A pessary is a medical device designed to support pelvic organs, often used to manage conditions like pelvic organ prolapse or urinary incontinence. This removable silicone device is inserted into the vagina to provide structural support for organs such as the uterus, bladder, or rectum. While pessaries offer a non-surgical approach to improve quality of life, a common concern among users is their potential to affect bowel function. This article explores the connection between pessary use and constipation, offering insights into how this can occur and strategies for management.
Understanding Pessaries and Constipation
A pessary serves to hold pelvic organs in their correct anatomical positions, preventing them from prolapsing or causing discomfort. This support can alleviate symptoms like a feeling of heaviness or a bulge in the vagina. However, despite their benefits, pessaries can indeed lead to or exacerbate constipation in some individuals. The physical presence of the device in the vaginal canal sometimes interferes with normal bowel movements. The fit of the pessary plays a significant role in its impact on bowel function. If a pessary is too large or improperly fitted, it can create unwanted pressure on surrounding structures. This can make existing constipation worse or trigger new bowel difficulties.
How a Pessary Can Affect Bowel Function
The primary way a pessary can influence bowel function is through its physical interaction with the rectum and lower colon. When a pessary is in place, especially if it is larger or positioned unfavorably, it can exert direct pressure on the rectum. This compression can narrow the pathway for stool, making it more challenging for waste to pass through. Such pressure may also lead to a sensation of incomplete bowel emptying, even after a bowel movement. The physical presence of the device might obstruct the natural mechanics of defecation, where the rectum needs to expand and contract freely.
Strategies for Managing Constipation
Managing constipation while using a pessary often involves lifestyle adjustments and, if necessary, medical interventions. Increasing dietary fiber intake is fundamental, with adult women generally advised to consume around 25 grams of fiber daily from fruits, vegetables, whole grains, and legumes to promote regularity. Adequate hydration and regular physical activity are also important for stimulating bowel movements. If lifestyle changes are insufficient, over-the-counter options like stool softeners or various types of laxatives (osmotic, stimulant, or lubricant) may be considered. A healthcare provider can assess if the pessary’s fit contributes to the problem and may recommend a different size or type, or suggest temporarily removing it before a bowel movement.
When to Seek Medical Advice
While constipation is a common side effect, it is important to know when to consult a healthcare provider. Persistent or worsening constipation that does not respond to home remedies warrants medical attention. Severe abdominal pain, inability to pass gas or stool, or any other concerning new symptoms should prompt immediate contact with a doctor. A healthcare professional can evaluate if the pessary’s fit needs adjustment, rule out other potential causes of constipation, or recommend specific medical treatments. They can also provide guidance on appropriate use of laxatives and ensure the overall health and comfort of the individual. Open communication with your provider ensures safe and effective management of pessary-related concerns.