Overcoming Anal Sphincter Tension and Weakness: Tips for Relief

The discomfort of tightness and weakness in the anal sphincter?

Hello Dr.
Lee, for the past six months, I have been suffering from "tightness and weakness of the anal sphincter" during bowel movements.
To describe it, it's like trying to push open a door with one hand; on one side, my hand feels weak, and on the other side, the door is tightly shut.
I did some research online and found out that straining too hard can lead to anal fissures.
The causes of this condition may include lack of exercise and insufficient water intake.
I usually drink water, but I really don't exercise.
If I increase my exercise level, will it help improve this situation? Or do you have any other suggestions? Thank you.
PS: The stools I pass are still soft, so it shouldn't be due to constipation.

Xiao Zhi, 20~29 year old female. Ask Date: 2011/11/13

Dr. Li Yongming reply Gastroenterology and Hepatology

Hello, are you referring to the sensation of urgency to defecate but being unable to do so? This is what traditional Chinese medicine describes as "interior urgency with a feeling of heaviness." Conditions such as colorectal polyps or tumors occurring in the sigmoid colon or rectal area may present with such symptoms.
Additionally, patients with irritable bowel syndrome (IBS) may also experience this, which is related to issues with gastrointestinal neuromuscular coordination.
Therefore, a colonoscopy is necessary to rule out organic lesions (such as early-stage cancer).
As for the relationship between IBS and stress, there are currently medications available for treatment; however, this falls under "diagnosis by exclusion." Please visit a gastroenterology clinic for further evaluation and management.

Reply Date: 2011/11/13

More Info

Overcoming anal sphincter tension and weakness can be a challenging issue, but there are several strategies that may help alleviate your symptoms. Based on your description, it seems that you are experiencing a combination of tension and weakness in the anal sphincter, which can indeed lead to discomfort and difficulty during bowel movements. Here are some insights and recommendations that may assist you in managing this condition.

Understanding the Condition
The anal sphincter consists of two main muscles: the internal and external anal sphincters. These muscles work together to control bowel movements. When there is tension in these muscles, it can lead to a feeling of tightness or inability to relax, making it difficult to pass stool. Conversely, weakness in these muscles can lead to incontinence or difficulty maintaining control.
Your mention of soft stools suggests that constipation is not the primary issue, which is a positive sign. However, the tension you are experiencing may be related to various factors, including stress, anxiety, or even habitual muscle tension.

Recommendations for Relief
1. Increase Physical Activity: Regular exercise can improve overall muscle tone and promote better bowel function. Activities such as walking, swimming, or yoga can help reduce tension in the pelvic area and improve circulation. Aim for at least 30 minutes of moderate exercise most days of the week.

2. Pelvic Floor Exercises: Strengthening the pelvic floor muscles can help improve sphincter control. Kegel exercises, which involve contracting and relaxing the pelvic floor muscles, can be particularly beneficial. To perform Kegels, identify the muscles you would use to stop urination, contract them for a few seconds, and then relax. Repeat this several times a day.

3. Relaxation Techniques: Stress and anxiety can contribute to muscle tension. Incorporating relaxation techniques such as deep breathing, meditation, or progressive muscle relaxation can help reduce overall tension in your body, including the anal sphincter.

4. Hydration and Diet: While you mentioned that you drink water regularly, ensure that you are consuming enough fluids throughout the day. A well-hydrated body can help maintain softer stools and promote regular bowel movements. Additionally, a diet rich in fiber (fruits, vegetables, whole grains) can help support digestive health.

5. Warm Baths: Taking warm baths can help relax the anal sphincter and reduce tension. You might consider sitting in a warm bath for 15-20 minutes to help soothe the area.

6. Avoid Straining: When using the bathroom, try to avoid straining. If you feel the urge to go, respond to it promptly. Consider using a footstool to elevate your feet while sitting on the toilet, which can help align your body for easier bowel movements.

7. Consult a Specialist: If your symptoms persist or worsen, it may be beneficial to consult a gastroenterologist or a pelvic floor specialist. They can provide a thorough evaluation and may suggest additional treatments, such as biofeedback therapy or physical therapy focused on the pelvic floor.

Conclusion
In summary, increasing your physical activity, practicing pelvic floor exercises, managing stress, and maintaining proper hydration and diet can all contribute to alleviating anal sphincter tension and weakness. Remember that it may take time to see improvements, so be patient with yourself as you implement these changes. If your symptoms continue to be bothersome, seeking professional medical advice is always a prudent step.

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