Tired of Endless Wiping? There's a Surprising Fix for That
Sure, it's normal to wipe multiple times when you have the runs or after you eat something that your stomach can't handle (hello, cheese charcuterie), but if you find yourself wiping over and over (and over) again on a regular basis, it may be time to investigate. What few endless wipers realize is that consistently hard-to-clean poops are often a result of an underlying health condition.
Hemorrhoids are a top medical cause of extended wiping, but they're far from the only possible culprit. Read on to learn how an out-of-whack pelvic floor can also prevent easy clean-up — and why seeing a pelvic PT could help you poop faster and easier, every single time.
What your pelvic floor has to do with wiping
When it comes to the ins and outs of bowel movements, your pelvic floor is critical. The muscles of your pelvic floor surround your anus and help regulate when and how you let out poop and hold it in. When these muscles are working properly, you're much less likely to have to wipe 3+ times before you can flush and get on with your day.
To get into a little more detail, the pelvic floor provides dynamic support, structure, and coordination to your bowel function in the following ways:
Dynamic Support - When working like they should, the muscles of the pelvic floor wrap around the anus and create a muscular sling of dynamic support at the bottom of the rectum where stool is stored until you are ready to poop. Even at rest, your pelvic floor muscles work in sync with the anal sphincter muscles to help protect you against leakage or gas or stool as you move around throughout your day, especially during those inconvenient moments when you have to go but cannot find the bathroom.
Structure - The connective tissues of the pelvic floor help to support the unique position and function of your pelvic floor muscles, working to keep you leak free before and after bowel movements, and preventing your pelvic organs from slipping out of place.
Coordination - Once on the toilet, your pelvic floor muscles reflexively relax to lengthen, helping you to open your anus and easily move the stool from your rectum into the toilet. When you’re done, the pelvic floor and anal muscles automatically reset back to their baseline tone, and help to “close up” the anal opening, making it easy for you to wipe clean.
5 Pelvic floor issues that can lead to endless wiping
Lots of wiping after a bowel movement can be frustrating and more than one factor may be contributing to the problem. While hemorrhoids are often to blame, this article highlights other potential causes, including anal skin tags or an anal abscess. While these issues are typically well known to primary care providers, doctors are often unaware that pelvic floor dysfunction can also make wiping difficult.
Seeing a pelvic floor physical therapist in person — or for a quick virtual visit — can help you determine if one of the pelvic floor problems applies to you. Why is this worth doing? Beyond solving your endless wiping woes, working with a pelvic floor PT will ensure that these issues don't lead to more and bigger symptoms down the road.
1. Your pelvic floor may be weak
When the pelvic floor muscles are injured and/or weak, you may develop accidental bowel leakage, which is when stool slips past the muscular barriers of the pelvic floor and anal muscles. The amount of accidental stool loss can vary from a small amount that makes you have to wipe more, to full loss of control over your bowel function.
Pelvic floor muscle weakness can occur for a variety of reasons including underuse, or even injury to the pelvic floor muscles or nerves that help provide these muscles function. Pudendal nerve injury is one such example, and can occur as a result of prolonged pressure to the pelvic nerves, chronic straining while constipated, and even after excessive stretch while pushing during childbirth.
2. Scar tissue can make it hard for your muscles to do their job
In addition to excessively stretching the pelvic nerves during a vaginal delivery, lingering scar tissue after a birth injury could contribute to difficulties wiping. Perineal injury is common in up to 85% of people who give birth vaginally. Some tears will only impact the skin of the vulva and perineum, but some will impact the pelvic floor muscles and anal musculature, to varying degrees.
After healing, the scar tissue that remains can impair the function of the muscles, and contribute to fecal leakage. Scar tissue can also cause lingering pain making it difficult (and painful) to wipe the area effectively, and it can even limit the flexibility of muscles which makes it hard to fully empty. As a result, lingering stool can accidentally slip out and you may find yourself wiping more than usual.
While prenatal perineal massage may be effective in reducing the chances of more severe tears during delivery, postpartum perineal scar massage can be effective at reducing the impact of scar tissue when you do get injured. Often, after scar tissue is mobilized and function to the muscle is restored then the pelvic floor muscles can go back to doing their job of protecting against fecal leakage.
3. Your pelvic floor muscles may be too tight
Another common type of pelvic floor muscle dysfunction is overactive pelvic floor muscle dysfunction which is characterized by muscles that are tight and inflexible. It is a very common cause of constipation. The excessive straining that often accompanies constipation can lead to hemorrhoids which are notoriously hard (and sensitive) to clean around, which can mean you have to wipe more than usual.
Another complication of chronic constipation is that your colon can become overstretched and less sensitive to stretching (stretch from filling is how your colon signals to your brain that there’s enough poop in there to warrant a trip to the bathroom). In a normally sensing colon, your pelvic floor muscles automatically tighten to hold more weight. In those with chronic constipation, this feedback loop is disrupted, and can allow for liquid stool to slip out, around the impacted stool — most of the time, you aren’t even aware until you see the evidence in your underwear the next time you visit the loo.
4. Stool could be too soft for your pelvic floor to manage
While your diet and gastrointestinal health have a lot to do with your stool consistency, your pelvic floor is also involved. Your stool consistency can impact how well your pelvic floor muscles are able to perform and may also indicate underlying pelvic floor dysfunction.
Runnier, more liquid stool is much harder for your pelvic floor muscles to control against. Less efficient pelvic floor muscles may allow for accidental stool leaks even while you’re trying to wipe clean. Plus soft, sticky stool leaves more fecal matter behind after you poop, causing you to have to work through more toilet paper than usual.
If you’re wondering if poop is too soft, check out The Bristol Stool Chart (see below). It is a common tool that healthcare professionals use to “size up” your stool and gut health. Take a peek into your toilet bowl after your next bowel movement. Your poop should look like Type 3 or Type 4 in the chart below.
If you have consistently soft poop, try adding fiber to your diet to bulk up your stool, and check in with your healthcare provider to see if any food intolerances or sensitivities are contributing to softer stools.
5. Pelvic Organ Prolapse may make it hard to fully empty
When the pelvic floor muscles become weak or injured it can contribute to your pelvic organs slipping out of place. This is known as pelvic organ prolapse, and common symptoms include difficulties fully emptying your bowel, and fecal incontinence. When the rectum is prolapsed (as shown below), it can trap stool which can lead to straining. If pelvic floor muscle weakness is contributing to your prolapse, then the muscle weakness is likely also allowing for fecal leakage.
What should you do if you suspect your pelvic floor is causing endless wiping?
If any of these sound familiar, and you think that your pelvic floor muscles could be contributing to your endless wiping, checking in with a pelvic physical therapist is an important step. They will be able to chat with you about your symptoms, and if they think your pelvic floor could be contributing too, they will assess your pelvic floor, check in on your diet, and help you identify any muscle dysfunction, scar tissue, or organ prolapse that could be causing your symptoms. (If you're curious about that assessment, check out the behind the scene details here).
A pelvic floor physical therapist will help you find pelvic floor strengthening exercises if your pelvic floor needs support, help you learn to release tension in your muscles and learn proper pelvic floor coordination. They will even help you learn scar massage to help manage any lingering post-birth restrictions, and iron out any bathroom habits that could be contributing. They will also let you know if your symptoms are likely more related to a medical condition that your physician should check into — or make a referral if you need one.
The physical therapists at Origin are experts in all-things-pelvic-floor, including your wiping habits, so schedule an evaluation with them today. They can see you in one of their many in-person locations throughout the United States, or visit with them virtually in the comfort of your own home.