An exploration of pelvic floor problems

Pelvic floor problems are often thought of as an issue which is exclusive to women. However, this is not the case. Renowned colorectal surgeon Mr Pasquale Giordano explores pelvic floor problems, including common symptoms, treatments and prevention methods.

Who can suffer from pelvic floor problems?

Pelvic floor problems can impact a very wide population. It is conventionally believed that only women, especially those of a certain age, experience these issues. While this is true to some extent, pelvic floor problems and functional challenges can affect individuals of any gender and age. However, in my specialised practice, I frequently encounter young male and female patients with these problems.

Unfortunately, these conditions are often misunderstood or overlooked by colleagues and general practitioners, leaving patients to suffer without proper recognition or attention. It is crucial to acknowledge that these conditions are prevalent and can affect anyone, regardless of gender or age.

What are the common symptoms of pelvic floor problems?

Symptoms related to pelvic floor problems cover a very wide range of symptoms, involving a various organs linked to pelvic floor. This means that symptoms could be generated from a bowel, gynaecological or gastrointestinal perspective, as well as concerns related to urination.

In my practice, I focus principally on a colorectal perspective. These symptoms can be extremely prevalent and once again can affect anyone, any age, including the following issues:

• Chronic constipation.
• Difficulty going to the toilet.
• Difficulty opening the bowel.
• Poor bowel control.
• Chronic pelvic pain.
• Bowel prolapse.

These symptoms can often occur together, can be subtle and not always easily recognised. The condition can also encompass less specific symptoms such as abdominal pain, bloating, discomfort and nausea.

Can pelvic floor exercises help managing pelvic floor issues?

Absolutely. Pelvic floor exercises play a key role in the management of pelvic floor patients. Pelvic floor exercise provided are done under the guidance of a specialist, and can play an important role in the management of these conditions. Moreover, pelvic floor exercises or physiotherapy are very safe, suitable for long-term use, and are essential components of managing individuals with pelvic floor problems.

What are the available treatment options to manage this pelvic floor disorders?

There are multiple treatment options available, ranging from non-invasive management or conservative approaches, to invasive or surgical approaches. Understanding the specific underlying problem in each patient is crucial for tailoring effective treatment. Initially, a conservative approach is recommended, involving lifestyle and diet modifications, along with medications if necessary.

Pelvic floor physiotherapy and bowel retraining are considered as part of this conservative strategy. If these measures prove insufficient, specialist investigations are conducted to determine the root cause and assess the need for surgical intervention.

Surgical procedures, when performed appropriately, can be highly effective, but the complexity of the underlying issues often leads to mismanagement. Therefore, a multidisciplinary team (MDT) approach, involving specialists in bowel, gynaecology, and urology, is essential for comprehensive patient care. The MDT should include support from a specialist nurse, physiotherapist, and dedicated physiologist to enhance the understanding and management of the underlying problems.

How do pelvic floor problems impact daily life and activities?

Pelvic floor problems can significantly impact a person's quality of life, manifesting in a variety of symptoms such as difficulty with bowel function. Patients may struggle with opening their bowels, leading to prolonged efforts, embarrassment, and even invasive measures. Bowel control issues can also cause social, personal, and sexual distress. Many patients find it challenging to discuss these problems, often revealing them only after being prompted by a specialist.

Pelvic pain, abdominal pain, and bloating are additional symptoms that can hinder physical activity and exercise, negatively affecting daily life. While finding a definitive solution may not always be easy, non-invasive interventions can often make a substantial difference, avoiding unnecessary surgeries. It is crucial for patients to consult specialists who understand these issues, as mismanagement is common and can exacerbate the impact on quality of life.

Are there preventive measures or lifestyle changes that can improve pelvic floor health?

Yes,  improving simple things, such as lifestyle and diet can create a significant difference to these symptoms. It should be noted that improving fibre and liquid intake, adopting a healthier diet, incorporating exercise, and practicing specific pelvic floor exercises can make a substantial difference for patients, even those experiencing severe constipation or control issues.

Prevention is crucial, particularly for women, especially after childbirth, as maintaining muscle health through exercises can reduce the risk of developing symptoms later in life. Overall, a healthy lifestyle, including exercise and a balanced diet, is emphasised as an important long-term strategy to minimise the risk of pelvic floor symptoms.

If you are suffering from pelvic floor issues and would like to book a consultation with Mr Giordano, do not hesitate to do so by visiting his Top Doctors profile today.