Supportive Care for Complications Associated with Eating Disorders

Eating disorders are mental illnesses that manifest with physical complications that can be both dangerous and life-threatening, affecting 1 in 10 people of all ages and sizes. Pelvic health providers have a unique skillset to address some of the symptoms experienced by patients working to recover from eating disorders, including gastrointestinal distress, abdominal pain, abdominal bloating, bowel dysfunction (constipation or fecal incontinence), urinary issues, prolapse symptoms and pelvic pain. A pelvic health physical or occupational therapist can also be an important resource in supporting patients with eating disorders during pregnancy and the postnatal time.

Our therapists can support individuals by addressing conditions or concerns, including: 

• Pelvic pain 
• Abdominal pain 
• Bloating 
• Bowel dysfunction (constipation or fecal incontinence) 
• Urinary urgency, frequency, and leakage 
• Pelvic prolapse 
• Breathing dysfunction  

Our Specialists 

Dr. Rachel Philipp cares for patients in our Lakeview and Loop locations. 

Constipation 

Symptoms of infrequent bowel movements, excessive straining, bloating and flatulence can be address with manual techniques for musculoskeletal tension that is limiting bowel evacuation, pelvic muscle re-education, and bowel habit training. 

Chronic constipation can contribute to other issues or conditions, including: 

• Fecal impaction: Hardened stool gets lodged in the rectum, causing pain and discomfort. 
• Anal fissures: Tears in the anus from straining during bowel movements. 
• Hemorrhoids: Swollen veins in the rectum or anus. 
• Loss of bowel control: Stool leakage due to stretching of the rectum. 

Pelvis and Abdominal Pain

Our therapists can help reduce pain with urination, bowel movements, menstruation, sexual activity, sitting, and physical activity through manual techniques, restorative exercises and stretches, and counseling on body mechanics.

Urinary Incontinence 

An involuntary leakage of urine. There are 4 types of urinary incontinence that can be successfully treated by physical therapists and occupational therapists. 

Anal Incontinence 

An involuntary leakage of flatus, solid, or liquid feces. Anal incontinence can be successfully treated by physical or occupational therapists. Causes can include inflammatory bowel diseases, diarrhea, post-radiation, neurological conditions, pelvic floor weakness, pelvic floor tightness, or constipation. 

Incontinence Treatment 

Physical and occupational therapist care for incontinence may include a combination of therapeutic exercises to strengthen and relax the pelvic floor and abdominal muscles, as well as muscles surrounding the hips and spine. Other treatment options may include bladder or bowel training and education on bladder and bowel irritants. 

Dyspareunia, Interstitial Cystitis (IC), Levator Ani Syndrome, Vulvodynia, Pelvic Floor Dysfunction, Dysmenohhrea (Menstrual Pain), and Vaginismus 

• In addition to urinary incontinence, a pelvic health occupational or physical therapist can treat individuals experiencing pelvic pain, including vaginal pain, testicular pain, pain with intercourse, buttock pain or pain in the pelvis that radiates to the front or back of the thighs.  A variety of musculoskeletal problems throughout the low back, hips, pelvic girdle, and even the knee and ankles can contribute to changes in the pelvic floor musculature, sometimes leading to pain. A physical therapist or occupational therapist can help address these limitations and help the body work efficiently with less pain. 

Pelvic Organ Prolapse 

Cystocele, Rectocele, Enterocele, Urethrocele and Uterine Prolapse 

Pelvic Organ Prolapse (POP) occurs when a pelvic organ “drops down” in the pelvis. This can occur due to chronic constipation, straining, pelvic floor muscle weakness, childbirth, menopause, or a hysterectomy. Common symptoms of POP include a sensation of “fullness” or “heaviness” in the vagina, difficulty having bowel movements, urinary or fecal incontinence, tissue protruding from the vagina, urinary retention, pelvic pain, or pain with intercourse. 

Pelvic Organ Prolapse Treatment 

Treatment for POP can include bowel/bladder retraining, education on support wear, pelvic floor strengthening, and functional assessments.  

What to expect during therapy: 

A pelvic health physical or occupational therapist will provide a thorough subjective and objective evaluation and develop a treatment program specific to your problems and goals. Treatments may include one or more of the following:

• Manual therapy or dry needling to reduce muscle guarding and tightness, joint mobilization or muscle energy techniques to influence the joints in the pelvis, hips, ribs or spine.
• Specific therapeutic exercises will be prescribed to address muscle tightness and improve strength.
• Meditation and breathing techniques may be utilized to  relax muscles and change blood chemistry. The ability to take deep breaths can be limited by ribcage muscle tightness, impaired posture and decreased diaphragm coordination.  Manual therapy and movement techniques can help improve the ability to take restorative breaths.
• Neuro-muscular reeducation improves the coordination between muscle contractions and relaxations so that joints and muscles are used efficiently with less pain and increased function.

In addition to addressing abdominal and pelvic symptoms, patients navigating eating disorders have additional complications related to muscle atrophy and loss of bone mineral density, and may have a need for trauma-informed care.  Depending on your particular health concerns and presentation, specific interventions will be incorporated, including:

• Guided strengthening to restore core muscle strength can improve stability and facilitate functioning in daily activities.
• We utilize principles of the BoneFit^(TM) program to increase bone density and reduce future fracture risk.  
• Therapists have additional training in providing trauma-informed, sensitive care and will collaborate with you to ensure that you feel safe, respected and empowered during your therapy. 

Please call (773) 665-9950 for more information or schedule an appointment.