Bowel Evacuation Problems
Bowel evacuation problems or difficulty emptying the bowel can be common symptoms of pelvic organ prolapse. Pelvic organ prolapse involves a pelvic organ moving from its normal position to push against the vaginal walls, causing pressure, stretching, pain and difficult or obstructed defecation. Because the organs are moved out of place and can put pressure on the rectal area, patients may find it difficult and painful to defecate.
Pelvic organ prolapse is most often caused by the strain placed on the pelvic muscles during childbirth, which commonly stretches or weakens the pelvic muscles. Other factors that put pressure on the pelvis and may lead to pelvic prolapse include:
- Chronic cough
- Frequent straining for bowel movements
- Pelvic floor dysfunction
- Weakness in the area due to aging
Types of pelvic organ prolapse include:
- Rectocele – A rectocele is a prolapse of the rectum pushing up into the vaginal wall and sometimes out of the vagina. Difficulty with bowel movements can occur when stool gets trapped in the pocket of the rectocele.
- Rectal prolapse – A rectal prolapse is a condition where a section of the wall of the rectum falls or descends from its normal position and in some cases, may protrude out of the anus.
- Compressive Enterocele – A compressive enterocele is a herniated small bowel. An enterocele occurs when the front and back walls of the vagina separate and the intestines push against the vaginal opening. Enteroceles may also compress the rectum making it difficult to pass stool.
Treatment for this condition may vary depending on the location and severity of the problem. Patients with mild obstructed defecatory symptoms can often treat their condition at home through changes in the diet by staying hydrated and increasing their fiber intake. Cases that do not respond to home treatments may require the insertion of a pessary, a small device inserted into the vagina to relieve pain and pressure and hold the organs in place. More severe cases may benefit from surgery to repair damaged tissue. In some cases, rectal prolapse surgery may be performed.
It is important for obstructed defecation to be thoroughly evaluated as it may be due to a number of conditions. If left untreated, obstructed defecation can get worse over time.