Exercises that strengthen and tighten the anal sphincter may help treat bowel incontinence (fecal incontinence) and can reduce the chance of leaking stool or gas in the future. The anal sphincter is made up of a thick band of muscle. It surrounds the anal entrance and can be opened and closed.
The anal sphincter holds stool in the body until it is ready for defecation. These muscles can be strengthened through exercise.
Bowel control problems are surprisingly common. It affects 36% of adults in the United States (though it is thought that this number may be higher). Unfortunately, many people are unaware that simple exercise can improve bowel control and overall quality of life.
This article discusses the anal sphincter, the causes of fecal incontinence, and what you can do to strengthen it. It also explains how your health care provider can help you.
fecal incontinence
Anatomy of the anal sphincter
Understanding the muscles that control the anal sphincter and what they do will help you understand the strengthening exercises you can use to tighten your anal muscles. The anus has two muscular rings: the internal anal sphincter and the external anal sphincter.
female anal sphincter
internal anal sphincter
The internal anal sphincter is an inner ring of muscles and is an involuntary muscle, so it cannot be controlled consciously. Like the beating heart and diaphragm, this muscle works every second of the day without thinking about its function.
The internal sphincter is programmed to remain closed. This is why most adults do not pass stool during sleep.
external anal sphincter
The outer ring of muscles around the anus is the external sphincter. This is a voluntary muscle that can be controlled to close tighter. Training and strengthening these muscles will help you maintain control of your bowel movements.
pelvic floor muscles
Organs in the lower pelvis, such as the bladder and colon, are supported by a large group of muscles called the pelvic floor muscles. Pelvic floor muscles work with the anal sphincter muscles to help prevent gas and stool from leaking.
This is a muscle that tightens tightly when you have persistent diarrhea and there is no toilet nearby. Similarly, these muscles also help control urine flow and bloating (gas).
causes of incontinence
As we age, the tone of the pelvic floor muscles decreases, which can lead to bladder and fecal incontinence. Weakness can also occur in young people.
It can begin with less control over the passage of gas than usual. Or you may leak small amounts of urine or stool when you sneeze or stand up suddenly. However, it can progress to the point where you lose complete control of your bladder and bowels.
Factors that cause fecal incontinence include:
Before doing anal sphincter exercise
If you’re having trouble with gas or stool leakage, it’s important to talk to your health care provider first. Emerging health issues like this need to be constantly evaluated. In addition to a physical exam and symptom questions, your health care provider may order tests such as: Electromyography (electromyogram) or ultrasound examination.
First, talk to your health care provider.
There are many treatable conditions that can cause fecal incontinence. In these cases, simply tightening your pelvic floor muscles through exercise will not be effective. It may even prevent proper treatment of the underlying disease.
How to train your anal muscles
If you do not have a medical condition or functional problem that causes fecal incontinence, you can tighten your anal sphincter and pelvic floor muscles in the privacy of your home. Just a few minutes of exercise each day is enough. Kegel exercises, which consciously tighten your pelvic floor muscles, have been around for decades and are very easy to do.
If you’ve ever stopped your urine flow or consciously held up gas, you’ve probably already done Kegels. Women may have been advised to do Kegel exercises after giving birth.
The key to Kegel exercises is to know: which one muscles that contract. This is the same muscle group used to stop the flow of urine. One way to tell which muscles are involved is to start and stop the flow of urine and feel which muscles contract.
Men may feel their muscles differently than women. Most men report feeling tightness around the anus, while many women feel a tug when they get close to the vagina.
How to do Kegel exercises
Kegels can be practiced standing or lying down. However, if you are a beginner, it may be helpful to try the exercise while sitting on a firm chair.
- You don’t want to work these muscle groups, so relax your abdomen and buttocks.
- Spread your legs slightly.
- Consciously tighten your anus and pelvic floor muscles, as if you were trying to stop yourself from urinating.
- Press and hold for 3 seconds.
- Please release your hand slowly.
- Repeat as many times as you can, up to 10-15 times.
It may be easier to understand if you think of these muscles as elevators. If you contract (squeeze) them, the elevator will slowly rise to the top. Gently relax your muscles and imagine the elevator returning to ground level.
Gradually increase these exercises to three times a day. No one needs to know that you’re training your pelvic floor muscles. You can do Kegels while sitting at your desk, or you can wait in your car at a traffic light.
Strengthening muscles takes time
If you’re doing the exercise correctly, you should actually feel your pelvic floor muscles lift. Contracting these muscles for 10 to 15 repetitions may be difficult, but it gets easier as muscle tone improves. If you repeat the exercise several times each day, you should see improvements in just a few months.
It’s important to be patient when trying to strengthen your muscles. If you’ve ever tried to get in shape faster by doing too much weight training or running too many miles, you know that rushing the process can backfire.
Don’t overdo it. In this case, more is not necessarily better. In fact, these muscles can become fatigued and cause temporary incontinence.
When reinforcement is not enough
If pelvic floor muscle weakness is not due to irreversible damage (such as a complete spinal cord injury), many people improve with these exercises, and for some the problem disappears completely.
Some people find that their symptoms never go away. In this case, there are other options to treat fecal incontinence.
physical therapy
If you haven’t noticed an increase in the strength of your anal sphincter muscles, it’s important to make sure you’re doing the exercises correctly. Your health care provider may refer you to a physical therapist to help you. It is important to find a therapist who has experience treating people with pelvic floor muscle dysfunction.
In a 2018 study, supervised Those who performed pelvic floor muscle training (that is, those who worked with a physical therapist) were five times more likely to report improvement in fecal incontinence than those who performed the exercises on their own.
biofeedback or electrical stimulation
Biofeedback is a technique used to learn how to control the body’s functions. During this treatment, you are connected to electrical sensors. The sensors provide your health care provider with information about your body so they can guide you while you exercise.
A 2015 study found that pelvic floor physical therapy combined with biofeedback was more effective than pelvic floor muscle exercises alone. Furthermore, when he added electrical stimulation (sacral nerve stimulation) to these two treatments, the effects were further improved.
summary
The anal sphincter is a band of muscle that surrounds the entrance to the anus. It is responsible for holding stool in the body until it is ready for defecation.
Bowel incontinence, also known as fecal incontinence, is a common problem. It occurs when stool or gas leaks. Your health care provider can help determine the cause of your incontinence. We may suggest doing Kegel exercises or trying other therapies such as biofeedback or electrical stimulation to treat fecal incontinence to strengthen your anal sphincter muscles.