Who Needs Rectal Dilation?

Perhaps you’ve heard of vaginal dilation before, but what about rectal dilation? Rectal dilation (also called anal dilation) isn’t a treatment used only in rare cases or just after surgical procedures. It can actually be very useful for a wide range of needs and conditions, no matter your genitals or gender. 

After all, everyone has a pelvic floor! The pelvic floor refers to a group of muscles within your pelvis that is responsible for supporting your pelvic organs, posture, stability, and things like urinary, bowel, and sexual function.

When things go wrong with the pelvic floor, these daily functions can be significantly restricted. Constipation, pelvic pain, incomplete bowel emptying, painful sex, painful urination, and many other issues can be caused by pelvic floor problems—known as pelvic floor dysfunction.

This is where dilation comes in! Dilation gently stretches and mobilizes the tissues of your pelvic floor, as well as other areas depending on whether you are dilating vaginally or rectally. Of course, for this post, we’re focusing on rectal dilation!

Rectal dilation not only helps encourage better function for your pelvic floor, but it can also support better tissue flexibility and reduce tension in your rectum and anus.

These effects allow your bowel movements and other pelvic floor functions to be smoother and painless! So if you’re wondering who needs rectal dilation or what kind of conditions can be treated with it, the answer is that this treatment is actually suitable for a lot of different needs.

Below, we’ll explore many different conditions, symptoms, and needs that can be addressed with rectal dilation! If you don’t see your problem listed below, don’t worry. A pelvic floor therapist like myself can help determine if dilation is a good fit for you.

To get started with dilation and pelvic floor treatment for your unique needs, book an appointment with me!

As mentioned before, everyone has a pelvic floor; and unfortunately, many things can go wrong with this part of the body. These muscles can become weak, tight, inflexible, uncoordinated, or even all of the above.

These problems can create a multitude of bowel-related conditions and symptoms. For example, when the pelvic floor muscles have too much tension, it can cause symptoms like constipation, incontinence, hypersensitivity, or muscle spasms in the rectum. These problems can be painful, inconvenient, and disruptive to daily life.

Pelvic floor tension can also affect the pudendal nerve, which is an important nerve for both function and sensation for your genitals and anus. When this nerve becomes irritated or compressed, it can lead to painful bowel movements, constipation, painful sex, erectile dysfunction, and more.

For some, pelvic floor overactivity can be a major cause of these symptoms. Pain guarding, chronic clenching, fear of exams, or poor toilet habits can significantly worsen pelvic floor tension. Luckily, there are treatments that can help reduce this tension and relieve your symptoms—including dilation!

Dilation can gently and effectively relieve tension found in the pelvic floor muscles, anus, and rectum. It can be a great way to manage pelvic floor tension and other forms of pelvic floor dysfunction, especially when integrated into a comprehensive physical therapy care plan.

Now that you better understand how the pelvic floor works and why it may cause a variety of symptoms, you’ll have a better understanding of why dilation can support the rest of the conditions on this list, too!

Constipation may seem like a simple condition, but there are actually a few different types of constipation that can be caused by a variety of factors. These different types of constipation can cause a variety of symptoms, too. 

Different types of constipation can have different treatment options. The consistency of your stool, the frequency of your bowel movements, how complete these movements are, and the level of straining with each movement are all factors considered with constipation. 

Remember how we mentioned pelvic floor dysfunction earlier?

For some individuals, constipation can be caused or worsened by problems with the pelvic floor muscles. This is referred to as dyssynergic defecation—a condition where the pelvic floor muscles cannot coordinate, therefore resulting in constipation and impacted bowels.

When an individual cannot coordinate their muscles properly, making a bowel movement can prove difficult. For those struggling with muscle spasms, tight pelvic floor muscles, anal fissures, hemorrhoids, or painful bowel movements as a result of these conditions, rectal dilation may be recommended. 

Those who feel like their stool (poop) is getting “stuck” or who need to use a splint to empty their bowels are other good candidates for dilation.

Dilation can help relax and gently stretch the dysfunctional pelvic floor muscles that are restricting bowel movements. This can include relaxing both the rectum, which may be constricted and too tight to allow fecal matter to pass easily, and the sphincter muscles, which may not be relaxing or responding enough to allow for a bowel movement.

Dilation may help assist those with slow transit constipation too, as tight pelvic floor muscles can often slow gastrointestinal motility. If you struggle with constipation often, ask your provider or consult with a pelvic floor physical therapist to see if dilation may be a suitable option for your symptoms!

Problems with the pelvic floor aren’t limited to bowel troubles. These muscles play a very important role in arousal, sexual function, and appreciation, too. When the pelvic floor is in good health, it allows for painless, smooth, and pleasurable sex. 

These muscles need to be strong, flexible, and mobile to allow for vaginal or anal penetration—even in non-sexual situations, such as with exams or suppositories. 

When there is pelvic floor dysfunction present, insertion or penetration can be painful. Additionally, tension in the pelvic floor can contribute to other forms of sexual dysfunction, such as erectile dysfunction.

Those experiencing pain with anal sex, pain with other forms of insertion, or sexual dysfunctions such as erectile dysfunction should consider seeking pelvic floor therapy. Dilation can be used as a part of your overall physical therapy treatment to reduce tension and improve coordination of your pelvic floor.

Dilation can also help individuals prepare for sex by relieving pain, reducing the risk of injury, improving arousal, and supporting better sexual appreciation overall.

It may be surprising to hear that pelvic floor dysfunction can cause bodily pains. You’d probably expect it in the pelvis, but did you know it can also affect your hips, lower back, and tailbone, too?

This is because the pelvic floor is very interconnected with many areas of the body. It works together with other muscles and structures to support your daily movements, weight, balance, and other functions. When you climb stairs, play sports, lift items, or even just stand and sit, your pelvic floor is supporting you each time!

Unfortunately, things like poor posture, poor form, prolonged sitting or standing, harmful restroom habits, or muscle imbalances can affect your pelvic floor and cause straining, tension, or tightness.

Pelvic floor tension can cause significant pain to many areas of the body, and can become chronic if not addressed properly.

A physical therapist can properly identify the root of your body pains and provide treatment with a variety of methods. For those struggling with pelvic floor tension, dilation can be a fantastic supportive treatment to reduce pain and encourage better pelvic floor control.

Fissures and hemorrhoids are both conditions relating to pain around the anus or rectum…

Fissures are small, painful tears found at the anal opening, or in some cases the lower portion of the rectum. These are usually caused by the passing of hard stool, straining, and constipation.

Hemorrhoids are swollen blood vessels found near the anus or within the rectum. They can be painful, and are typically caused by excessive straining, poor body positioning on the toilet, or sitting on the toilet for extended periods of time (longer than 10 minutes).

These two conditions are not usually severe, and can often be resolved with lifestyle changes. However, in some cases these conditions can be chronic and recurring. Anal fissures or hemorrhoids that are caused by difficult bowel movements, constant straining, and pelvic floor tension may benefit from dilation.

The root cause of these issues will determine the appropriate treatment. Dilation is usually recommended if these conditions occur as a direct result of pelvic floor tension and difficult bowel movements. In this case, dilation can serve to provide relief from tight, tense muscles and allow for easier bowel movements.

If you are considering dilation, be sure to consult with a professional to ensure safe and effective treatment!

A rectocele is a type of pelvic organ prolapse that occurs in those born with a vagina or individuals who are post-vaginoplasty. It occurs when the tissue that separates the rectum and vagina weakens, and so the rectum begins to fall or bulge into the back vaginal wall.

Pelvic organ prolapse can range in severity. In some cases, a rectocele can prevent the regular passage of stool through the rectum. This can cause incomplete bowel movements, the need for assistance during bowel movements (splinting), incontinence, and general discomfort.

The good news is that pelvic floor physical therapy can provide significant support and management of pelvic organ prolapse symptoms, especially in milder cases.

Treatments such as dilation can help individuals better understand their pelvic floor muscles, which can aid in pelvic floor coordination, strengthening, relaxation, and other techniques that aim to better manage and prevent progression of pelvic organ prolapse.

Levator ani syndrome refers to a condition characterized by sudden pain in your rectum or vagina. This sudden pain is caused by muscle spasms of the levator ani muscles, which may be a result of tension or a lack of pelvic floor control—though the exact cause of levator ani syndrome has yet to be determined.

The levator ani muscles make up a large portion of your pelvic floor. They are found around the openings of the vagina, urethra, and anus. They are part of what allows you to make bowel movements and control the continence of your bowels.

Rectal dilation can be effective in managing symptoms of levator ani syndrome by reducing tension and improving control over your pelvic floor. Relieving pelvic floor tension will reduce muscle spasms, and regaining control over your pelvic floor can help minimize a relapse of this condition.

Other forms of pelvic floor therapy treatment may be necessary to relieve levator ani syndrome, so if you suspect you are struggling with this condition, don’t hesitate to seek physical therapy.

Proctalgia fugax is a condition that causes a sudden sharp pain in the anus that lasts anywhere between a few seconds and a few minutes. It is recurring, often happening multiple times over the course of several weeks or months. The pain can be severe and may occur at random during the day or night.

This condition can be caused by a variety of factors, some of which include nerve irritation (specifically the pudendal nerve) and muscle spasms—two things that can be created or exacerbated by pelvic floor dysfunction. 

As with many of the other conditions described above, rectal dilation can help relieve this tightness, encourage better pelvic floor control, and support overall pelvic floor health to reduce your pain and symptoms. 

In fact, pelvic floor physical therapy is often one of the main treatments for this condition, so be sure to work alongside a pelvic floor physical therapist for the best and most effective treatment experience.

Many different experiences in life can influence the pelvic floor and impact its mobility, function, and overall health. Practically anything that involves the pelvis can affect your pelvic floor, including:

• Childbirth (both vaginal delivery and cesarean)
• Pelvic surgeries like prostatectomy, hysterectomy, pelvic organ prolapse surgery, etc. 
• Cancer treatments such as radiation
• Pelvic injury or trauma
• And more

Any of these scenarios can result in a weakened pelvic floor, muscle tension, scar tissue restrictions, and a lack of coordination in these important muscles.

Pelvic floor physical therapy will be extremely beneficial and in many cases essential to restoring normal function and sensation after any of the above-listed situations. For many individuals, rectal dilation can encourage normal, painless bowel movements post-surgery or treatment.

In some cases with surgery or conditions such as Crohn’s disease and inflammatory bowel disease, anal stenosis may become a concern. Anal stenosis is the narrowing of the end of the rectal canal and the anal opening. This can make bowel movements difficult and may cause symptoms of constipation or impaction. 

Rectal dilation can be very suitable for these situations. It will reduce tension associated with stenosis and allow for normal function during bowel movements. For some conditions and situations, rectal dilation may even be recommended by your provider. 

Rectal dilation can play a significant role in pelvic floor health and is suitable for a wide range of needs, as you can see above! However, dilation is not always simple or as easy as it seems. 

Inserting these tools safely, moving up in size effectively, choosing dilators and lubricant, and practicing pelvic floor exercises during the process can be difficult without guidance. Additionally, by working with a pelvic floor therapist like myself, you’re more likely to experience effective results and have a lower risk of relapse.

While working with me, you can expect a comprehensive treatment experience where I identify the root cause of your symptoms and curate a plan just for your needs! Dilation can be a fantastic form of treatment, but it may not be the only treatment you need.

You’ll have better results by engaging in other treatments like manual therapy, exercise, behavioral modifications, neuromuscular re-education, and more.

If you’d like to get started and see if dilation is right for your needs, book an appointment with me! Those who have appointment or treatment-related questions can try a free discovery call.