Rectocele: Yet Another Reason to Do your Kegels
Minor symptoms of the condition Rectocele or perhaps just the fear of Rectocele is the reason I decided that it’d be beneficial for me to upgrade from my regular Kegel exercises (with no product) to a set of Kegel balls.
There’s an abundance of articles on Kegel products and why Kegels are important, and they are all very well-done, so I am not going to focus so much on that as I am the actual condition called Rectocele.
Rectocele is a form of prolapse. It’s also called “rectal prolapse.” Prolapse is where an organ “falls” or slides forward or down. Basically, what happens with Rectocele is your rectum descends towards the vaginal opening where it often protrudes. It can also protrude out of the anus, especially in men who have Rectocele, which is rarer than for women.
You may have an idea of why Rectocele is not commonly discussed in everyday life. It’s not something people like to share about, but I feel compelled to.
Note: Cystocele is a similar, but separate condition where the bladder “drops” and the “bulge” is present from the anterior wall. Cystocele can also protrude from the vagina.
Symptoms of Rectocele
Of course, there are early, middle and late stages of Rectocele, and there are minor cases, mild cases and severe cases of the condition.
Some doctors have said that it’s possible for many females to have Rectocele and remain asymptomatic, while for others, symptoms can be seen and felt.
Someone with mild Rectocele may experience these symptoms
Note: One can have a combination of all symptoms, some of the symptoms or none. Those listed in the “mild” and “severe” lists are just the typical symptoms for severe or mild Rectocele. It doesn’t mean mild Rectocele can’t have symptoms listed in the severe section and vice-versa. For instance, I would definitely be considered to have mild, if even that, but I have also experienced a few symptoms from both the “severe” list and the “mild” list.
- A sensation of pressure in the vagina or rectum.
- A sensation of incomplete bowel movements.
- A slight bulge of the posterior vaginal wall, not necessarily large or protruding.
- Bulge becomes larger or protrudes with straining.
- A feeling of tone loss in the vagina. Some people describe it as a feeling of “looseness” or “less “tight.”
- Rectal pain.
Someone with severe Rectocele may experience these symptoms
- Fecal incontinence.
- Prolapse — the “bulge” can protrude from the vagina.
- A feeling of tone loss in the vagina. Some describe it as a feeling of “looseness” or less “tight.”
- Rectal pain.
- Lower back pain that can be relieved once you lie down.
Ever since my early high school years, if not sooner, I had one of the symptoms of Rectocele — “the bulge,” which I’ll explain momentarily — but of course, I didn’t know it was a symptom of anything. I didn’t even know something like rectal prolapse was possible. So I thought nothing of it until one day, online, I managed across a website where someone mentioned having a “bulge” on the posterior wall of the vagina (the “back wall”) and the need to apply pressure, usually with a finger to this bulge felt inside the vagina in order to have or complete a bowel movement.
I know, you probably didn’t want to read that, but I can assure you, I wanted to say it even less. There’s even a term for it, “splinting.” Splinting is apparently common for women who have Rectocele as well as for those who are just trying to speed things along.
Reading that completely clicked with me. I thought “That sounds similar to me!” I panicked. While that description of this condition I’d never heard of called “Rectocele” resonated with me and my own body, it was the norm for me. I hadn’t known something was wrong or that all the other people describing these same symptoms online also usually described having their rectum actually “fall out of the vagina” within a short time of the bulging symptom occurring!
The thought of my rectum falling out was frightening, especially at only age 21 having never given birth or had serious surgery. The only surgery I’ve ever had was laparoscopic for endometriosis. I’d read the stories of my fellow females who had this condition and many of them said theirs came about after (and likely due to) surgery such as a hysterectomy or childbirth. I knew my symptoms could not have been due to my recent surgery for endometriosis at the time because I’d had this same exact “symptom” with no worsening since high school, at least. And I knew it was not due to childbirth. So I went on to learn more about the causes of Rectocele.
You see, I just kind of thought of this whole bulge in the vagina as being a sort of ability that all women had, but never talked about. I figured it was just one of those things we have but assume we’re the only ones who have it so we don’t mention it in conversation with other females. Another “theory” I had was that perhaps this was just something we females could do — a method to, ahem, push things along during a restroom visit — but perhaps other women just didn’t know they could do!
Never did I think something was actually wrong, and I’m still not sure there is. That’s another reason I wanted to suck up my embarrassing feelings over talking about this and just do it. I have read that there are women who just have the ability to push things along, but it isn’t a sure indication of Rectocele. This gives me hope and can possibly help others to better know which category they may fall into.
I had also read, among the horror stories, that some women require surgery and some live “normal” lives, and that if it doesn’t worsen and cause problems for you, then you may be able to live with it without the need of surgery. In fact, one website stated that if it wasn’t giving one problem, they aren’t recommended to have surgery for it. According to three gynecologists, a simple case of constipation can allow one to feel the contents via the posterior vaginal wall.
Possible Causes of Rectocele
The main “causes” of Rectocele are said to be hysterectomies, vaginal childbirth (especially when an episiotomy is required) and age. According to an article on Nih.org, the process of childbirth remains the most significant risk factor for any form of pelvic organ prolapse.
The reason a hysterectomy is the main cause because when you remove the organs, it leaves an open space, and having your organs like the uterus removed can allow the other organs such as the rectum and bladder to become detached — since there’s less support — and fall into that open space.
According to Healthwise Incorporated, Rectocele can be present at birth but is rare. Rectocele can be present in men as well, in which case the organ could come out of the anus instead of the vagina. Apparently, Rectocele in men is rarer than in women.
In addition, there are still plenty of things that can cause or contribute to Rectocele
- Multiple childbirth.
- Long, difficult labor.
- Prolonged constipation is said to be a cause, but is supposedly rare.
- Fissures or chronic injury to the anus, such as fissures that occur repeatedly due to constipation.
- Irritable Bowel Syndrome is said to be a contributing condition to Rectocele. This is mostly due to problems such as diarrhea and constipation that accompany IBS. A lot of people who suffer from Rectocele find that IBS often accompanies it. Talk about a double bummer! This is likely due to IBS being terribly rough on your intestines and rectum.
- Menopause (because of decreased estrogen, which can affect elastin).
- Pelvic surgery.
- Obesity. This is because sometimes, obesity can cause strain on the body, including the muscles we don’t see.
- Weakened pelvic muscles.
- Chronic cough and similar respiratory issues have been said to be a “cause” of Rectocele. It’s hard to believe a chronic cough could do this, but coughing a lot does put pressure on your rectal and vaginal muscles. Those who have a chronic cough and show symptoms of Rectocele or Cystocele could possibly benefit from Kegels exercising.
Kegels and Rectocele
Now we come to my favorite, and possibly the easiest way to decrease your chances or Rectocele or decrease Rectocele that’s already developed and even improve it.
This could also be effective for Cystocele. Of course, Kegels are a natural remedy but keep in mind results vary greatly. I’ve heard a lot of people say that Kegels did not help them. It’s all going to depend on the severity of the condition, whether or not you stick with it, among other things. It won’t take a Kegel scientist to figure out that the milder the Rectocele is, the easier to improve it.
Rectocele, a lot of times is due to lax rectal muscles instead of weak vaginal muscles. However, the muscles in the vagina also play a role in both prevention and how Rectocele will affect different people. This is because to have strong vaginal muscles means your chances of the rectum slamming deeper into the posterior vaginal wall could be lessened. It also means if you have not been affected by prolapse, doing Kegel exercises can prevent it from happening in the first place.
This is actually one good thing because we can exercise our muscles without the need of insurance or medical care or a whopping amount of cash. The second good thing is that not only can you lessen your chances of prolapse by strengthening the vaginal muscles, but you can also strengthen the rectal ones.
How to Perform Kegel Exercises
If you aren’t aware of how to do Kegels to strengthen both the vaginal and rectal muscles, basically it’s the same thing as the Kegels you do for your vagina only it’s a slightly “deeper” squeeze. If you take a second to focus on your rear while performing a Keel, take a breath in and squeeze the muscles as hard as you can. I find that short, quick Kegels don’t target my rear muscles as much as when I take the time to squeeze as hard as I can. You will feel your rear end do a little “jumping” motion just like with the vagina. It can feel like a pulling sensation back there too.
If all else fails, using the tip of your index finger, place it right at the crack of your bum and squeeze. You should feel the skin there move if you’ve done it correctly.
After you’ve worked the muscles for a short period of time, you’ll begin to feel even your butt cheeks move a little! Just like with vaginal Kegels when you start to see your entire crotch move up and down when you Keel.
Both your rectal and vaginal muscles need to maintain a good deal of strength to stay healthy and prevent Rectocele or prevent worsening of the condition. However, there are some people who have recently gone public with their “claims” that Keel exercises actually [italic|cause] Rectocele! For years, I’ve read that Keel exercises [italic|prevent] it and many women have attested to the exercises bringing them benefits, but it’s up to you to decide whether Kegels are bad or good for your own body. I know of only one person (and her website) that makes the claim that Keel exercises are bad for us. Otherwise, I’ve only heard that they’re beneficial.
I began doing Kegels years ago but didn’t have a set schedule or goal for each day. I just did sets of them when I thought about doing them. Then, I began doing them daily before bed. I still do this sometimes. I would take one breath in and focus everything on squeezing all my muscles down there (front and back), then repeat. Soon after learning that using a product to aid in muscle tone, last year I bought a set of Keel balls that I’ve been using ever since.
After a few weeks of using the Keel balls daily, I thought I noticed some minor results — stronger orgasm, the ability to Keel with more of a “clench.”
After a couple of months, I didn’t just think I noticed results, I did! My orgasms were far stronger, they did last longer — which wasn’t my ultimate goal, but was greatly appreciated — and I was able to use both Keel weights for hours without them slipping or falling out. Even a whole year after starting the Keel balls for extra help exercising, I am pretty symptom-free and nothing has worsened.
Other Natural Remedies for Rectocele
Upon researching remedies and various forms of treatment and relief, one of the remedies that were popular seemed to bring most people relief was witch hazel.
Bu Zhong Yi Qi Tang — A Natural, Chinese Medicine Remedy
In Traditional Chinese Medicine, it is believed that conditions such as prolapse are related to a Qi (in Chinese Medicine, meaning “life force”) deficiency. In Chinese Medicine, the central Qi is responsible for providing vital energy for the body, including the internal organs.
Bu Zhong Yi Qi Tang targets the spleen to provide nourishment as well as replenish the Qi of the body. A weak Qi can result in organs can fail to support themselves, which is exactly what happens when prolapse occurs. The rectum isn’t being supported, so it can drop or “slip.”
Bu Zhong Yi Qi Tang is a combination of an herbal formula — originally created by Li Dong-Yuan– that contains herbs. The main ingredients are astragalus, licorice, and ginseng. Astragalus stimulates the central nervous system, has cardiotonic and sex hormone-like actions, strengthens muscle tone, promotes metabolism.
Ginseng also stimulates the central nervous system, increases digestive absorption, and strengthens “general bodily functions. Licorice is also an ingredient in Bu Zhong Yi Qi Tang because it also strengthens “general bodily functions,” and when combined with astragalus, its efficacy is increased. Atractolydes, another ingredient in Bu Zhong Yi Qi Tang, promotes fluid absorption from the digestive tract, which stimulates diuresis. All of these promote macrophage phagocytosis and antibody production.
There are several more ingredients used in Bu Zhong Yi Qi Tang, but these are a few of the main “active” ingredients when used to treat prolapse. It is indicated in China Pharmacopoeia to replenish Qi and elevate the spleen. It is also used to cure fatigue, physical weakness, and different types of prolapse including rectal, uterus and stomach — all of which can accompany prolapse.
Dong-Yuan said that conditions such as prolapse were linked to chronic spleen deficiency, where the skeletal, supportive tissues and smooth muscles lack tone. The lack of tone here, Dong-Yuan said is what results in gastric atony, floating kidney, hernia, rectal prolapse, uterine prolapse as well as other forms of prolapse.
This is why Bu Zhong Yi Qi Tang is used for prolapse conditions — because, as I said, it is supposed to nourish the spleen and replenish the body’s Qi.
Clinical Audit for Women with Rectocele
An article featured in the Hunan Journal of Chinese Medicine, titled “The Treatment of 86 Cases of Rectocele Treated by Bu Zhong Yi Qi Tang Jia Wei,” told that Li Dong-Yuan’s formula “Bu Zhong Yi Qi Tang” was an effective treatment for different forms of organ prolapse, including Rectocele.
A total of 86 patients — all females with Rectocele and all between the ages of 30-76 years old — enrolled in a clinical audit at Dong Kou County People’s Hospital and were given Li Dong-Yuan’s Bu Zhong Yi Qi Tang treatment, internally. Over the course of the study, some patients were given extra herbs or certain ones were removed from their treatment, depending on their personal needs, such as when a patient didn’t have difficulty with defecation.
The patients had been suffering for Rectocele between 1-25 years. All of the patients had given birth from 1-4 times.
Their clinical symptoms included: constipation, difficult evacuation during a bowel movement, difficulty defecating, lack of force in defecation, sensations of incomplete defecation, long periods of time between defecations, a sensation of sagging, failing of the perineal. Some cases included dyspareunia. The patients enrolled suffered from slight to severe Rectocele.
The results were “Cure was defined as smooth, easy defecations with no sensation of incomplete bowel movements, no sensation of perineal falling and descending, and return to normal of all signs of Rectocele as confirmed by repeat colorectal examination.
In addition, there was no recurrence on follow-up after one year. Some effect was defined as free-flowing and smooth or easy defecation, no sensation of incomplete bowel movements, and a marked decrease in feelings of falling and descending in the perineum and improvements in the signs of Rectocele on repeat colorectal examination. No effect was defined as no obvious improvement in any of the signs and symptoms of Rectocele from before to after treatment. Based on these criteria, 21 cases (24.4%) were judged cured, 60 cases (69.8%) got some effect, and five cases (5.8%) got no effect. Therefore, the total effectiveness rate was given as 94.2%. In general, time to seeing an obvious effect was 10-15 days.”
So, this means that some patients’ previous symptoms such as the sensations of the organ “falling out,” were gone and other patients showed a “marked improvement” in the symptoms they previously had due to Rectocele, such as the “falling out” sensation and bowel problems.
An Ayurvedic Remedy for Rectocele
While there are plenty of these remedies, one I’ve read “relief stories” about uses Tender Lotus leaves and petals. This remedy calls for drying both, then turning them into powder (using a churn.) The powders are then mixed with rock candy sugar, and then taken by the spoonful twice daily.
The Lotus remedy is said to put the rectum back in its normal position
Diet & Lifestyle Changes for Relief
Add more fiber into diet or the use of stool softeners. Besides OTC stool softeners, others include whole grains such as whole-wheat bread and whole-grain cereals. Potatoes, corn, Lima beans, green peas are beneficial vegetables. Other beans such as pinto, red, navy, black garbanzo beans are all high in fiber.
Foods that contain 5-6 grams of fiber and up are considered “high-fiber” foods. So be sure you’re getting that amount.
Avoid constipation with foods such as apple juice or cider, olive oil, seabuckthorn oil, blackstrap molasses, raisins, barley, psyllium husks. I’ve read a lot of people say psyllium husks and apple juice or cider has been very beneficial for these symptoms. Psyllium is a natural fiber, so you may not require a fiber supplement with it. Adding lemon juice to water can also provide relief from constipation.
- Raw honey with warm water (or a good herbal tea) is effective for mild constipation. I have a glass of warm tea & raw honey with cinnamon in the morning for its detoxifying and energizing benefits.
- Drink 6-8 glasses of water. You’d be amazed at the changes once you manage to choke down that much water! Even 4 glasses do wonders.
- Avoid straining and heavy-lifting, which can cause Rectocele to progress.
There is a surgical treatment, called Colporrhaphy for Rectocele.
Rectocele is sometimes diagnosed upon a typical pelvic exam, such as when a bulge is obvious. It is also diagnosed using a defecography, a special x-ray. Biofeedback is used, sometimes to treat both Rectocele and Cystocele. There are other surgeries sometimes required for Rectocele, such as a Colporrhaphy and Perineoplasty together. It completely depends on the patient.
Surgery has proven successful in patients, but there’s a chance it won’t respond to surgery and could recur after operation in about 10 percent of cases, according to Better Health. In addition to that, another article states that the surgery may be responsible for a high return rate of Rectocele.
Surgery to repair Rectocele (again, it depends on the person, severity and other damages) can be done laparoscopically, anally or transvaginally.
Biofeedback helps isolate the muscle groups in the pelvis, using little sensors internally with sensor pads placed on the external body. The neat little sensors measure the electrical signals that happen when muscles contract. The signals are shown on a computer screen so you are able to see the muscle activity. The computer also shows the strength of the muscles, which allows you to follow your progress rate, and basically, with your own eyes, watch your muscles strengthen.
Biofeedback training gives a patient feedback in response to muscle activity. Biofeedback training involves targeting specific muscle groups and exercising them regularly.
Biofeedback has shown to be successful in some patients, although success depends on each person, their health and the severity of the condition. For someone with mild to moderate Rectocele, Biofeedback would be worth looking into, especially since it’s non-invasive.
Who to See for Treatment or Diagnosing Possible Rectocele
- A colorectal surgeon.
- General surgeon.
- Your current doctor.