Bowel Issues After Coccyx Injury: Causes and Solutions

Difficulty with bowel movements?

Hello Doctor: I injured my coccyx last year (while stepping on stairs), and since then, I have been experiencing issues with bowel movements.
I often feel a sense of urgency (only feeling the need to go when I am close to the anus), and later on, I always feel like I haven't completely emptied my bowels.
I have a feeling of heaviness in the perineum, and there have been several occasions where I had to apply pressure to the perineal area while straining to have a bowel movement.
Additionally, my stools are often curved (about 90 degrees) or in small pieces.
Once, when I was in a hurry and strained, I even felt a slight stabbing pain in the perineum and vaginal area.
Could this be due to pressure on the intestines from the coccyx, or could it be rectal prolapse? (I found similar information online.) If the intestines are being compressed, should I consult a specialist for the coccyx? Will recovery of the coccyx lead to improvement in my symptoms?

da, 20~29 year old female. Ask Date: 2016/04/15

Dr. Ke Fangxu reply Surgery

First of all, it should not be a rectal prolapse issue, as this condition primarily occurs in the elderly and is caused by prolonged straining during bowel movements combined with weakened pelvic floor muscles.
Your situation may be due to a coccygeal fracture causing bowel irregularities, but it could also simply be constipation.
I recommend increasing your intake of dietary fiber and fluids, and performing pelvic floor exercises (Kegel exercises).
If the symptoms persist without improvement, it is advisable to consult a physician for further evaluation.

Reply Date: 2016/04/15

More Info

Understanding bowel issues after a coccyx injury can be quite complex, as the coccyx, or tailbone, is located at the base of the spine and plays a role in pelvic floor function. When an injury occurs in this area, it can lead to a variety of symptoms, including those affecting bowel movements.
In your case, the symptoms you describe—such as urgency, a sensation of incomplete evacuation, and discomfort in the perineal area—could indeed be related to your coccyx injury. The coccyx is connected to the pelvic floor muscles, which support the pelvic organs, including the rectum and bladder. An injury to the coccyx can lead to muscle spasms or dysfunction in these pelvic floor muscles, which may contribute to bowel issues.

The urgency you experience, where you only feel the need to go when you are close to the toilet, can be a sign of altered bowel function. This can occur due to nerve irritation or muscle dysfunction in the pelvic region. The sensation of incomplete evacuation and the need to apply pressure to the perineum to facilitate bowel movements may indicate that the pelvic floor muscles are not functioning optimally. This can lead to difficulties in coordinating the muscles required for defecation.

Additionally, the fact that your stools are described as bent or in short segments could suggest that there is some form of obstruction or that the stool is not being formed properly, which can also be influenced by diet, hydration, and the overall function of the intestines.
Regarding your concern about whether the coccyx is pressing on the intestines or if you might have rectal prolapse (rectocele), it is essential to consult with a healthcare professional who can perform a thorough examination. Imaging studies, such as an MRI or CT scan, may be necessary to assess the coccyx and surrounding structures. A physical examination by a specialist in pelvic floor disorders can also provide insight into whether there is any dysfunction in the pelvic floor muscles or if there are other underlying issues contributing to your symptoms.

In terms of treatment, addressing the coccyx injury is crucial. This may involve physical therapy focused on the pelvic floor to help strengthen and coordinate the muscles involved in bowel movements. Techniques such as biofeedback therapy can also be beneficial in retraining the pelvic floor muscles. Additionally, ensuring that you maintain a high-fiber diet and adequate hydration can help improve stool consistency and ease bowel movements.

If there is significant pain associated with bowel movements, pain management strategies may be necessary. Over-the-counter pain relievers, such as NSAIDs (non-steroidal anti-inflammatory drugs), can help alleviate discomfort. However, it is essential to consult with a healthcare provider before starting any new medication.

In summary, your bowel issues following a coccyx injury are likely interconnected with the injury itself and the function of the pelvic floor muscles. A comprehensive evaluation by a healthcare professional specializing in pelvic health is recommended to determine the best course of action for your symptoms. Addressing both the coccyx injury and any potential pelvic floor dysfunction will be key to restoring normal bowel function and alleviating your discomfort.

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