The Effect of Pelvic Floor Muscle Training in Functional Constipation

The Effect of Pelvic Floor Muscle Training on Symptoms, Core Muscle Function, and Quality of Life in Functional Constipation

The aim of this study is to examine the effect of individualized pelvic floor muscle training on symptoms, core muscle function, and quality of life in patients with functional constipation.The research is being conducted at the Department of Internal Medicine, Gastroenterology Division, Faculty of Medicine, Ege University.The study group received diaphragmatic breathing exercises, lifestyle modification training, and individualized pelvic floor muscle training, while the control group received diaphragmatic breathing exercises and lifestyle modification training. These treatments were applied to the patients for 8 weeks. Demographic information was recorded using a data record form. Frequency of bowel movements, stool types and shapes were assessed using the Bristol Stool Scale, muscle function using superficial electromyography (EMG), quality of life using the Constipation Quality of Life Scale, and severity of constipation using the Constipation Severity Scale. All assessments were repeated at weeks 4 and 8.

Inclusion Criteria:

• Female cases diagnosed with functional constipation (according to ROMA IV criteria)
• Over 18 years of age and under 70 years of age
• According to ROMA IV criteria:
• Onset of symptoms at least 6 months prior to diagnosis, and experiencing any two or more of the following symptoms in the last 12 weeks (not necessarily consecutive): a) straining during at least 25% of defecations, b) hard stools in at least 25% of defecations, c) feeling of incomplete bowel movements in at least 25% of defecations, d) feeling of anorectal blockage/obstruction in at least 25% of defecations, e) needing to empty the rectum (supporting the pelvic floor muscles), and f) fewer than three bowel movements per week
• Very rare achievement of soft stools without laxative use
• Having insufficient criteria for irritable bowel syndrome,
• Ready to write in Turkish
• Cases who have signed the informed consent form will be included in the study.

Exclusion Criteria:

• Patients with secondary constipation (metabolic, endocrine, and neurological)
• Patients with slow transit constipation
• Patients with major orthopedic limitations that may affect the study
• Patients with megacolon, pseudo-obstruction, and severe anorectal disorders (Grade 3-4 hemorrhoidal disease, anal fissure, anal fistula, anorectal abscess, pilonidal sinus, etc.)
• Patients who have undergone pelvic floor surgery, coloproctological surgery, bridileus surgery, or similar major abdominal surgery (excluding appendectomy)
• Patients with drug-induced constipation
• Patients with any serious systemic disorder including heart, lung, gastrointestinal system, or uncontrolled diabetes mellitus
• Patients with cognitive difficulties that would hinder the conduct of the study (Mini Mental Test score <24)
• Patients with major psychiatric problems that may affect the study
• Pregnant patients will be excluded.