Bowel disorders refer to issues with bowel movements. Having bowel problems is certainly not easy, and often times are embarrassing to discuss, even with your provider. It is important to discuss your concerns with your health care provider so you may get the help and treatment you deserve. Fecal (stool) and gas incontinence and constipation are common conditions that are evaluated and treated at Pelican Health.

• Fecal and gas incontinence is the inability to control gas or a bowel movement. More than 5.5 million Americans have fecal incontinence. It affects people of all ages–children as well as adults. Fecal incontinence occurs either when you feel the urge to have a bowel movement and are unable to hold it until you can get to a toilet or when stool may leak from the rectum unexpectedly.
• Constipation refers to the inability to have bowel movements on a normal schedule without excessive straining. Medical evaluation can help determine the primary cause of constipation. In some cases constipation is associated with pelvic floor muscle problems. The ‘pelvic floor’ refers to a group of muscles that attach to the front, back, and sides of the pelvic bone and sacrum (the large bone at the bottom of your spine just above the tailbone). These muscles support the organs in the pelvis including the bladder, uterus, and rectum. They also wrap around the urethra, rectum, and vagina (in women). When the muscles of the pelvic floor are not working properly, bowel disorders often occur.

Painful Bladder Syndrome (PBS) is a bladder condition that usually consists of multiple symptoms. Most people with PBS have pain and pressure in the lowest part of the abdomen, they experience urinary frequency (needing to urinate often) and urinary urgency (feeling a strong need to go urinate). Painful bladder syndrome may also be referred to as bladder pain syndrome (BPS), interstitial cystitis (IC), and chronic pelvic pain.

Pelvic organ prolapse occurs when a pelvic organ, such as your bladder, drops (prolapses) from its normal place in your pelvis and pushes against the walls of your vagina. There are six types of pelvic organ prolapse: cystocele, rectocele, urethrocele, enterocele, rectal prolapse and uterine prolapse.

• Cystocele is a condition where the bladder is bulging back into the vaginal canal. Some of the symptoms may include feeling a bulge when wiping on the toilet or when showering, “falling out feeling,” pelvic pressure, recurrent urinary tract infections, feeling of incomplete urination, dribbling upon standing after urination, pain with sexual activity, inability to wear a tampon or hitting something when inserting a tampon.
• Rectocele is a condition where the rectum is bulging forward into the vaginal canal. Some of the symptoms are feeling a bulge when you wipe or when showering, “falling out feeling,” pelvic pressure, feeling of incomplete defecation (pooping) like the bowel movement is getting stuck, splinting for defecation (using your finger in the vagina to push back on the rectum or using your finger between the vagina and the anus and pushing upward and backward to get the stool out), loss of stool during sexual activity or pain during sexual activity.
• Urethrocele is a condition where the urethra has dropped out of its original position. Symptoms may be feeling a bulge where the urine comes out, urinary urgency or urinary frequency.
• Enterocele is a condition where a part of your small intestine drops between the rectum and the vagina. The symptoms seem to be the same as a rectocele, but enteroceles tend to be more painful than rectoceles.
• Rectal prolapse is a condition where the rectum is coming out of the anus. The main symptom of this condition is a feeling that the rectum is coming out of the anus with defecation. Sometimes you will have to push the rectum back up in the body. Other symptoms are a “falling out feeling,” pelvic pressure or feeling a bulge at the anus when wiping.
• Uterine prolapse is a condition where the uterus is falling down the vaginal canal. Common symptoms of this condition is a “falling out feeling,” pelvic pressure that gets worse as the day goes on, if you’re on your feet a long time or with lifting, feeling a bulge with wiping or showering, pain with sexual activity, especially deep vaginal penetration, inability to wear a tampon or hitting something when inserting a tampon.

Pelvic Pain is pain in the lowest part of your abdomen and pelvis. In women, pelvic pain might refer to symptoms arising from the reproductive, urinary or digestive systems, or from musculoskeletal sources.

Depending on its source, pelvic pain can be dull or sharp; it might be constant or off and on (intermittent); and it might be mild, moderate or severe. Pelvic pain can sometimes radiate to your lower back, buttocks or thighs. Sometimes, you might notice pelvic pain only at certain times, such as when you urinate or during sexual activity.

Pelvic pain can occur suddenly, sharply and briefly (acute) or over the long term (chronic). Chronic pelvic pain refers to any constant or intermittent pelvic pain that has been present for six months or more.

Postpartum pelvic floor disorders encompass a wide variety of conditions. The ‘pelvic floor’ refers to a group of muscles that attach to the front, back, and sides of the pelvic bone and sacrum (the large bone at the bottom of your spine just above the tailbone). These muscles support the organs in the pelvis including the bladder, uterus or prostate, and rectum. They also wrap around the urethra, rectum, and vagina (in women).

Childbearing brings dramatic changes to a woman’s body. The trauma that can occur from childbearing may result in damage to the uterus, bladder, and rectal organs. The term ‘disorder’ encompasses many postpartum problems. The most common postpartum problems experienced by women include: urinary incontinence, fecal and gas incontinence, pelvic pain, painful intercourse, and pelvic organ prolapse.

Recurrent urinary tract infection (UTI) refers to ≥2 infections in six months or ≥3 infections in one year

Risk factors for recurrent UTI include:

• sexual activity
• spermicide and contraceptive device use (such as intrauterine devices or IUDs)
• hormonal deficiency in postmenopausal women
• diabetes
• foreign objects (including bladder stone)
• urinary tract obstruction (including benign prostatic hyperplasia or stones).

Sexual health problems, also referred to as sexual dysfunction, is not just one condition. Instead, there are several types of sexual health problems affecting women.

• Painful intercourse, also called dyspareunia. The pain can range from discomfort to an excruciating sharp knife-like pain. Some women experience a burning or tearing sensation. The pain can last just a few seconds to an entire week after intercourse.
• Vaginismus– Vaginismus is vaginal tightness causing discomfort, burning, pain, penetration problems, or complete inability to have intercourse.
• Vulvodynia– Vulvodynia is chronic pain on the external female genitalia without an identifiable cause. The location, constancy and severity of the pain vary among sufferers. Some women experience pain in only one area, while others experience pain in multiple areas. The most commonly reported symptom is burning, but women’s descriptions of the pain vary. One woman reported her pain felt like “acid being poured on my skin,” while another described it as “constant knife-like pain.”
• Vaginal atrophy (vaginal dryness) is thinning, drying and inflammation of the vaginal tissue due to your body having less estrogen. Vaginal atrophy occurs most often after menopause. For many women, vaginal atrophy not only makes intercourse painful, but also leads to distressing urinary symptoms.

Urinary frequency means you empty your bladder too often (more than eight times per day and/or waking up at night to use the bathroom). You feel like fluids are going right through you and you know the location of every bathroom. You feel like you are living in the bathroom and usually feel like you are not emptying your bladder completely.

Urinary urgency is when you feel the urge to urinate and you have to rush to the bathroom right away. You do not leak urine but you feel like you can’t delay urination. Urinary urgency is often accompanied by urinary frequency.

Urinary incontinence is the unintentional leaking of urine. There are four types of urinary incontinence: urge, stress, mixed, and functional.

• Urge Incontinence is urinary leakage accompanied by a strong urge or sensation that you need to urinate. The urine loss amount can range from a few drops to wetting your outerwear. It is common for the loss of urine to occur while trying to get to the bathroom in time.
• Stress Incontinence is urinary leakage with activities such as coughing, laughing, sneezing, lifting, exercising, or jumping. The urine loss amount can range from a few drops to wetting your outerwear.
• Mixed Incontinence is a combination of urge incontinence and stress incontinence.
• Functional Incontinence consists of the inability to get to the bathroom in time due to a physical impairment. Usually this impairment decreases the speed in which you can get to the bathroom in time or it may impair your ability to unbutton or unzip your pants. It may also affect your ability to sit down on the toilet safely.

Urinary retention means you are unable to empty your bladder completely. Urinary retention can be sudden (acute) or can build up slowly over a period of time (chronic). Acute urinary retention usually means you are unable to pass any urine even though your bladder is full. If you have chronic urinary retention you can usually pass some urine but cannot completely empty your bladder.