Bowel problems after childbirth: hemorrhoids, constipation or unwanted discharge

Although it is rarely discussed, many women experience bowel problems during and especially after pregnancy. The Pelvic Floor Book discusses the problem in detail. We summarize the information for you.

Bowel problems after pregnancy or childbirth

Fecal incontinence

One in eight women has stool leakage after pregnancy or childbirth. The inability to hold solid or runny stool is called fecal incontinence. This can occur with an urge to have a bowel movement, but it can also occur in an unconscious form and is then called passive fecal incontinence or soiling. In that case, you notice soiling in your underwear without being aware of stool leakage.

Flatulence (farting)

There is also the involuntary loss of gas or air that is released through the anus. This is called flatulence incontinence. Everyone passes wind every day, but some women have no control over holding in wind at times when they feel it is inappropriate to pass gas.

Constipation

Everyone has different bowel movements, but if you have a bowel movement less than three times a week or are unable to have a bowel movement for more than three days in a row and also complain of abdominal pain or hard stools, then you are often suffering from constipation.

Difficulty pushing out stool

You can also suffer from so-called incomplete emptying or obstructive defecation and have difficulty pushing out stool. You then have the feeling that your bowel is never empty after a visit to the toilet. This is often accompanied by the feeling that you could keep wiping after defecation.

Hemorrhoids

Hemorrhoids and cracks around the anus can occur if you, for example, push hard to get a bowel movement out. This can happen because you do not relax your pelvic floor enough and is also more common during and after pregnancy. Hemorrhoids or piles (in technical terms: hemorrhoids) are swollen and prolapsed erectile tissue in the rectum. We all have these erectile tissues; they help to close off our anal canal and ensure that no stool leaks out of the anus. When these erectile tissues swell too much and (possibly even externally) prolapse, we speak of (external) hemorrhoids. This can cause pain and an unpleasant feeling of pressure.

Cracks around the anus

Anal fissures or tears are superficial cracks in the external skin of the anus. These can also cause discomfort and cause some (bright red) blood when making a bowel movement.

How is the diagnosis made?

Are you having problems with your bowel movements or do you have questions? Then definitely bring it up with your doctor. With a good conversation and a few specific questions, he or she can work out a plan with you. General practitioners, gastroenterologists, gynaecologists, urologists and physiotherapists (specialised in pelvic floor re-education) can also perform additional tests to better assess your problem. Possible tests include:

• Stool diary
• Internal probe: a kind of ‘balloon’ that the pelvic floor physiotherapist inserts and which is connected to a screen on which he can read what your muscles are doing
• Transperineal pelvic floor ultrasound, in which a probe provides a good image of the condition of your pelvic floor muscles and the suspension system
• Transrectal ultrasound, in which a gastroenterologist examines the condition internally through the anus

For more information, you can contact specialized centers and your trusted doctor. On www.thepelvicfloor.be you can find links to a doctor or specialized physiotherapist in your area.

Source: