We’ve all had those ‘butterflies in our stomach’ moments. You know the ones I mean, the times when excitement or nerves suddenly change the way our bodies are working.
The adrenaline rush we experience when we’re excited is a positive experience but what about on going levels of anxiety and stress? How do they affect our bodies and in particular our bladder, bowel and pelvic floor muscles?
Our bladder works best when – we are calm and relaxed
We’re usually not even aware that our bladder is filling. It’s a process going on in the background, not affecting our thoughts and behaviour, until our bladder gradually reaches its capacity at around 300-600ml. This often takes around 3 hours during the day when we’re drinking the recommended amount of 1.5 to 2 litres of fluid.
Everything changes when we’re tense and anxious. There is more adrenaline in our system and our bodies are much more sensitised. It’s thought that this heightened sensitivity can trigger the reflex of needing to pass urine as well as increasing the tension in our bladder muscle. Whatever the reasons, the result is often a strong desire to pass urine and an urgency that’s hard to control.
Now this cycle of events is ok if it is occasional and associated with one off events such as perhaps an interview, exam or driving test. But what if it is an on-going situation?
Perhaps you have a constant feeling of unease about the ever-changing regulations around Covid. The on-going situation with this virus has led many people to have an increase in their background levels of anxiety.
In addition to this tension what if you also feel nervous and anxious about your ability to control your bladder? What if the thought of leaving the house fills you with dread because you don’t know where you’ll be able to find a toilet? It becomes a catch 22 situation where your bladder will always be edgy and sensitive because you’re anxious about it.
Some of the new patterns of behaviour we’ve taken on board as we live alongside Covid may not be that great for bladder health.
Working from home means that you can be tempted to nip to the toilet and empty your bladder more often than necessary just because the loo is handy. If you’re working in an environment where a mask or a visor is required it can be a real challenge to ensure your fluid intake is kept at an acceptable level.
Not only do our bodies need to be well hydrated to stay healthy, adequate fluid intake reduces the risk of developing urine infections.
Our bowel works best – when it has a routine
Waking up, having some breakfast or a warm drink and moving around often triggers that familiar reflex when we have a strong sensation of needing a bowel movement. Some people experience this sensation after an evening meal or at other times in the day.
Stress affects our bowels in very different ways
Many people will remember the sensation of cramping or stomach ache that can creep up quickly when we’re worried or anxious. We know adrenaline affects the muscle of the bowel wall causing the contractions to speed up.
These contractions propel the contents of our colon along more quickly. The reason this makes a difference is that there less time for water to be re-absorbed by the gut wall. Instead of having a firm formed stool that’s easy to hang onto until we reach the toilet we may have a softer more liquid stool. Even if the muscles around our back passage and in the pelvic floor area are Olympic standard a watery stool is a real challenge to hang onto!
Other people find stress, especially if it is on-going, has the opposite effect and they become constipated. Stress hormones can cause inflammation and slow down movement of the gut contents.
So it’s complicated but we know our emotions along with some of the less helpful lifestyle changes we’ve taken on board as we live with Covid may not be great for bowel health. Dark nights and ‘comfort’ food, reduced exercise and more TV time along with drinking less fluid are all factors likely to make constipation worse.
Our pelvic floor works best when – it moves
There is a mantra in the world of physio that ‘motion is lotion’ for both our physical and mental well being!
Skeletal muscles love movement and there are three things that are especially important to them:
One – lengthening, fully releasing and letting go.
Two – slowly tightening, shortening and holding on when they are loaded.
Three – quickly responding to a command to ‘wake up’ and contract.
Stress and anxiety cause an increase in muscle tension and perhaps not surprisingly this includes our pelvic floor area. This tension often leads to an inability to release and relax leading to constipation, difficulty emptying our bladder and even pain during sex.
If the situation continues and the pelvic floor muscles are constantly working ‘overtime’ never releasing and letting go they may become shorter, stiffer and tighter. This can reduce the blood flow and make the whole area more sensitised.
What’s the answer to having a stress free pelvis?
Perhaps it’s about knowledge being power. The internet can be overwhelming, it’s a minefield of information, some of it useful and some of it ‘fake news’!
The answer is to keep it simple
- Move around and stay active, choosing a type of exercise that firstly you really enjoy and that secondly fits easily into your daily routine.
- Make sure your diet is sensible and you’re monitoring your fluid intake.
- Don’t feel guilty about having some chill time. Factoring in active relaxation is vital to our wellbeing.
- If you have on going issues with bladder, bowel or pelvic health that don’t go away with simple measures then seek advice from your GP or check out the Squeezy directory to find a specialist physio in your area. https://www.squeezyapp.com/directory/
A quick final note
We’re individuals when it comes to our bladder and bowel habits but never ignore any changes in the hope that they will just go away. Some changes are classified as ‘red flags’ and need checking out.
Written by Chartered Physiotherapist, Jane Appleyard.
Find out more about Jane here.
The information on this website is written to give general information and does not in any way replace advice from your G.P. or qualified healthcare professional. If you have any specific concerns about your health you should seek an individual consultation with your G.P. for diagnosis and advice.
