Oh no, I need to go to the bathroom again! Does this sound familiar? Have you ever wondered why some women have problems with bladder and bowel function, and others do not? Let’s discuss what causes some women to have dysfunction in these areas?

Pelvic floor dysfunction could be the result of many things, including pelvic floor weakness, ligamentous laxity, surgeries, childbirth, heredity, muscle spasms, retention, urinary frequency, as well as some health conditions. Diabetes can be one of the conditions that lead to complications with your bowel and bladder. Having blood sugar levels that are above target over time can lead to nerve damage, also known as neuropathy. This can, in turn, lead to Pelvic Floor Dysfunction. When neuropathy affects the bladder or bowel, it can cause urine or fecal leakage. If a person is overweight and has diabetes, the weight may complicate matters with increased intra-abdominal pressure on both bowel and bladder. The combination of increased abdominal weight, increased intraabdominal pressure, and decreased pelvic floor strength, can lead to urinary incontinence.

What is incontinence? It is a loss of bladder or bowel function without one’s control. It happens involuntarily. There are several types of incontinence.

• Stress urinary incontinence can happen with sudden movements and increased stress on the pelvic floor. Such instances include coughing, sneezing, jumping, or laughing.
• Urge incontinence occurs when one cannot deny a strong urge to use the bathroom and may be walking to the toilet but leaks on the way. People with urge incontinence have issues making it to the bathroom “in time”. They may also leak urine as they are turning the key in the lock to enter the house or when they see their driveway. Urge incontinence usually has a trigger that can make people have a sensation of urge that they cannot overcome.
• Mixed urinary incontinence is a combination of both stress and urge incontinence. The person dealing with mixed urinary incontinence may leak urine with coughing or sneezing and may leak when they have a strong urge just by walking into the bathroom.
• Fecal incontinence occurs when one cannot hold his or her bowel movement, and fecal matter moves through the rectum and out the anus without muscular control. This may happen during physical activity like running, walking, or with extreme coughing. It may also occur in those who experience other gastrointestinal conditions. These can be embarrassing moments for anyone, but there is help available.

Pelvic floor physical therapists can help. Pelvic floor physical therapists are licensed Physical Therapists who have advanced training specifically in the areas of pelvic wellness and dysfunction. Here are ways in which they can help:

• Assist in reducing and resolving urinary and fecal frequency, urgency, post-void dribbling, and incontinence.
• Assist with pelvic pain during intercourse and vaginal dryness which can develop as a result of menopause.
• Manage diuretics and other medications which can lead to frequent urination.
• Train pelvic floor muscles to improve strength and thus prevent leakage. Kegel exercises are just the beginning. Physical Therapists can help with isolating the pelvic floor and core muscles and teach how to make them various exercises.
• Train your pelvic floor muscles to relax in order to completely empty both bowel and bladder. Breathing exercises are often taught to assist with relaxation techniques.

Pelvic floor physical therapists may help you gain confidence and control over your life and live it to the fullest. Urinary and bowel symptoms should not control one’s life. Although pelvic floor dysfunction is not discussed much, many women deal with this issue alone or know someone who does. If you experience uncontrolled urine and/or fecal leakage, urgency or frequency, please do not “tough it out alone.” Contact a pelvic floor physical therapist near you.

You can find a practitioner near you through Herman and Wallace - https://pelvicrehab.com/

Sources:

• Golbidi, Saeid. “Bladder Dysfunctions in Diabetes Mellitus.” Front Pharmacol, 1, no 1 (2010):136. Accessed July 26, 2019. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3153010/
• Izci, Yenal. “The association between diabetes mellitus and urinary incontinence in adult women.” In Urogynecol J Pelvic Floor Dysfunct. 20 no 8 (2009): 947-952. Accessed July 26, 2019. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2706373/
• Yerkes, Adeline M. “Urinary Incontinence in Individuals with Diabetes Mellitus.” Diabetes Spectrum 11, no. 4 (1998): 241-247. Accessed July 26, 2019. http://journal.diabetes.org/diabetesspectrum/98v11n4/pg241.htm

 

Katrina Heath was born in Charlotte, North Carolina. She has practiced physical therapy for nearly 17 years in the states of North Carolina, Michigan, and New Jersey. Following her licensure to practice as a Physical Therapist in 2002, she served at North Carolina Baptist Hospital in acute care on the orthopedic/trauma team, and she traveled as a therapist, working in various settings including outpatient orthopedic, skilled nursing, home care, and acute care facilities.

Katrina has always had a passion for pelvic floor rehabilitation. It was her dream to become a therapist specializing in pelvic floor disorders. She has focused her treatment on women, men, and children with pelvic floor dysfunctions for the past 13 years. She has treated pelvic dysfunctions including, but not limited to, urinary frequency, nocturia, incomplete emptying, urinary hesitancy, bowel dysfunctions, urinary, and fecal urgency/incontinence, endometriosis, pelvic pain, bedwetting, and constipation.

Outside of work, Katrina enjoys spending time with her amazing husband and two adorable children. She loves attending worship services, visiting family and friends traveling to NC, cooking, singing, reading, and shopping. It is her passion to help people overcome pelvic dysfunctions and live their best functional lives every day. Her personal motto is: “If I can help somebody live a better life, my living will not be in vain”.

Katrina earned her Bachelor of Science in Human Anatomy and Physiology degree as well as her Master of Physical Therapy degree from Andrews University in 2002. In 2006, she received her Doctorate in Physical Therapy from Rocky Mountain University of Health Professions. She received her Certification for Pelvic Rehabilitation (PRPC) through Herman and Wallace in 2018. She enjoys working currently at Penn Medicine Center for Pelvic Wellness in Princeton, NJ. Please contact her via email at Katrina.heath@pennmedicine.upenn.edu