Home Patients Glossary A B C D E F G H I L M O P R S T U V A Anterior repair An anterior repair also known as an anterior colporrhaphy is a surgical procedure to repair or reinforce the fascial support layer between the bladder and the vagina. It is most commonly performed to treat a cystocele. More Information ACPGBI Association of Coloproctology of Great Britain and Ireland Anorectal Physiology Anorectal physiology evaluates the muscles and nerves of the anal canal and rectum. If you are having trouble opening or controlling your bowels, an anorectal physiology test will help us to find out why. These diagnostic procedures are typically painless and require no sedation. Anterior Resection Syndrome Anterior resection syndrome (also known as low anterior resection syndrome) is a collection of bowel symptoms that can happen after surgery to remove all or part of your rectum or in those that have had radiation therapy to the pelvis. These symptoms can lead to difficulties in bowel emptying, frequency, urgency and symptoms of faecal incontinence.They are long-term symptoms that can have a significant impact on quality of life. Anismus Anismus is a functional disorder where the anal sphincter muscles fail to relax, or actively contract, during attempted bowel movements. This causes chronic, severe constipation and the feeling of incomplete evacuation Anus The anus is the external opening at the end of the digestive tract where stool leaves the body. Altemeier procedure An Altemeiers procedure (perineal rectosigmoidectomy) is an operation performed for external rectal prolapse. The surgeon pulls the rectum through the anus, removes a portion of the lower bowel (rectum and sigmoid) and attaches the remaining bowel to the back passage. The decision whether this operation is performed is made on the type of prolapse you have, previous surgery performed, your medical fitness and your preference. Anal Fissure An anal fissure is a small tear or crack in the lining of your anal canal. It is a common cause of sharp pain and bright red bleeding during or after bowel movements. Anal Fistula An anal fistula is a small, abnormal connection (tunnel) between the inside of the anal canal and the outside skin. It is usually caused by a previous anal abscess (a collection of pus) that hasn’t healed properly. Symptoms include persistent anal pain, swelling, and the discharge of pus or blood, which often temporarily relieves the pain. Because fistulas rarely heal on their own, surgery is the standard treatment to clear the infection and close the tunnel while protecting the anal muscles responsible for bowel control. Anal Sphincter The anal sphincter is a pair of ring-shaped muscles at the end of the rectum that controls the release of stool and gas. It is made up of two distinct muscles, the internal and external sphincters, which work together to maintain continence and facilitate bowel movements. Anal Sphincterotomy An anal sphincterotomy (often called a lateral internal sphincterotomy) is a surgical procedure used to treat severe, non-healing anal fissures. It involves making a small cut in the internal anal sphincter muscle to relieve pressure, reduce spasms, and restore blood flow to allow the tear to heal. Around 15% of patients may experience some long-term anal incontinence after the procedure. Anal Manometry Anal manometry is a diagnostic test that measures the pressures of your anal sphincter muscles. It involves placing a small catheter (tube) within the anus and takes about 15-20 minutes to perform. The results can help evaluate potential causes of chronic constipation, faecal incontinence, and unexplained pelvic pain. Antegrade Continence Enema (ACE) An Antegrade Continence Enema (ACE), sometimes called a Malone or MACE procedure, is a surgical technique used to manage severe, treatment-resistant constipation and fecal incontinence. The ACE operation fashions a small stoma and channel between the skin of the abdomen and the colon often utilizing the appendix. A catheter can be placed in the ACE stoma to introduce an enema or warm water into the bowel. This stimulates colonic contractions allowing the bowel to empty and also flushes stool downward through the entire large bowel. Anal Acoustic Reflectometry (AAR) Anal Acoustic Reflectometry (AAR) is an advanced medical diagnostic technique used to measure anal sphincter function. By transmitting sound waves into a small, inflatable polyurethane bag placed inside the anal canal, the test calculates how the canal opens and closes to evaluate muscle tone, elasticity, and detect conditions like fecal incontinence. Anal reflex The anal reflex (also called the "anal wink") is an involuntary contraction of the external anal sphincter triggered by gently stroking the skin around the anus. It is a critical neurological test used to assess the integrity of the lower sacral spinal segments (S2–S4). B Bile Acid Malabsorption (BAM) Bile Acid Malabsorption (BAM) is a condition where the small intestine fails to reabsorb bile acids, which are then passed into the colon. This excess causes the colon to secrete extra water, leading to chronic watery diarrhea, urgency, and abdominal cramps. It is often mistaken for IBS with diarrhea (IBS-D). Breath Test A breath test is a non-invasive and safe test used to investigate and diagnose intestinal conditions, such as Small Intestinal Bacterial Overgrowth (SIBO). Bacteria that live in the small intestine produce gases called hydrogen and methane when they digest sugar. These gases then travel from the small intestine to the lungs, where they are released. It is normal to have bacteria in your large intestine, as it helps with the digestion of food. However, if you have too much bacteria in your small intestine, it can interfere with digestion. This is a condition known as small intestinal bacterial overgrowth (SIBO). SIBO can cause a variety of symptoms, including bloating, abdominal discomfort, nausea, flatulence and diarrhoea. Biofeedback Biofeedback is a technique that makes you aware of a particular body function, using a device or individual that provides information regarding the quality of the activity being performed. For pelvic floor disorders, biofeedback training can help you learn which muscles to use, when to use them and how hard to contract them to prevent leakage. Biofeedback may use a number of techniques that 'feedback' how well the muscles of the pelvic floor are working. Visual and auditory feedback of muscle co-ordination and strength is provided by a trained member of staff or a special machine that picks up pelvic floor muscle activity. This may require application of a pad to the skin or a probe inserted gently into the vagina or anus. Rectal sensory retraining and simulated defaecation may also be performed using a small, lubricated balloon that is gently inserted into the rectum and inflated. Behavioural Therapy Behavioural Therapy is an umbrella term that covers the conservative treatment of bowel dysfunction. This nurse or physiotherapy led service intially includes education about bowel function, diet, lifestyle changes, continence management and bowel emptying techniques. Use of medication, suppositories, enemas may be trialled. When simple measures have failed biofeedback therapy, physiotherapy, electrical stimulation and trans-anal irrigation may be used. Botulinum Toxin (Botox) Botulinum toxin is a potent neurotoxic protein produced by the bacterium Clostridium botulinum. By blocking the release of acetylcholine, it prevents nerve signals from reaching muscles, causing temporary flaccid paralysis. It is used widely in the management of overactive bladder and urge urinary incontinence and also in the treatment of anal fissure. Bristol Stool Scale The Bristol stool scale is a medical aid designed to classify the form of human faeces into seven categories based on stool consistency. Bladder The bladder is a hollow, muscular, balloon-shaped organ located in the pelvis that collects and stores urine. It receives urine from the kidneys and holds it until it exits the body through the urethra. An adult bladder can typically hold about 300 to 500 milliliters (roughly 1.5 to 2 cups) of urine before triggering the urge to go. Barostat A rectal barostat is a medical device and diagnostic test used to measure visceral sensitivity, rectal wall compliance (stiffness), and muscle tone in the rectum. It is considered the gold standard for evaluating conditions like Irritable Bowel Syndrome (IBS) and fecal incontinence. C Colporrhaphy Is a surgical procedure used to treat pelvic organ prolapse (POP) by repairing and strengthening weakened vaginal walls. It is performed to reduce uncomfortable symptoms such as bulging (prolapse), urinary incontinence and problems with bowel emptying. Constipation Constipation means different things to different people. Medically it is defined as having fewer than three bowel movements per week, or passing stools that are hard, dry, lumpy, and difficult or painful to pass. It is often accompanied by bloating, stomach cramps, and a feeling of incomplete evacuation. Colon The longest part of the large intestine (a tube-like organ connected to the small intestine at one end and the anus at the other). The colon removes water and some nutrients and electrolytes from partially digested food. The remaining material, solid waste called stool, moves through the colon, is stored in the rectum, and leaves the body through the anus. The colon is part of the digestive system. Colonoscopy A colonoscopy is a diagnostic procedure where a doctor uses a long, flexible tube with a camera (a colonoscope) to examine the lining of your large intestine (rectum and colon). It is used to investigate symptoms, check for diseases like colitis, and screen for or remove precancerous polyps. Cumberlege Report The Independent Medicines and Medical Devices Safety Review (Cumberlege Report), led by Baroness Julia Cumberlege, examined harms caused by pelvic mesh implants, sodium valproate, and hormone pregnancy tests in the UK. Published in 2020 as First Do No Harm, it found that thousands of women with pelvic mesh implants suffered severe complications including chronic pain, infection, mobility problems, and sexual dysfunction. It highlighted that many patients felt dismissed or ignored by healthcare professionals. The report concluded that the healthcare system failed to listen to patients, respond quickly to safety concerns, or provide proper informed consent about the risks of mesh surgery. It recommended a patient safety commissioner, specialist mesh centres, financial redress for affected patients, and major reforms to how medical device safety is monitored and communicated. Cystocele A cystocele (or prolapsed bladder) is a type of pelvic organ prolapse that occurs when the muscles and tissues supporting a woman's bladder weaken. This causes the bladder to drop and bulge into the front wall of the vagina. Mild cases often present no symptoms, but moderate to severe prolapses can cause discomfort, urinary symptoms and effect sexual function. Symptoms include sensation of fullness, heaviness, or pressure in the lower pelvis/vagina. A patient may see or feel a bulge of tissue inside or protruding from the vaginal opening. Urinary symptoms include difficulties in bladder emptying, frequent urinary tract infections (UTIs) and incontinence when coughing, sneezing, or exercising. Discomfort or pain during sexual intercourse may also occur. Coeliac Disease Coeliac disease is a condition where your immune system attacks your own tissues when you eat gluten. This damages your gut (small intestine) so your body cannot properly take in nutrients. Coeliac disease can cause a range of symptoms, including diarrhoea, abdominal pain and bloating, fatigue and anaemia. Gluten is a protein found in wheat, barley and rye. The only treatment is a lifelong, strict exclusion of these cereals from the diet. Colonic Transit Study A colonic transit study is a diagnostic test that measures how quickly food and waste move through your large bowel. It is primarily used to investigate and diagnose the causes of severe or chronic constipation. Calprotectin A calprotectin stool test measures levels of a specific protein released by white blood cells (neutrophils) into the gut. It is a highly reliable, non-invasive biomarker used by doctors to detect intestinal inflammation. Elevated levels are primarily used to distinguish between Inflammatory Bowel Disease (IBD) and Irritable Bowel Syndrome (IBS). Coccydynia Coccydynia is the medical term for pain in the coccyx, or tailbone, the small, triangular bone at the base of your spine. It is typically caused by trauma (like a fall), childbirth, or repetitive strain, resulting in localized tenderness and severe discomfort when sitting or during attempted defaecation. Colostomy A colostomy is a surgical procedure that brings a section of the large intestine (colon) to the outside of your abdomen through an opening called a stoma. Waste is collected in a pouch attached to the skin. It can be temporary or permanent Cystometry A cystometry (or cystometrogram) is a diagnostic test used to measure bladder pressure, capacity, and function during bladder filling and emptying. It helps specialists identify the exact causes of incontinence, frequent urination, or blockages. D Dyssynergia Pelvic floor dyssynergia (also called dyssynergic defecation or anismus) is a condition where the muscles and nerves of the pelvic floor fail to coordinate during a bowel movement. Instead of relaxing to allow stool to pass, these muscles inappropriately tighten, causing chronic constipation and a feeling of incomplete emptying. Delorme Procedure The Delorme procedure is a surgical operation used to repair external rectal prolapse without requiring abdominal surgery. It involves stripping the inner lining (mucosa) from the prolapsed bowel, plicating (folding and stitching) the remaining muscle layer to reinforce the wall, and trimming the excess mucosa. The decision whether this operation is performed is made on the type of prolapse you have, previous surgery performed, your medical fitness and your preference. Diarrhoea Diarrhoea is the frequent passing of loose, watery, or unformed stools. Most acute cases (lasting a few days) are caused by viral or bacterial stomach bugs (gastroenteritis) or food poisoning. Chronic diarrhoea is persistent diarrhoea that continues for more than four weeks for which there are many causes. Chronic diarrhoea should always be investigated by an appropriate healthcare professional. Dysmotility A gastrointestinal (GI) motility disorder is a condition where the muscles and nerves of the digestive tract do not work together efficiently. This dysfunction disrupts the normal, automatic contractions (peristalsis) that move food and fluids through the body, causing a wide range of digestive, absorptive, and bowel emptying issues. Dysparaunia Dyspareunia is the medical term for persistent or recurring genital pain that occurs just before, during, or after sexual intercourse. It can manifest as sharp, burning, or aching sensations, either at the vaginal entrance or deep within the pelvis. Dysbiosis Dysbiosis is the term for a bacterial imbalance within the digestive tract. Dysbiosis develops when levels of probiotic bacteria, such as Lactobacilli and Bifidobacteria, are reduced and other species of bacteria become overly abundant. The early symptoms of dysbiosis mainly affect the bowel, and one of the first signs of abnormal fermentation is bloating. This can progress to cause a change in bowel habit, such as constipation or diarrhoea, often with cramping pains. E Enema An enema is fluid that is inserted into the rectum through the anus (back passage) to trigger a bowel movement and clear the lower part of the bowel. They are commonly used to treat constipation, faecal incontinence or to prepare the lower bowel for medical procedures like a colonoscopy or sigmoidoscopy. Evacuation Disorder An evacuation disorder, often called obstructed defecation syndrome or pelvic floor dyssynergia, is a condition where the muscles and nerves of the pelvic floor fail to coordinate during a bowel movement. Instead of relaxing, the muscles squeeze, causing severe chronic constipation and a sensation of incomplete emptying. In some patients there may also be a mechanical element such as rectal intussusception or trapping of stool within a rectocele that contributes to the disorder. Episiotomy An episiotomy is a surgical incision made in the perineum (the tissue between the vaginal opening and the anus) during childbirth. It widens the vaginal opening to allow the baby to pass through more easily or to speed up a difficult delivery. Enterocele An enterocele is a type of pelvic organ prolapse where a loop of small intestine drops down and pushes into the space between the rectum and the vagina. It occurs when the muscles and connective tissues of the pelvic floor weaken and can lead to discomfort, pelvic pain or heaviness and difficulty in bowel emptying. Electrical Stimulation Pelvic floor electrical stimulation (PFES) is a therapeutic technique that uses low-voltage electrical currents to stimulate and contract the muscles of the pelvic floor. It is primarily used to treat urinary and fecal incontinence, overactive bladder, and pelvic pain by strengthening muscles and retraining nerve pathways. Elastase A faecal elastase (FE-1) test measures the concentration of the enzyme elastase in your stool. Because the pancreas produces elastase to help digest fats and proteins, this test is the primary, non-invasive method for evaluating pancreatic function and diagnosing Exocrine Pancreatic Insufficiency (EPI) which can be a cause of chronic diarrhoea or fatty stools. EDS Ehlers-Danlos syndromes (EDS) are a group of 13 genetic disorders that affect connective tissues, such as skin, joints, and blood vessels. Common symptoms include joint hypermobility (loose, unstable joints that easily dislocate), fragile or stretchy skin, and chronic fatigue. Endoanal ultrasound An endoanal ultrasound (or anal endosonography) is a diagnostic scan that uses high-frequency sound waves to visualize the muscles of the anal sphincter and rectum. It helps doctors identify muscle tears, thinning, or abnormalities causing bowel issues like fecal incontinence or chronic constipation. Electromyography (EMG) Pelvic floor electromyography (EMG) is a diagnostic and rehabilitative tool that measures the electrical activity of the pelvic floor muscles. It helps evaluate muscle tone, identify dysfunction (such as overactivity or weakness), and guide physical therapy for conditions like incontinence, prolapse, and chronic pelvic pain Enteric Nerve System The enteric nervous system (ENS) is a vast network of nerves embedded in the walls of the digestive tract, from the oesophagus to the rectum. Often called the "second brain," it operates almost entirely on its own to manage digestion, control gut movements, and produce feel-good chemicals like serotonin without needing to bother your main brain. F Functional Bowel Disorder (FBD) A functional bowel disorder (FBD) is a chronic gut-brain interaction disorder. It causes recurring gastrointestinal symptoms, such as abdominal pain, bloating, and altered bowel habits, without any structural, inflammatory, or biochemical abnormalities. Diagnosis relies on recognizing characteristic symptom patterns and ruling out other diseases. Faecal Incontinence Faecal incontinence (bowel incontinence) is the involuntary leakage of solid or liquid stool. It is a symptom, not a diagnosis, and often results from underlying issues like nerve damage, weakened pelvic floor/anal sphincter muscles, chronic constipation, or diarrhoea. Faecal Urgency Faecal urgency is a sudden, intense need to have a bowel movement with the fear that you won't make it to a toilet in time. FIT The Faecal Immunochemical Test (FIT) looks for tiny traces of blood in your stool that are too small to see. The test recognises human blood. This means it is less likely to pick up other blood in your stool that might have come from something you ate. Traces of blood in your stool can be caused by other medical conditions and doesn’t necessarily mean you have cancer. But if it is cancer, finding it at an early stage means treatment is more likely to work. Flatus Flatus is the medical term for intestinal gas expelled through the anus, commonly known as a fart. It is a natural byproduct of digestion and swallowing air, with the average person passing gas 14 to 25 times a day. Fibre Fibre is the part of plant foods (fruits, vegetables, grains, beans, nuts, seeds) that you do not digest. It therefore ends up in your large bowel, where it is partially or fully broken down by gut bacteria. Fibre can make your stools bigger and softer and sometimes looser. However, it can also produce gas, and in some people with bowel disorders bloating, wind and abdominal pain. The main characteristics of fibre that affect its function are solubility (how well it dissolves in water), viscosity (how thick or fluid it is) and fermentability (how well it is broken down by our gut bacteria). Soluble fibre (found in foods such as oats, rye, barley, onions, leeks, root vegetables, apples and bananas) draws water through the small bowel wall and further down from the large bowel wall into the gut lumen. This makes the stools bigger, softer and easier to move along the gut. Insoluble fibre does not absorb water but can stimulate the bowel to secrete more water. This, as well as secreting mucus, helps speed the transit of stool along the gut. This type of fibre is found in foods such as wholegrain bread and wholegrain cereals, nuts and seeds, leafy vegetables and potatoes with their skins on. Beans and pulses contain both type of fibe. G Gut-Brain Interaction The gut-brain connection is a two-way communication network (the gut-brain axis) linking your central nervous system to your digestive system. This explains why emotional stress causes stomach cramps, and why gut issues like IBS heavily impact your mood and mental health. Gastroparesis Gastroparesis, or delayed gastric emptying, is a chronic disorder where stomach muscles don't work properly to move food into the small intestine. Common causes include diabetes and nerve damage, resulting in symptoms like nausea, vomiting, and feeling full quickly. It can be associated with other gastrointestinal motility disorders. H Hysterectomy A hysterectomy is a surgical procedure that removes the uterus (womb). After surgery, you can’t become pregnant and won’t get a menstrual period. Reasons for this surgery include abnormal bleeding, uterine prolapse, fibroids and cancer. Haemorrhoids Haemorrhoids (also known as piles) are swollen, inflamed blood vessels in the rectum and anus. Common symptoms include bright red bleeding after a bowel movement, itching, soreness, or a palpable lump. I Intussusception Rectal intussusception, also known as internal rectal prolapse, occurs when the wall of the rectum telescopes or folds into itself without protruding through the anus. It is commonly associated with pelvic floor dysfunction and severe straining, often causing obstructed defecation syndrome. Incontinence Incontinence is the involuntary leakage of urine (urinary incontinence) or feces (bowel/fecal incontinence). It is a highly common but medically treatable condition affecting millions, often caused by weakened pelvic floor muscles, nerve damage, or underlying conditions like an overactive bladder or childbirth. Irritable Bowel Syndrome (IBS) Irritable Bowel Syndrome (IBS) is a common, long-term condition of the digestive system. It is a functional disorder, meaning the gut and brain communicate improperly, causing symptoms like abdominal pain, cramping, bloating, and unpredictable shifts between diarrhea and constipation. Injectable Bulking Agents Injectable therapy using bulking agents composed of synthetic materials, bovine collagen, or autologous substances are used in urinary and faecal incontinence. For urinary incontinence they augment the urethral wall and increase urethral resistance to urinary flow. For faecal inconitinence it adds volume to the anal canal, allowing the anus to close more tightly and help prevent leakage. Whilst in some patients short-term benefit can be observed, evidence suggests poor efficacy in the long-term with a need for repeat treatments because of symptom recurrence. Interstitial cystitis Interstitial cystitis (IC), also known as Bladder Pain Syndrome (BPS) or Painful Bladder Syndrome (PBS), is a chronic condition causing bladder pressure, bladder and pelvic pain, and an urgent or frequent need to urinate, in the absence of a urinary tract infection or other identifiable causes. Ileostomy An ileostomy is a surgical procedure that creates an opening in the abdominal wall by bringing the end of the small intestine (the ileum) out to the surface of the abdomen. This opening is called a stoma. Because the procedure bypasses or removes the large intestine (colon), waste can no longer pass through the rectum and anus. Instead, digestive waste leaves the body through the stoma and is collected in a pouch worn on the outside of the abdomen. L Low Anterior Resection Syndrome (LARS) Low anterior resection syndrome (LARS) is also known as anterior resection syndrome. It’s a collection of bowel symptoms that can happen after surgery to remove all or part of your rectum or in those that have had radiation therapy to the pelvis. These symptoms can lead to difficulties in bowel emptying, frequency, urgency and symptoms of faecal incontinence. They are long term symptoms that can have a significant impact on quality of life. Laxative Laxatives are medications or compounds used to treat or prevent constipation by softening stool and increasing bowel movement frequency. They range from natural supplements to prescription-only medications, and should ideally be used only after attempting lifestyle changes like increasing fiber and fluid intake. Large Intestine The large intestine (large bowel) is the final section of the gastrointestinal tract, measuring about 5 feet (1.5 meters) long. It processes indigestible food material, absorbs vital water and electrolytes, houses helpful bacteria that produce vitamins, and compacts waste into solid stool for excretion. Late Effects Late effects refer to persistent or new physical, psychological, or functional symptoms that emerge six months or more after cancer treatment. They are caused by injury or removal of tissues, nerves and lymph nodes by pelvic radiotherapy and surgery. While some side effects fade, late effects can become chronic or manifest long after initial recovery. These commonly include bowel and bladder dysfunction, sexual discomfort, and localized nerve pain. These symptoms can have a significant impact on quality of life. Levator Ani Syndrome Levator ani syndrome is a functional pelvic floor disorder characterized by recurrent, aching pain or heavy pressure in the rectum or vagina. Caused by spasms in the levator ani muscle, symptoms typically worsen while sitting and ease when standing or lying down. M Mesh Rectopexy Mesh rectopexy, often performed laparoscopically as a Laparoscopic Ventral Mesh Rectopexy (LVMR), is a minimally invasive surgical procedure. It is used to correct external rectal prolapse and severe internal rectal prolapse (intussusception). The surgery pulls the rectum into its correct anatomical position and anchors it to the sacrum using a synthetic mesh or a biological graft. Mitrofanoff The Mitrofanoff procedure is a surgical operation that creates a continent channel between the bladder and the skin (usually in or near the belly button). This allows patients to drain their bladder by inserting a catheter through the new opening rather than the urethra. The procedure is commonly used for individuals with conditions like spina bifida, spinal cord injuries, or severe incontinence who cannot empty their bladders naturally or face challenges with urethral catheterization Microbiome Your gut microbiome refers to all of the bacteria and microorganisms that live within the gut. It consists of over 100 trillion microorganisms and is completely unique to each individual. The microbiome has many functions, including defending against harmful microorganisms and digesting dietary fibre, that humans are unable to digest. It plays an essential role in the immune system, body weight, heart and overall health. Many factors can shape the gut microbiome, including sleep, medications (such as antibiotics), environment and diet. An imbalanced microbiome (dysbiosis) can affect gut health and may play a role in intestinal diseases like irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). The bloating, cramps and abdominal pain that people with IBS experience are thought to be due to changes in the gut microbiome. This is because the microbes produce a lot of gas and other chemicals, which contribute to the symptoms of intestinal discomfort. O Obstructed Defecation Syndrome (ODS) Obstructive Defecation Syndrome (ODS) is a condition where an individual has difficulty evacuating stool from the rectum, despite the urge to defecate. Patients experience severe straining, a sensation of incomplete emptying, and sometimes need to manually assist bowel movements. It can be caused by anatomical issues (like a rectocele or internal prolapse) or functional pelvic floor dysfunction (dyssynergia, anismus). OASI OASI stands for Obstetric Anal Sphincter Injury. It is a severe perineal tear (third- or fourth-degree tear) that can occur during a vaginal delivery which leads to injury to the anal sphincter muscles. Overactive Bladder (OAB) Overactive bladder (OAB) is a condition that causes a sudden, uncontrollable urge to urinate, often leading to frequent bathroom trips and involuntary leakage. It occurs when the bladder muscles contract involuntarily even when the bladder is not full. Common symptoms include a sudden, strong, and difficult-to-control urge to urinate and symptoms of increased urinary frequency (the need to urinate eight or more times over a 24-hour period). Patients with OAB will often need to wake up more than twice during the night to use the bathroom (Nocturia) and may suffer from symptoms of urge urinary incontinence. P Percutaneous Tibial Nerve Stimulation (PTNS) PTNS involves sending a small electric signal to the nerves controlling the bowel and the muscles of the back passage. It is achieved by using a small needle (very much like an acupuncture needle) and inserting it behind the ankle where the tibial nerve runs. This nerve shares some of the nerve roots that supply your back passage. The needle is connected to an electric stimulator and it will send signals back up the nerve to help regulate your symptoms. More Information Posterior Repair A posterior repair (also known as an posterior colporrhaphy) is a surgical procedure to repair or reinforce the fascial support layer between the rectum and the vagina. It is most commonly performed to treat a symptomatic rectocele. Proctogram A proctogram (or defecating proctography) is a specialized imaging test that evaluates how well your rectum and pelvic floor muscles function when you empty your bowels. It helps diagnose conditions like chronic constipation, fecal incontinence, or pelvic organ prolapse. It can be performed using x-rays (fluoroscopy) or magnetic resonance imaging (MRI). Probiotics Probiotics are live microorganisms, usually beneficial bacteria and yeasts, that promote health by restoring or maintaining the natural balance of microbes in your gut. When consumed in adequate amounts, they help crowd out harmful pathogens, improve intestinal barrier function, and assist in digestion. While research is ongoing, scientific evidence suggests probiotics can be particularly helpful for easing symptoms of Irritable Bowel Syndrome (IBS), constipation and lactose intolerance. Probiotics are also used to treat inflammatory bowel disease (IBD) where they can restore microbial balance, strengthen the intestinal barrier and reduce gut inflammation. Prebiotics Prebiotics are non-digestible carbohydrates and dietary fibers that act as "fertilizer" for the beneficial bacteria in your gut. They travel through your digestive tract largely intact and are then fermented by gut microbes, producing beneficial short-chain fatty acids (SCFAs) that support metabolic and immune health. Pelvic Floor The pelvic floor is a supportive network of muscles lie across the base of the pelvis. Acting like a hammock they holds the pelvic organs (bladder, bowel, and uterus or prostate) in the correct position. The muscles are held in place by ligaments that support the organs especially when there is an increase of pressure in the abdomen that occurs with lifting, bending, carrying and straining. The pelvic floor muscles work to help keep the bladder and bowel openings closed to prevent unwanted leakage (incontinence) and they relax to allow easy bladder and bowel emptying. They also have an important role in sexual function. Pelvic floor dysfunction can be caused by many conditions including pregnancy and childbirth, pelvic surgery, repetitive straining, neurological disorders, connective tissue disorders and behavioural factors. Not all patients with bladder and bowel symptoms have weak pelvic floor muscles, but sometimes they need to learn to use their pelvic floor muscles in the right way and at the right time. Pelvic floor muscles should be kept strong and active just like any other muscle in the body. Peritonocele A peritonocele is a type of pelvic floor hernia where the peritoneal sac (and sometimes the fat within it) bulges into the rectovaginal space during straining. It is closely related to conditions like enteroceles or sigmoidosceles and is primarily diagnosed as a contributing factor to Obstructed Defecation Syndrome (ODS). Physiotherapy A pelvic floor physiotherapist specializes in treating the muscles, ligaments, and connective tissues that support the bladder, bowel, and reproductive organs. They assess and treat conditions like incontinence, pelvic organ prolapse, chronic pelvic pain, and sexual dysfunction by retraining the core and pelvic floor muscles. Pessary A pessary is a small, removable medical device inserted into the vagina. It is most commonly used to support pelvic organs (like the uterus, bladder, and rectum) for conditions like pelvic organ prolapse or stress urinary incontinence. Passive Faecal Incontinence Passive soiling of liquid or solid stool, which occurs when an individual is unaware of stool leaking from the anus. This can occur after a bowel movement, or at any time. Post-defecation soiling Post-defecation soiling is the accidental leakage of small amounts of stool into underwear shortly after a bowel movement. It typically occurs because residual stool gets trapped in the anal canal, weak anal sphincter muscles prevent a complete closure, or underlying constipation causes liquid stool to bypass hard blockages. Proctalgia fugax Proctalgia fugax is a condition that causes sudden, sharp, and severe cramping in the anus or lower rectum. The pain is typically fleeting, lasting anywhere from a few seconds to 30 minutes, and completely disappears on its own, leaving no pain between episodes. Perineum The perineum is the diamond-shaped area of soft tissue located at the bottom of the pelvis. In females, it lies between the vagina and the anus; in males, it lies between the scrotum and the anus. R Rectocoele In women, a rectocoele is a bulge in the front wall of the rectum that pushes into the back wall of the vagina. The rectum and vagina are normally separated by a strong sheet of fibrous tissue known as the “rectovaginal septum”. This sheet of tissue can become thin and weak over time, resulting in a rectocoele. A rectocoele may occur by itself or be part of a general weakening of the pelvic floor muscles. Other pelvic organs, including the bladder (cystocoele) and small intestine (enterocoele), may also bulge into the vagina, causing similar symptoms. More Information Rectal Prolapse Rectal prolapse occurs when the rectum, the final part of the large intestine, becomes stretched and slips down inside or sticks out through the anus. It can be caused by loss of support to the rectum due to weakened pelvic floor muscles, chronic straining from constipation, past childbirth, connective tissue disorders or heavy lifting. Internal prolapse (intussusception) may be asymptomatic or cause a number of symptoms including difficulty in passing stool, the constant feeling the bowel is not empty, faecal incontinence, passing of mucous and a sensation of pelvic pressure. It can often be treated with non-operative treatments but in some patients surgery may be considered. External rectal prolapse in early stages may only appear during a bowel movement and retract on its own; however, as the condition progresses, it can require manual repositioning or remain constantly protruded. This can lead to difficulties in bowel control, pain and discomfort. In rare cases, the blood supply to the bowel can be compromised. External rectal prolapse typically requires a surgical procedure to fully repair. More Information Rectal Sensation Rectal sensation refers to how the lower digestive tract registers fullness, pressure, and the need to have a bowel movement. It relies on nerve pathways to signal the brain when the rectum stretches. Disruptions in these signals can cause either an overactive urge or an inability to feel fullness. In addition, abnormal rectal sensation can lead to the nerves and muscles in the pelvis failing to work together which can cause pelvic floor muscle discoordination (often called dyssynergic defecation). Rectum The rectum is the final straight portion of the large intestine, measuring roughly 10 to 15 cm in length. It acts as a temporary holding tank for feces. When it is full, receptors send signals to the brain, triggering the urge to defecate through the anus. Rectopexy A rectopexy is a surgical procedure used to correct rectal prolapse. The operation involves repositioning the rectum back into the pelvis and securing it to the sacrum (tailbone) using stitches, a surgical mesh or biological graft. Resection Rectopexy Resection rectopexy (sometimes called the Frykman-Goldberg procedure) is a surgical treatment for rectal prolapse. It combines the removal of a section of the sigmoid colon (bowel resection) with lifting and stitching the rectum back into its correct anatomical position against the sacrum. Recto-vaginal fistula (RVF) A rectovaginal fistula (RVF) is an abnormal connection between the rectum and the vagina. This allows gas or stool to leak into the vagina. The severity of symptoms depends on the size and location of the fistula. Common signs include uncontrolled passage of gas or stool from the vagina, foul-smelling vaginal discharge, recurrent vaginal or urinary tract infections (UTIs), irritation, pain, or inflammation in the perineum or vaginal area and pain during sexual intercourse. Childbirth injuries are the most common cause, followed by inflammatory bowel diseases like Crohn's disease, pelvic cancers, and radiation therapy. Rectocele A rectocele, or posterior vaginal prolapse, occurs when the supportive wall of tissue between a woman's rectum and vagina weakens. This causes the front wall of the rectum to bulge or herniate into the back wall of the vagina. Small rectoceles are common after childbirth and are asymptomatic. Symptoms vary based on the severity of the prolapse and may include a feeling of pressure, fullness, or a visible bulge of tissue in the vagina. This can lead to pelvic discomfort or pain during sexual intercourse. A rectocele can also effect bowel function leading to difficulties in bowel emptying and a sensation of incomplete evacuation. If stool becomes trapped within the rectocele physically pressing (splinting) on the back wall of the vagina or perineum may help empty the bowel. Radiation Proctopathy Radiation proctopathy (often termed radiation proctitis) is damage caused to the rectum caused by ionizing radiation, typically following pelvic radiotherapy for prostate, cervical, or rectal cancer. It causes symptoms like rectal bleeding, bowel urgency, and diarrhea, and can be managed with endoscopic procedures or medications. Rectal Compliance Rectal compliance is the rectum's ability to stretch and accommodate faecal matter as it fills. It reflects the relationship between volume and pressure inside the rectum. As stool enters, the rectal walls are designed to relax (accommodate) to hold the waste. Normal compliance allows the rectum to act as a reservoir without causing an immediate, uncomfortable increase in pressure. A "highly compliant" rectum stretches easily and can hold more stool before signaling the need to use the restroom. A "stiff" or "poorly compliant" rectum resists stretching, meaning that even a small amount of stool causes a sharp rise in pressure, resulting in faecal urgency or pain. S STARR procedure STARR (Stapled Transanal Rectal Resection) is a minimally invasive surgical procedure that can be used to treat Obstructed Defecation Syndrome (ODS). It removes excess or floppy tissue in the rectum using surgical staplers to fix internal rectal prolapse which may reduce the need to strain during bowel movements. More Information Sacral nerve stimulation Sacral Nerve Stimulation (SNS), also known as sacral neuromodulation (SNM), is a therapy that uses mild electrical impulses to stimulate the sacral nerves. These nerves, located near the base of the spine, control the bladder, bowel, and pelvic floor muscles. It can be used to treat urinary and faecal incontinence, urinary retention and pelvic pain. It is typically considered when conservative treatments, like physiotherapy and medication have failed. More Information Sacral Neuromodulation Sacral Neuromodulation (SNM), also known as sacral nerve stimulation (SNS), is a therapy that uses mild electrical impulses to stimulate the sacral nerves. These nerves, located near the base of the spine, control the bladder, bowel, and pelvic floor muscles. It can be used to treat urinary and faecal incontinence, urinary retention and pelvic pain. It is typically considered when conservative treatments, like physiotherapy and medication have failed. Suppository Suppositories are mild laxatives used to stimulate bowel movement and remove faeces from the rectum, which means they are inserted into the back passage. There are differing types of suppositories available and the type of suppository you will be offered will depend on the reason for them being used. They are commonly used for patients suffering with constipation but they can also be for individuals with faecal incontinence. Sphincteroplasty Anal sphincteroplasty (also known as anal sphincter repair) is a surgical procedure to repair torn, severed, or weakened anal sphincter muscles. It is primarily performed to treat fecal incontinence (loss of bowel control) resulting from trauma, most commonly childbirth-related injuries. Small Intestine The small intestine (or small bowel) is the longest section of the gastrointestinal tract, connecting the stomach to the large intestine. It is named for its narrow diameter rather than its length and can be divided into three parts; the duodenum, jejenum and ileum. Essentially it is a muscular tube responsible for breaking down food and absorbing what the body needs to survive. It is also is an important part of the bodies immune system. Sigmoidoscopy A sigmoidoscopy is a minimally invasive medical procedure used to examine the rectum and the lower third of the large intestine (the sigmoid colon). It helps doctors find the cause of digestive symptoms, check for inflammation, or screen for bowel cancer Small Intestinal Bacterial Overgrowth (SIBO) It is normal to have bacteria in the bowel but when there is an excess of colonic-type bacteria within the small intestine symptoms of Small Intestinal Bacterial Overgrowth (SIBO) can occur. Bacteria that live in the small intestine produce gases called hydrogen and methane when they digest sugar. When there are too many bacteria producing gas symptoms like bloating, nausea, flatulence, abdominal pain and diarrhoea can occur. Hydrogen and methane is absorbed by the small intestine and travels to the lungs, where they are released. These gases are detected in a breath test and can help aid diagnosis in the management of abdominal symptoms. Sacrocolpopexy A sacrocolpopexy is a surgical procedure used to treat pelvic organ prolapse, typically in women who have previously had a hysterectomy. It involves using a synthetic mesh or your own tissues (fascia lata) to lift the top of the vagina and suspend it securely to the sacrum (tailbone), restoring the vaginal vault to its natural position. Sacrospinous Fixation A sacrospinous fixation is a surgical procedure to treat uterine or vaginal vault prolapse by attaching the top of the vagina to the strong sacrospinous ligament in the pelvis. Performed entirely through the vagina without abdominal incisions, it provides lasting support, usually replacing dissolving stitches with scar tissue. Sigmoidocele A sigmoidocele is a type of pelvic organ prolapse where a loop of the sigmoid colon drops down and pushes into the space between the rectum and the vagina (in females). It is often associated with chronic constipation, difficulty emptying the bowels and pelvic pain, discomfort or heaviness. Slow Transit Constipation Slow transit constipation is where the muscles lining the gut wall do not work properly, resulting in sluggish movement of contents through the bowel down to the rectum. Symptoms may include infrequent bowel movements, severe bloating and abdominal cramping. SeHCAT A SeHCAT (Selenium Homocholic Acid Taurine) test is a nuclear medicine procedure used to diagnose Bile Acid Malabsorption (BAM). It tracks how well your gut absorbs bile salts, which helps your doctor find the cause of chronic, unexplained diarrhoea. Stool The solid waste matter that is discharged from the body through the bowel (also known as faeces, poo, poop or a bowel movement). Stoma A stoma (derived from the Greek word for "mouth" or "opening") is a surgically created opening on the surface of the abdomen. It connects the digestive or urinary tract to the outside of the body, allowing waste to be diverted and collected in a specialized pouch. T TPFS The Pelvic Floor Society Transanal irrigation Transanal irrigation (TAI) is a bowel management procedure where lukewarm water is gently introduced into the rectum and colon using a soft catheter or cone. It is used to flush out stool, effectively preventing fecal incontinence and managing chronic constipation by emptying the lower bowel on a regular schedule. U Urge Faecal Incontinence Urge faecal incontinence occurs when the urge to have a bowel movement is very strong and access to a bathroom is needed urgently. The anal sphincter muscles are not strong enough to hold the stool back, so leakage occurs before toileting can occur. It can be associated with diarrhoea, weak anal sphincter muscles, rectal prolapse and incomplete rectal emptying. Urinary Retention Urinary retention is the inability to pass urine despite persistent effort. Chronic retention of urine leads to incomplete emptying of the bladder and lead to urinary incontinence and recurrent urinary tract infections. Urethra The urethra is the tube that carries urine from the bladder out of the body. In males, it also serves as a pathway for semen. UTI Urinary tract infections (UTIs) affect different parts of your urinary tract and include cystitis (bladder infection), urethritis (infection of your urethra) and kidney infection. Symptoms include pain or a burning sensation when passing urine (dysuria), needing to pass urine more often than usual (frequency) including during the night (nocturia), needing to pass urine suddenly or more urgently than usual (urinary urgency), observing urine that looks cloudy or is blood stained, experiencing pain in the lower abdomen or back, or having a high temperature, or feeling hot or cold and shivery. UTIs may be treated with antibiotics, but they're not always needed. Urodynamic Studies Urodynamics is a series of tests that evaluate how well the bladder and urethra store and release urine. During the procedure fluid is run into the bladder and the pressure response to filling and emptying the bladder is measured using a small catheter (tube). Urodynamic studies are sometimes combined with X-ray screening to look in more detail at the way the bladder expands and contracts. Whilst urodynamic studies may not always provide an explanation for urinary symptoms it is primarily used by urologists or urogynaecologists to diagnose the root cause of urinary incontinence, frequent urination, leakage, or sudden urges. Uroflowmetry Uroflowmetry is a quick, non-invasive diagnostic test that measures the volume and speed of your urine flow. By recording how fast urine exits the body, it helps doctors identify urinary tract blockages, an enlarged prostate, or a weakened bladder. V Vaginismus Vaginismus is an involuntary tightening or spasm of the pelvic floor muscles surrounding the vagina. This automatic reflex makes any form of vaginal penetration painful, difficult, or impossible. This can lead prevent sexual intercourse, using a tampon, or undergoing a pelvic exam. Vaginismus is typically a psychological or nervous system response manifesting physically and is highly treatable with appropriate supportive and multi-disciplinary care. Vault Prolapse Vaginal vault prolapse occurs when the top of the vagina loses structural support and sags downward into the vaginal canal, or protrudes outside the body. It most commonly happens after a hysterectomy when pelvic floor muscles and supporting ligaments weaken. Symptoms often include a sensation of heaviness in the pelvis, the feeling of a lump or protrusion in the vagina, and urinary or bowel discomfort. Vagina The vagina is an elastic, muscular canal that connects the external female genitalia (the vulva) to the cervix (the neck of the uterus). It serves three primary functions: it acts as a passageway for menstrual blood, a receptacle for the penis during intercourse, and the birth canal during childbirth. Vulva The vulva is the collective term for the mostly external, visible structures of the female genitalia leading into the interior of the female reproductive tract. It includes the mons pubis, labia majora, labia minora, clitoris, vestibule, urinary meatus, vaginal introitus, hymen, and openings of the vestibular glands (Bartholin's and Skene's). Pelvic floor muscles support the structures of the vulva and in addition to forming a protective barrier it has a role in sexual pleasure, urination, and reproduction.