The Rehabilitation of Individuals With Gastrointestinal Issues Beyond Pelvic Floor Muscle Function: Considering a Larger Picture for Best Practice

Abstract

Pelvic health physical therapy's primary role in gastroenterology-related care has been primarily viewed as biofeedback therapy of the pelvic floor muscles in the medical literature; however, emerging research suggests that expanding this role toward a whole-body approach may be optimal. Common gastroenterology-related referrals to pelvic health physical therapy include chronic constipation, fecal incontinence, levator ani syndrome, and mixed presentations of those mentioned previously. Many of these common referral diagnoses fall under the umbrella of disorders of gut-brain interaction (DGBIs) and have associated impairments involving multiple bodily systems. Pelvic health physical therapists have a robust knowledge of multiple bodily systems and are well-positioned providers for individuals with DGBIs as part of an interdisciplinary team and can incorporate an expanded plan of care outside of direct pelvic floor muscle interventions for best practice. Additional components of a plan of care for individuals with DGBIs that the following article reviews include the incorporation of physical activity and targeting cardiopulmonary measures, mental health considerations, and nutrition-based advice.