Can a Pessary Affect Bowel Movements? What You Need to Know

If you’ve recently started using a pessary and are noticing changes in your bowel habits, you’re not alone and you’re not imagining it. 

For many people, the physical presence of a pessary can lead to uncomfortable or unexpected gastrointestinal symptoms, especially in the early stages of use. 

At Creekwood Physiotherapy, we understand that pelvic health can be personal and questions around bowel function can feel awkward to ask. But these conversations matter.

Let’s see how a pessary might affect your bowel movements, what you can do about it, and when it’s time to speak with a healthcare professional.

How Does a Pessary Work?

A pessary is a medical device, usually made of silicone, inserted into the vagina to provide support for pelvic organs. It’s commonly used to manage pelvic organ prolapse or stress urinary incontinence.

Impact on Neighbouring Structures

While pessaries are effective non-surgical tools, their placement near the rectum can sometimes cause:

• Direct pressure on the rectum
• Shifts in the angle or ease of rectal evacuation
• Sensations of fullness or incomplete bowel movements

These effects occur because the vagina and rectum share pelvic space. When that space is altered, changes in bowel habits are possible.

Common Bowel Changes With Pessary Use

Here’s what some people experience after starting to use a pessary:

Constipation or Difficulty Passing Stool

The pessary might press against the rectal wall, making it harder for stool to pass easily. This can feel like “backed up” pressure or frequent trips to the bathroom without resolution.

Feeling of Incomplete Evacuation

Even after a bowel movement, some users describe the sensation of not having fully emptied their bowels.

Changes in Stool Consistency

Whether stools become harder or looser, some people report a shift in texture or frequency after pessary insertion. This can also vary depending on diet, medications, and hydration.

What Else Affects Bowel Movements?

It's important not to assume the pessary is the only factor. Bowel function is influenced by several variables:

Diet and Fiber Intake

Low fiber diets can lead to harder stools. Adding more fruits, vegetables, and whole grains may help ease passage.

Hydration

Inadequate fluid intake is a common cause of constipation. Aim for 1.5 to 2 L of water per day, unless otherwise advised by a physician.

Physical Activity

Regular gentle exercise, even simple walking, can help stimulate bowel movements.

Medications

Common medications like painkillers, iron supplements, or antidepressants can also impact the frequency and quality of bowel movements.

Management Strategies: What You Can Do

While some symptoms may resolve as your body adjusts to the pessary, here are several strategies that can support better bowel function:

Optimize Your Diet

• Incorporate enough fiber daily.
• Include prunes, flaxseeds, or chia seeds for natural laxative effects.
• Reduce processed foods that slow digestion.

Stay Hydrated

Drinking water regularly keeps stool soft and easier to move. A good rule of thumb: pale urine often indicates proper hydration.

Mind Your Posture

Use a footstool during bowel movements to elevate your knees above your hips. This can help straighten the rectum and reduce strain.

Stay Active

Light activity like yoga or pelvic floor-focused physiotherapy movements can improve motility and overall pelvic alignment.

Consider Over-the-Counter Options

Occasional use of stool softeners or gentle laxatives may help but always check with a healthcare provider first.

When to Talk to a Healthcare Provider

Most of the time, mild bowel changes are manageable and improve over time. But certain signs should prompt further discussion:

Red Flag Symptoms Include:

• New or worsening pelvic pain
• Blood in stool or rectal bleeding
• Unintended weight loss
• Painful bowel movements or significant straining
• Symptoms persisting beyond a few weeks

If you’re uncertain, don’t hesitate to reach out. At Creekwood Physio, we create space for open, respectful conversations about pelvic health.

Our personalized treatment programs are designed around what matters most: your needs, your goals, and your quality of life.