Dyssynergic Defecation (Anismus) – What Does It Have to Do With the Pelvic Floor?

Dyssynergic defecation, also known as anismus, is a condition that causes trouble with bowel movements. It occurs when the pelvic floor is too tight or unable to coordinate properly to allow for a smooth bowel movement, resulting in constipation and impacted bowels. But what exactly is the pelvic floor?

Every person has a pelvic floor! It is a group of twenty-six different muscles located in the pelvis, all of which support many important bodily functions: bladder and bowel continence, sexual function and appreciation, support and stability, and more.

When these muscles become too tight, weak, inflexible, short, or uncoordinated, it is referred to as pelvic floor dysfunction.

With dyssynergic defecation, the pelvic floor muscles are usually very tight and unable to relax to allow for a bowel movement. Many individuals who have chronic constipation are experiencing dyssynergic defecation. 

Dyssynergic defecation makes it difficult to pass stool. Therefore, those with this condition may have infrequent bowel movements, incomplete bowel movements, painful stool, and possibly pain in the anus or stomach. Individuals who have dyssynergic defecation may strain a lot while on the toilet, and may feel like they need physical assistance to let the stool out. They may also feel like they need to use the restroom often in order to attempt a bowel movement.

Individuals with dyssynergic defecation may feel bloated in the stomach. It may feel as though there is pressure in their pelvis, or a general discomfort. This condition may also create a sensation that stool is stuck in place. It can be a very uncomfortable and inconvenient condition that may make individuals fear restroom trips outside of their own homes.

As mentioned before, dyssynergic defecation is caused by pelvic floor dysfunction, specifically a tightened or uncoordinated pelvic floor. You may be wondering how your pelvic floor becomes tight or uncoordinated—there are actually many different factors that can cause this. Some examples include:

Pre-existing conditions: Individuals with pre-existing chronic conditions are much more prone to pelvic floor tension due to repeated exposure to pain and stress, which can lead to repeated tightening of the muscles (often unknowingly).

Pregnancy and childbirth: The pressures and stress of pregnancy and childbirth can significantly affect pelvic floor health. Pregnancy and childbirth can lead to a lack of coordination in the pelvic floor and other dysfunctions that can worsen if left untreated.

Daily behaviors: Excessive straining during bowel movements, sitting on the toilet for long periods of time, frequent restroom trips, and many other habits can harm the pelvic floor over time.

Surgery or injury: Those who have had previous injuries or surgeries to their pelvic area may have scar tissue, which can cause restriction to the pelvic floor. When those muscles are inflexible and immobile, tension can build over time.

Additionally, surgeries and injuries have a risk of causing neurological problems. When nerves in the pelvic floor cannot coordinate properly, they may restrict one’s ability to complete a bowel movement.

For more information about causes of pelvic floor tightness, please visit the pelvic floor tension page.

Pelvic floor physical therapy is absolutely necessary for conditions like dyssynergic defecation. While things like improving your diet and water intake or trying medication for constipation may provide some level of relief, these things do not necessarily solve the root cause of your issue.

This condition is directly related to the pelvic floor, meaning you will need the help of someone like me—a pelvic floor physical therapist! 

With curated pelvic floor therapy treatments, I will be able to release the tension in your pelvic floor and improve its coordination—which will restore your control over your own body. 

Pelvic floor physical therapy can involve a wide variety of treatment methods! For example, to release tension in your pelvic floor, I may utilize treatments such as manual therapies, exercises or stretches, and breathing techniques. 

Some other important treatments for dyssynergic defecation include those that improve your pelvic floor coordination, such as neuromuscular re-education and biofeedback.

These treatments help improve your control over your pelvic floor through real-time feedback and practice. Regaining control over your pelvic floor’s ability to contract and relax will allow them to better coordinate as needed to allow for a bowel movement!

I strongly value long-term comfort and results for every one of my patients, so I’ll provide guidance and at-home strategies that will help you protect your pelvic floor’s health even after your symptoms have faded. 

To achieve this, it is important that you have a good understanding of this part of your body and what factors can contribute to pelvic floor dysfunction. While receiving treatment, you can expect plenty of patient-friendly education and explanations. Feel free to ask questions, too!

I want you to feel confident and comfortable during treatment, and one way to do that is to improve your knowledge about the pelvic floor, how it works, and why it might not be performing as needed.

All of these different factors will help you work towards better pelvic floor health and smoother bowel movements. If you’d like to get started with my virtual or in-person sessions, make an appointment! Or, feel free to schedule a discovery call if you have any questions.