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Looking for advice regarding pelvic floor therapy.

I’ve had my pouch for 10 years and have learnt to manage flare ups of pouchitis and cuffitis, meaning that on the whole my pouch has been okay.

However last year I began getting pain and difficulty emptying, the feeling also felt new to me and didn’t respond to any of my usual go to treatments. Initially I thought this was a stricture, though this has been ruled out by my consultant. I’ve had two recent pouchoscopy which have both come up clear, but I still have daily pain and difficulty emptying, leaving me to think it was a muscular issue.

I was reading today on pelvic floor therapy and was alarmed by how many symptoms I have that can be contributing factors to pelvic floor trauma (especially chronic cough, I had pneumonia in March from where my problems escalated and haven’t recovered)

Has anyone had success with pelvic floor therapy? I’m also based in London, I’d be interested to know if there are any recommended specialists in the area.

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After having surgery #1 (With an external bag to capture the waste).  No problem. The pouch was actually connected to my anus. So with the help of a Physical Therapist that specializes in those things. She was able to inset a balloon up into my pouch and my goal was to force it out.  Which after practicing I did.

Fast forward to the take down.  It is often hard to get the pouch completely empty unless I want the stool to be almost all watery. If it's the right consistency, it's a struggle. She gave me a very good tip.  Before you try to go. get on your hands and knees on the bed or floor. Then get your bum as high as you can. This will make any gas float to the top.  Then when you go the gas helps push things out and you know you're empty when the stool stops coming out and you hear a fart.  It's not 100% but works most of the time.

Last edited by Eric in Seattle

Hi LFlower,

I just had a session of pelvic floor therapy yesterday. I am in Seattle (like Eric, who responded).  I had not heard of it contributing to pouch emptying, but my GI doctor mentioned it recently to me. I don't think I have troubles with pouch emptying, but I went through a bout of pouchitis a few years back. Now I am fine, but my GI doctor thinks that pouchitis may be linked to inadequate emptying of the pouch, and therefore pelvic floor exercises may help. It might be good for you to see a physical therapist who specializes in pelvic floor training. Be aware that the therapist will insert a gloved, lubed finger into your vagina to assess your pelvic floor muscles---how well you contract and how well you relax. The other item my GI doctor mentioned to me to facilitate pouch emptying is to purchase a small toddler's step stool (the kind that helps toddlers get to the sink) and put your feet on it while sitting on the toilet. This raises the knees a bit and gets you into more of a squatting position to better empty the pouch. I have not tried this yet. Lastly, I think Eric's suggestion is worth a try---use gas as a natural power source to get stool out! I never really thought about that before.  I hope some of these suggestions will help you. 

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