Pelvic Floor Disorders
North Carolina Surgery prides itself on its tradition of excellence in colorectal surgery. Our surgeons are specialists in all aspects of colorectal surgery, and when possible utilize laparoscopic techniques to minimize patient discomfort and recovery time.
Our expertise is derived from years of experience in performing everything from routine outpatient procedures to highly complex procedures. Despite the complexity of the procedures, our surgeons are always focused on our patients' safety and outcome, and have an extraordinary record of patient success and satisfaction.
The pelvic floor disorder procedures in which we specialize include but are not limited to:
Bowel (fecal) Incontinence
In order to maintain control over the bowels, the nervous system and muscles of the rectum and anus must be working properly. When a person loses control over any of these areas or becomes unable to respond to the need to have a bowel movement because of loss of mental capacity, it can cause incontinence.
There are a handful of reasons why a person might lose the ability to control bowel movements, including:
- Chronic constipation, which weakens the muscles
- Reduced awareness of the muscles
- Emotional problems
- Injury to the muscle during childbirth
- Muscle damage
Incontinence can be treated in a number of ways, depending upon its cause.
Patients may be able to deal with it by a change in diet. For instance, alcohol, dairy products and caffeine can cause diarrhea. Adding fiber intake can help thicken stools.
Medication can be used to reduce diarrhea and tone the bowel muscles. Some medications, like antacids, may also increase incontinence. Your physician will know which ones might be causing problems.
If these options are ineffective, surgery is an option. Types of surgery for bowel incontinence include:
- Sphincter repair – the anal muscles are tightened to help the sphincter close fully.
- Muscle transplant – muscle is taken from the thigh and placed around the sphincter to improve tone.
- Diversion – a colostomy may be performed if other treatments don’t work. This process includes attaching the colon to a hole in the abdomen where a bag collects the stool.
For more information on bowel incontinence, see the American College of Colon & Rectal Surgeons.
Muscle contractions in the colon are responsible for moving stool through the digestive tract. When the muscles contract too slowly or there are not enough fluids or fiber-rich foods in the system, it can create constipation.
Constipation is typically diagnosed when a patient has hard, dry stools or fewer than three per week. You should consult your physician if this is chronic or lasts longer than three weeks.
If the condition is severe enough, your physician will take an X-ray or perform a procedure like a colonoscopy to understand the problem.
Your physician might recommend lifestyle changes, such as:
- Increasing fiber and fluids in the diet
- Increasing physical activity
- Medication like fiber supplements, laxatives and stool softeners
- Prescription medication
If these are not successful in treating the problem, your physician may insert a finger into the anus and break up an impacted stool. Biofeedback (placing a probe into the rectum to find out what muscles are doing during defecation) is also possible to retrain muscles that are no longer working.
If the constipation is severe enough, your physician may recommend removing the part of the colon that is affected.
For more information on constipation and its treatment, see The National Institutes of Health.
When the lower part of the intestine stretches out and falls down, this is considered a rectal prolapse. There are three kinds:
- Partial – The lining slides out and sticks out of the anus
- Complete – The whole wall is stretched and sticks out
- Internal – Part of the lining is stretched, but it doesn’t stick out
Risk factors for rectal prolapse include straining during bowel movements, tissue damage to the area and muscle weakness in the area due to age.
People with rectal prolapse may experience:
- Leaking of stool or blood
- Inability to fully empty bowels
- Bright red tissue in the anus
To diagnose a prolapse, your physician will perform a physical exam and may order tests like a colonoscopy or a barium enema to get a better view of the area.
Your physician may allow you to push the prolapse back into place. Your physician may also recommend exercising the pelvic floor muscles, using stool softeners, eating foods high in fiber and drinking plenty of fluids.
If these treatments are not effective, surgery is an option. During surgery, the loose part of the wall can be attached to the pelvic floor or might be removed altogether.
For more information about rectal prolapse, see the American Society of Colon & Rectal Surgeons.