A disturbed gut flora produces symptoms that end up in the lowest segment: bloating, excess gas, alternating constipation and loose stools, urgency and burning around the anus. Frequent bowel movements and changing stool consistency irritate the skin and mucosa, and pain entrenches a reflex tightening of the sphincters.
That tension stays long after the gut settles down - and then becomes a cause of symptoms in its own right: it obstructs emptying, produces pain and favours fissures and enlarging haemorrhoids.
Treating the dysbiosis itself is not physiotherapy - investigation, diet and any medical treatment belong to a gastroenterologist and a dietitian, and that is where I refer. Physiotherapy deals with what the dysbiosis has done to the pelvic floor and the anal area, and with making sure the way you empty your bowel is not adding to the problem.
Therapy
- History: bowel rhythm, bloating, previous courses of antibiotics
- Functional examination of the pelvic floor and sphincters
- Releasing an overactive pelvic floor
- Visceral therapy and work on the abdominal fascia
- Learning to empty the bowel without straining despite changing stool consistency
- Breathing and diaphragm work
- A home programme