrointestinal Symptoms in Patients With Inflammatory Bowel Disease: Expert Review. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 17(3), 380–390.e1. https://doi.org/10.1016/j.cgh.2018.08.001
4. Bajwa, A., & Emmanuel, A. (2009). The physiology of continence and evacuation. Best practice & research. Clinical gastroenterology, 23(4), 477–485. https://doi.org/10.1016/j.bpg.2009.06.002
5. Butrick C. W. (2009). Pathophysiology of pelvic floor hypertonic disorders. Obstetrics and gynecology clinics of North America, 36(3), 699–705. https://doi.org/10.1016/j.ogc.2009.08.006
6. Pezzone, M. A., & Wald, A. (2002). Functional bowel disorders in inflammatory bowel disease. Gastroenterology clinics of North America, 31(1), 347–357. https://doi.org/10.1016/s0889-8553(01)00021-8