Patient Education and Behavior Modification

Many misconceptions can be dispelled as patients gain a better understanding of their disorder. This education begins with reviewing the anatomy of the pelvic floor musculature and discussing normal bowel and bladder function with the use of visual aids. This exchange is followed by reassurance that irregular bowel habits and other defecatory symptoms are common in the healthy general population. Patients may exhibit

Figure 13.8. Channel 1: sEMG tracing of the PFM during a Valsalva maneuver. Note the decreased muscle activity.Channel 2:Abdominal sEMG tracing.

Table 13.5. Surface electromyography pelvic muscle rehabilitation treatment goals

Short-term goals

Reinforce pelvic floor muscle contractions isolated from abdominal and gluteal contraction Reinforce pelvic floor muscle contractions toward greater amplitude and duration to improve strength and tone Improve the coordination of pelvic floor muscle by shaping pelvic floor muscle contractions with short repose latency and immediate recovery to baseline after voluntary contraction ceases Reduce chronically elevated pelvic floor muscle activity if implicated in perineal muscle pain, voiding dysfunction, or associated bowel disorders Reduce straining pattern by reinforcing pelvic floor relaxation during defecation or micturation To generalize skills learned in the office to the home situation Long-term goals

Decrease laxative, enema, or suppository use Increase number of spontaneous bowel movements Decrease frequency of incontinent episodes Improved symptoms of incomplete evacuation Decreased straining a variety of behavioral patterns. Some patients feel they need to have daily bowel movements and resort to laxative and enema misuse. Some patients may make several daily attempts straining to evacuate, while others may postpone the urge or make hurried attempts for convenience. Another frequently observed behavioral pattern, common among elderly women with symptoms of urinary incontinence, is the restriction of fluid intake to avoid leakage; in fact, this may worsen symptoms of constipation as well as symptoms of urinary incontinence. Reviewing a daily record of bowel habits guides the clinician to tailor education specifically to the underlying functional disorder.

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Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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