Pelvic Floor Dysfunction

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Pelvic Floor Dysfunction

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What is Irritable bowel syndrome?

Irritable bowel syndrome (IBS) is a common disorder that may affect over 15 percent of the general population. It is sometimes referred to as spastic colon, spastic colitis, mucous colitis or nervous stomach. IBS should not be confused with other diseases of the bowel such as ulcerative colitis or Crohn’s disease. IBS is a functional disorder where the function of the bowels may be abnormal but no structural abnormalities exist.

What are the symptoms of IBS?

People with IBS may experience abdominal pain and changes in bowel habits – either diarrhea, constipation, or both at different times. Symptoms associated with IBS include abdominal cramps, fullness or bloating, abnormal stool consistency, passage of mucous, urgency or a feeling of incomplete bowel movements.

What causes IBS?

The symptoms of IBS seem to occur as a result of abnormal functioning or communication between the nervous system and the muscles of the bowel. This abnormal regulation may cause the bowel to be “irritated” or more sensitive. The muscles in the bowel wall may contract too forcefully or too weakly, too slowly or rapidly at certain times. Although there is no physical obstruction, a patient may perceive cramps or functional blockage.

What role does stress play in IBS?

IBS is not caused by stress. It is not a psychological or psychiatric disorder, however emotional stress may contribute to IBS. Many people may experience nausea or diarrhea when nervous or anxious. While we may not be able to control the effect stress has on our intestines, reducing the sources of stress in our lives may help to alleviate the symptoms of IBS.

How can I tell if the problem is IBS or something else?

A careful medical history and physical examination by a colon and rectal surgeon or other physician are essential to exclude more serious disorders. Tests may include blood tests, stool tests, visual inspection of the inside of the colon with flexible sigmoidoscopy or colonoscopy, and x-ray studies. Fever, anemia, rectal bleeding and unexplained weight loss are not symptoms of IBS and need to be evaluated by your physician.

How is an abscess treated?

No. A fistula develops in about 50 percent of all abscess cases, and there is really no way to predict if this will occur.

What about treatment for a fistula?

Surgery is necessary to cure an anal fistula. Although fistula surgery is usually relatively straightforward, the potential for complication exists, and is preferably performed by a specialist in colon and rectal surgery. It may be performed at the same time as the abscess surgery, although fistulas often develop four to six weeks after an abscess is drained, sometimes even months or years later.

Fistula surgery usually involves opening up the fistula tunnel. Often this will require cutting a small portion of the anal sphincter, the muscle that helps to control bowel movements. Joining the external and internal openings of the tunnel and con-verting it to a groove will then allow it to heal from the inside out. Most of the time, fistula surgery can be performed on an outpatient basis. Treatment of a deep or extensive fistula may require a short hospital stay.

How long does it take before patients feel better?

Discomfort after fistula surgery can be mild to moderate for the first week and can be controlled with pain pills. The amount of time lost from work or school is usually minimal.

Treatment of an abscess or fistula is followed by a period of time at home, when soaking the affected area in warm water (sitz bath) is recommended three or four times a day. Stool softeners or a bulk fiber laxative may also be recommended. It may be necessary to wear a gauze pad or mini-pad to prevent the drainage from soiling clothes. Bowel movements will not affect healing.

What are the chances of a recurring abscess or fistula?

If properly healed, the problem will usually not return. However, it is important to follow the directions of a colon and rectal surgeon to help prevent recurrence.