Faecal Incontinence

Women's Health Physiotherapy

Article by Nadine Stewart

Faecal Incontinence

What is Faecal Incontinence?

Faecal incontinence is the inability to control your bowels leading to the uncontrollable leaking of faeces (stool / poo) or flatus (gas).

What Causes Faecal Incontinence?

Several factors can lead to faecal incontinence, including:

  • Damage or weakness of the pelvic floor muscles, anal sphincters and associated nerves through:
    • Pregnancy and childbirth
    • Surgery
    • Trauma
    • Radiation therapy
    • Straining to make a bowel movement if you have a history of constipation
    • History of some heavy lifting
    • History of respiratory conditions resulting in constant coughing
    • Presence of fistula or haemorrhoids
    • Decreased mobility/lack of exercise
  • Some medications
  • Medical conditions that affect the nervous system, e.g.Parkinson’s disease and MS
  • Medical conditions that affect the bowel, e.g. IBS and Crohn’s disease
  • History of Diarrhea
  • Blockage of the rectum/anus, e.g. rectal prolapse or faecal impaction
  • Lifestyle – diet and fluid ingestion

What are the Symptoms of Faecal Incontinence?

The symptoms of faecal incontinence may include:

  • Unintentional leakage of faeces (stool/poo) or flatus (gas) from the anus
  • Unintentional faecal staining on clothing, e.g. underwear
  • Loose stool consistency
  • Change in stool appearance, e.g. colour
  • Change in usual toileting routine/bowel movements
  • Urinary incontinence

How is Faecal Incontinence Diagnosed?

Usually, a clinical diagnosis can be made using the information you have given based on your medical history, toileting habits, and lifestyle (diet, fluid ingestion, medication and exercise). Occasionally a physical exam may need to be performed. During this examination, your physiotherapist may need to perform an internal exam to assess the position of the organs in the pelvic cavity and the strength and ability of the pelvic floor muscles to activate and coordinate correctly. If further information is required, other tests and investigations can be performed, including using a bowel diary, imaging e.g.ultrasound, colonoscopy. sigmoidoscopy, nerve tests including EMG (electromyograph), as well as other anorectal and colorectal tests. However, these tests will only be performed if required based on your individual presentation.

What Treatments are Available for Faecal Incontinence?

There are many treatments for faecal incontinence that you can achieve through participation in physiotherapy. These treatments can include:

  • Education
  • Diet recommendations regarding fibre intake
  • Recommendations regarding water / fluid consumption
  • Recommendations regarding exercise
  • Pelvic floor exercise program
  • Adjustment of usual toileting habits
  • The addition of stool bulking agents

Other Treatments:

A large proportion of people with faecal incontinence will have their symptoms improved or resolved with physiotherapy treatment. However, depending on the cause of your faecal incontinence, you may also need to follow up with your doctor for additional treatment if required, including:

  • Medications review/ prescription
  • Medical treatment for conditions that may put you at risk of faecal incontinence
  • Enemas and suppositories if required
  • Potential Surgery

Your physiotherapist will work closely with your doctor to ensure the best possible treatment outcome for you.

What Results Can You Expect?

A large proportion of people with faecal incontinence will have their symptoms improved or resolved with adjustment of lifestyle factors and a pelvic floor exercise program through physiotherapy treatment. However, if left untreated, the problem worsens gradually and may affect other areas, including the pelvic floor and bladder.

Will You Need Surgery?

There is a percentage of people who may not experience enough improvement with physiotherapy treatment alone. This often depends on the underlying cause of faecal incontinence, and as a result, some individuals may need to go on to have surgery to resolve their symptoms.

For more information please consult your physiotherapist with a special interest in pelvic floor conditions.

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Women's Health Physiotherapy Appointment FAQs

Q: What Do You Need To Bring To Your Women's Health Appointment?

A: Please bring any information regarding your condition from your GP, medical specialists or other health care providers with you to your appointment. You will also need to arrive 10 minutes before your appointment to fill out some paperwork. Alternatively, we can email information to you before your appointment.

Q: What Do You Wear To Your Appointment?

A: Please wear clothing that you can move around freely in.

Q: Will the Information That You Provide During Your Appointment Remain Confidential?

A: Yes. All the information you provide in your appointment will remain confidential, and your physiotherapist will only communicate with other healthcare providers involved in your care with your consent. We also conduct your appointment in individual rooms to ensure that what you say remains confidential. The one exception to this is cases of rectus diastasis, which we may treat in the general physiotherapy curtained consulting area unless otherwise requested.

Q: How Long Will Your Appointment Be?

A: The length of the appointment can vary depending on the condition that we treat.  Your initial women's health appointment will normally take 1-hour. Mastitis and rectus diastasis appointments will normally take 30 to 40-minutes. For information specific to your needs, please call our receptionist.

Q: What Will Your Women's Health Physiotherapy Appointment Cost?

A: The cost of the session can vary depending on the condition that will be treating. Please call our reception staff at Ashgrove (Ph: 3366 4221) for further information.

Q: Is Your Women's Health Physiotherapy Appointment Claimable Under Private Health Insurance?

A: Yes. Please bring the private health insurance card with you to your appointment to process your claim on the spot.

Q: Is Your Appointment Covered Under An EPC/Medicare Referral?

A: Yes, we do accept GP referrals under EPC guidelines. However, but due to the extended time allocated by your women's health physiotherapist, there will be a gap payment to cover the total cost of your consultation after the Medicare rebate is applied. Please call our reception staff for specific information.

Women's Health Conditions

Women’s Health Physiotherapy incorporates the assessment and treatment of a large number of women-specific conditions including:

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Electric Muscle Stimulation (EMS)

EMS Machines

Electronic muscle stimulation (EMS) may help you to strengthen weak muscles.


How Does Electric Muscle Stimulation Assist Strengthening?

There are several theories on how an EMS Machine may assist in muscle strengthening. One potential reason is that when you maximally contract a muscle, at best, only 30% of all your muscle fibres are in a state of contraction. The remaining 70% are dormant and awaiting recruitment when the contracting fibres fatigue. With EMS, you can potentially electrically stimulate these resting muscle fibres to improve their strength. Clinically, EMS appears to be more effective when the muscles are frail and you have difficulty performing regular anti-gravity exercises.

Another reason that EMS potentially works is via an improvement in the recruitment of nerve conduction rates. Explained, it takes approximately 10000 repetitions for your brain to learn how to quickly send a message to your muscles via the quickest nerve pathways. This contraction pattern becomes your "memory engram". The more frequent your muscle recruits, the better your body becomes at finding the fastest way to recruit that muscle. EMS can potentially provide you with repeated contractions to accelerate this learning process.

To achieve your best outcome, we recommend that you seek professional advice on best utilising your EMS machine from your local physiotherapist who has a particular interest in EMS muscle retraining.

Important EMS Machine Information

Use your machine only as directed. A TENS machine and an EMS machine are electronic medical devices. Always read the label and instruction manual. A TENS machine may assist you in modest short-term pain relief. Consult your doctor/healthcare professional before use and if symptoms persist.

EMS Machines

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Physiotherapist Prescribed Exercises

Why Do Physiotherapists Prescribe You Exercises?

The prescription of exercise appropriate to you and your injury or fitness level is one of the many professional skills of a physiotherapist. Whether you have suffered an acute injury, chronic deconditioning, or recovering from surgery, the correct exercise prescription is essential. That's why your physiotherapist's knowledge and skills will personalise your exercise dose.

Your physiotherapist not only is educated in injury diagnosis but also exercise physiology or the science of exercise. This training enables your physiotherapist to assess and diagnose your injury, plus also to prescribe injury, fitness or age-appropriate activities targeted to you now.

What Exercises Should You Do?

Your exercises shouldn't be painful. Would you please be cautious with some overzealous exercise prescribers who believe that the more painful the activity, the better? This isn't true—notably, the frail, immunosuppressed, deconditioned or post-operative person.

You'll find that your physiotherapist will thoroughly examine you and prescribe a series of exercises suitable for you in quantities that will not injure you further. Please seek an exercise expert, such as your physiotherapist, when you are planning your rehabilitation.

What Happens When You Stop Exercises?

Without some simple exercises, we know that specific muscles can become weak. When these supporting muscles are weak, your injured structures inadequately support and predispose you to linger symptoms or further injury. You can also over-activate adjacent muscles that may lead to further damage.

It is also essential to understand that even if you are "in good shape", you may have crucial but weak localised or stability muscles. When you have an injury, you should perform specific exercises that specifically strengthen the muscles around your injury and the adjacent joints. Your physiotherapist will assess your muscle function and prescribe the right exercises specific to your needs.

The exercises prescribed will usually be relatively simple, and do not require any special weights equipment, and can be performed safely at home.

Would You Stop Your Daily Prescription Drugs?

Your physiotherapist will prescribe your individualised dose or exercises. They are using their professional expertise to optimise your exercise dose. Would you stop taking your regular blood pressure medication because you were too busy or didn't think it worked? We would hope not!

Exercise, when prescribed by an expert such as your physiotherapist, should be treated as your recommended dose. Just like when you don't take your blood pressure medication, you can't expect the drugs to work if you don't take them as prescribed by your health professional.

So, next time you skip your "exercise dose", remember that you are not putting your health first. If you have any questions, please get in touch with your Physio Works physiotherapist for your best care.

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Physiotherapy Private Health Insurance Rebates

PhysioWorks Physiotherapy and Remedial Massage are more affordable than you think. Your Private Health Insurance (PHI) usually pays for most of your treatment fees, leaving you with only a small gap payment.

However, Private Health Funds vary their rebates payable depending upon the level of cover you have taken. Some funds have kept up with the costs of modern medicine whereas, sadly, others haven't, with rebates similar to what they were a decade ago.

HICAPS - Instant Health Fund Claims

Most health funds are members of the HICAPS instant claims system.  Swipe your health insurance card at our reception counter, and you can instantly claim your physiotherapy treatment via our online Hicaps System. Remedial Massage is claimable via Hicaps for some but not all funds. Please visit Hicaps for the latest funds for more information, which can use their instant claiming system.

Private health insurance rebates are available for all of our physiotherapists. Instant claims are possible via our in-practice Hicaps system.

Third-Party Insurers

PhysioWorks practitioners are registered providers for government, Workcover and insurance companies, including:

  • Workcover
  • InjuryNet
  • Australia Post; Coles Myer; Woolworths
  • Medicare
  • Department of Veterans' Affairs
  • CTP & Sports Insurers

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The internet is full of potentially unreliable information. Please source trusted healthcare information from reputable websites such as the following.




British Medical Journal



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