Coccydynia: Can Tailbone Injury Affect Bowel Movements?

Coccyx injury

Hello, doctor.
I would like to ask about an issue I have been experiencing.
Two years ago, I accidentally bumped my coccyx against the corner of a chair, which caused significant pain for a while.
Since then, I have noticed a persistent feeling of incomplete evacuation during bowel movements, as if there is still "a little bit" stuck in the anus that I cannot expel, despite straining.
This issue has not improved; in fact, it has worsened.
I have always had poor gastrointestinal function, so I initially thought it was related to my digestive system and delayed seeking medical attention.
Recently, I have undergone several treatments with traditional Chinese medicine for gastrointestinal issues, but there has been no improvement.
I am now concerned that this might be related to my coccyx injury.
Could a coccyx injury lead to this condition, or is it purely a gastrointestinal issue? How treatable is this? P.S.
This feeling of incomplete evacuation has been ongoing for nearly two years, and it occurs almost every time I have a bowel movement.

A-Dai, 10~19 year old female. Ask Date: 2004/12/16

Dr. Zhou Lizhi reply Orthopedics

Dear netizens,
Coccygeal issues can be categorized into coccyx fractures and dislocations, often caused by direct trauma, particularly from impacts to the area (such as landing directly on the buttocks).
Patients typically experience coccygeal pain and difficulty sitting or standing comfortably, although neurological symptoms are less common.
For those experiencing symptoms, it is advisable to first obtain an X-ray to check for dislocation, especially if there is a sensation of incomplete bowel evacuation.
If this is not the issue, then consideration should be given to potential nerve compression.

Reply Date: 2004/12/16

More Info

Coccydynia, or tailbone pain, can indeed have implications for bowel movements, particularly when there has been a previous injury to the coccyx. Your experience of feeling like you cannot completely evacuate your bowels after a tailbone injury is not uncommon. The coccyx, or tailbone, is located at the base of the spine and plays a role in supporting pelvic organs, including the rectum. When the coccyx is injured, it can lead to changes in how the pelvic floor muscles function, potentially resulting in constipation or a sensation of incomplete evacuation during bowel movements.

Understanding the Connection Between Tailbone Injury and Bowel Movements
1. Pelvic Floor Dysfunction: An injury to the coccyx can affect the pelvic floor muscles and ligaments. These muscles are crucial for proper bowel function. If they are weakened or injured, they may not contract and relax effectively, leading to difficulties in bowel movements.

2. Nerve Impingement: The coccyx is closely associated with the sacral nerves, which innervate the pelvic region. If there is swelling or structural changes in the area due to the injury, it could potentially irritate or compress these nerves, leading to altered bowel function.

3. Psychological Factors: Chronic pain can also lead to anxiety or stress around bowel movements, which can further complicate the situation. This can create a cycle where the fear of pain during bowel movements leads to constipation.

Treatment Options
Given that your symptoms have persisted for two years, it is advisable to seek a comprehensive evaluation from a healthcare provider, preferably a gastroenterologist or a pelvic floor specialist. Here are some potential treatment avenues:
1. Physical Therapy: Pelvic floor physical therapy can be beneficial. A specialized therapist can help strengthen the pelvic floor muscles and improve coordination, which may alleviate some of the symptoms.

2. Dietary Changes: Increasing fiber intake and ensuring adequate hydration can help improve bowel regularity. Foods rich in fiber, such as fruits, vegetables, and whole grains, can facilitate smoother bowel movements.

3. Medications: Over-the-counter laxatives or stool softeners may provide temporary relief. However, it is essential to use these under the guidance of a healthcare provider to avoid dependency.

4. Pain Management: If pain is a significant factor in your bowel issues, addressing the pain through medications or other therapies may help improve your overall bowel function.

5. Surgical Options: In rare cases, if conservative measures fail and the coccyx is significantly impacting quality of life, surgical intervention may be considered. However, this is typically a last resort.

Monitoring Your Condition
It is crucial to monitor your symptoms closely. If you notice any worsening of your condition, such as increased pain, changes in bowel habits (like blood in the stool or severe constipation), or new neurological symptoms (like numbness or weakness in the legs), you should seek medical attention promptly.

Conclusion
In summary, your tailbone injury could indeed be contributing to your bowel issues, and it is essential to address both the physical and psychological aspects of your condition. A multidisciplinary approach involving dietary changes, physical therapy, and possibly medical treatment can help improve your symptoms. Consulting with healthcare professionals who specialize in pelvic health will provide you with the best chance for recovery and relief from your symptoms.

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