Straining While Defecating? Constipation and Perineal Descent

Have you been ‘pushing yourself’ in the bathroom lately? There are several reasons why we’re not meant to strain when making a bowel movement — herniation, prolapse, hemorrhoids and today’s focus: perineal descent.

Though your perineum (the strip between your genitals and anus) might just seem like a few inches of flesh, it’s an integral part of your pelvic floor. The membranes and muscle that make up the area help control bowel continence and keep adjoining organs below the belt in their place. When you strain in the bathroom, you’re placing unnecessary pressure on your perineum, and over time this pressure can lead to weakening of the pelvic floor. What’s worse—perineal descent is a gradual process that runs on self perpetuation. A common symptom associated with this condition is chronic constipation. Further constipation can lead to further straining, which leads to deeper severity of the descent.

Once perineal descent is diagnosed, treatment options vary by degree of severity. If issues are caught early enough, the solution may be as simple as massaging the muscles back into place combined with complementary physical therapy. For more advanced cases, surgeries like a da Vinci Sacrocolpoperineopexy or posterior vaginal allograft placement will be performed to put everything back in place. The type of surgery we’ll perform will depend on how many other pelvic floor organs have been displaced along with the perineum.

Because perineal descent is so closely tied to bowel movement health, no matter what procedures or therapies our surgeons perform, we’ll always recommend a few things to keep things a bit smoother going forward. Make sure that you’re:

• Adjusting your diet to include more fiber from grains, fruits, and vegetables
• Drinking the recommended amount of water per day for your weight and activity level
• Squatting deeply for bowel movements—including getting a toilet stool for your home
• Keeping a daily bowel regimen a majority of the time

If you think you’re experiencing perineal descent, don’t hesitate to schedule a free consultation. Our specialists are here to help you diagnose, treat, and get back on your feet.