What is pelvic floor dyssynergia?

Pelvic floor dyssynergia is a condition characterised by the improper coordination of muscles in the pelvic floor, which can lead to chronic pain and issues with bowel function. Normally, the pelvic floor muscles relax to allow the passing of stool; however, in individuals with dyssynergia, these muscles contract rather than relax, causing discomfort and difficulty with bowel movements. This miscommunication between the brain and the pelvic floor muscles can lead to incomplete bowel emptying, straining, and chronic constipation.

Causes

The exact cause of pelvic floor dyssynergia is not fully understood, but it is often linked to a combination of factors, including chronic straining during bowel movements, trauma to the pelvic region, or neurological issues that impact muscle coordination. Emotional stress and anxiety can also play a role, as the pelvic floor muscles are sensitive to changes in stress levels. In many cases, individuals may develop dyssynergia over time due to a learned habit of incorrect muscle use during bowel movements.

Symptoms

Symptoms of pelvic floor dyssynergia are varied and can include constipation, the sensation of incomplete bowel evacuation, straining during bowel movements, and chronic pelvic pain. For some, the pain can extend to the lower back or abdomen, significantly impacting their quality of life.

This discomfort can be further compounded by psychological symptoms such as stress and anxiety, as the chronic nature of the condition can be physically and emotionally exhausting.

Treatment

Treatment options for pelvic floor dyssynergia are available and often involve a multidisciplinary approach. Biofeedback therapy, a common and effective treatment, uses visual and auditory feedback to help patients retrain their pelvic floor muscles to relax appropriately during bowel movements.

Physical therapy with a focus on pelvic floor muscle relaxation exercises is also beneficial, as is cognitive-behavioural therapy (CBT) to manage stress and anxiety. In some cases, a healthcare provider may recommend medications to manage symptoms of constipation or pain.

Early diagnosis and intervention are essential, as untreated pelvic floor dyssynergia can lead to further complications and a decline in quality of life. Individuals experiencing symptoms should consult a specialist in pelvic floor disorders, such as a gastroenterologist or pelvic floor physical therapist, to explore effective treatment options tailored to their needs. With the right approach, many people find significant relief from pain and improved bowel function.