The short answer
A rectocele—where the wall of tissue between the rectum and vagina bulges forward—can make bowel emptying difficult, often trapping stool in a pocket. While natural management techniques like proper toilet positioning and digital support (splinting) cannot cure or reverse the anatomical change, they can significantly reduce symptoms, ease bowel movements, and prevent further straining.
What is happening?
The supportive connective tissue and muscles between the vagina and rectum can stretch or weaken, often due to childbirth, chronic straining, or hormonal shifts.
- The mechanical effect: When a rectocele forms, the front wall of the rectum loses its firm backing.
- The bowel movement trigger: During a bowel movement, stool pushes downward. Instead of sliding smoothly toward the anal opening, part of the stool can push into the vaginal bulge, getting trapped in a pocket.
- The symptom: This creates a frustrating cycle of incomplete evacuation, a feeling of pelvic heaviness, and the temptation to strain harder, which only places more stress on the supportive tissues.
Why this can happen
Rectoceles develop from a combination of tissue changes and daily pressure habits:
- Straining habits: Chronic constipation or holding breath during bowel movements forces repetitive, high-pressure downward loads onto the pelvic floor.
- Connective tissue changes: Pregnancy, delivery trauma, or aging can alter the resilience of the fascial layer separating the rectum and vagina.
- Muscle coordination: Sometimes the pelvic floor fails to relax fully during a bowel movement, creating a barrier that worsens the trapping effect.
What you can do
Managing a rectocele practically focuses on reducing friction, changing your biomechanics, and assisting evacuation safely:
- Optimize toilet posture: Use a footstool (about 7 to 9 inches high) under your feet while sitting on the toilet. Elevating your knees above your hips straightens the angle of the rectum, making it mechanically easier for stool to pass without heavy pushing.
- Practice relaxed breathing: Keep your mouth open and breathe softly into your lower belly during a bowel movement. Avoid holding your breath and bearing down.
- Use gentle perineal support (splinting): If stool gets trapped, you can manually support the area to aid evacuation. With clean hands or wrapped tissue, apply gentle inward and upward pressure on the back wall of the vagina or the perineum (the area between the vagina and anus) just below the bulge during a bowel movement. This flattens the pocket, allowing stool to slide past smoothly.
What to avoid
- Do not strain aggressively: Forcing a bowel movement against a rectocele increases internal pressure and can worsen the bulging over time.
- Do not rely on aggressive self-treatments: Avoid harsh or painful internal manipulation. Splinting should feel like gentle structural support, never sharp or forceful.
When to get assessed
If manual support no longer helps, if bowel symptoms severely disrupt your daily life, or if you experience significant pelvic pain, bleeding, or complete inability to empty your bowels, consult a pelvic floor physiotherapist or urogynecologist. They can evaluate your symptoms, guide you on advanced management options, and discuss pessaries or surgical possibilities if conservative care is insufficient.
Bottom line
Natural management for a rectocele is about working with your anatomy rather than fighting it. By using a footstool to correct your bathroom angle and gentle splinting techniques to bypass the tissue bulge, you can achieve smoother, more comfortable bowel movements without unnecessary straining.