Happy Bowel logo.jpg

The Gold Coast

Gastroenterology and Colorectal

Pelvic Health 


Patients with Bowel Problems can often feel at a loss with their Bowel problems before they see a Pelvic Health Physiotherapist.

These problems are often challenging to self manage and finding answers seems mysterious!

I have a special interest in Bowel Problems and as a result I created the holistic and integrative "Happy Bowels Program" from a background of many years of clinical experience knowledge from extensive advanced training in the assessment of colonic and anorectal problems to help my patients in the most effective and empowering ways. This service is a holistic service that provides an evidence based and integrated approach to pain in a multidisciplinary setting with GPs and Specialists

Training and certification includes: Completion of Clinical Masters of Physiotherapy in Continence and Women's health, Postgraduate Conservative management of pelvic organ prolapse, advanced training in anorectal disorders
(Sydney colorectal and pelvic floor center, Melbourne Gastroenterology) and advanced training in pelvic floor sonography and prolapse assessment using transperineal and translabial real time ultrasound assessment for pelvic floor dysfunction, defecatory disorders including the assessment of Pelvic floor dyssynergia and levator ani functional assessment, I can also provide advanced Biofeedback treatment for correction of evacuation disorders (ie inability to empty bowel).

I have also undergone advanced training in administering low FODMAPs and dietary considerations for cancer recovery and functional gastrointestinal disorders from Monash University, advanced assessment in colorectal disorders.


Angela has over 20 years experience as a physiotherapist treating men and women with pelvic floor dysfunction and has post graduate qualifications in pelvic floor physiotherapy. Her special interest lies in the management of bowel disorders such as constipation, bowel frequency and/or urgency and bowel incontinence (loss of control).  Angela is passionate about educating and enabling people to manage their bowel condition, allowing them to enjoy a more active & happy lifestyle.


Angela has travelled extensively to centres in the UK, Europe and the US renowned for their management of bowel dysfunction and was awarded a Victorian Travelling scholarship by the Victorian Government in 2012. 


She is an invited lecturer at the University of Melbourne (School of Physiotherapy), a member of the Australian Physiotherapy Association and the Continence Foundation of Australia.


The therapy programme offered by physiotherapists, Angela and Isabella Lees-Trinca includes:

  • Thorough assessment of the existing problem(s) and possible contributing factors

  • Education about the condition and strategies for managing it on a daily basis

  • Establishing a regular bowel habit

  • A personalised programme designed to improve the function of the muscles involved in effective bowel emptying and/or effective bowel control.  These are practised daily at home and may include

                  Correcting posture & breathing patterns

                  Improving control of the abdominal muscles

                  Improving control of the pelvic floor and sphincter muscles


  • Assistance with diet and medication –  learning how to manage without bowel medications/laxatives or how to use them more effectively


  • Training may also include the use of a small balloon placed into the rectum (lower bowel) while in the clinic.  This is a type of biofeedback and is used to teach the muscles (and the brain) how to perform the correct actions of ‘emptying’ or ‘holding on’.  It also helps to train bowel sensation – recognising a proper urge to go to the toilet.  This treatment is safe.


The initial session is one hour.  Learning new skills and developing new habits takes time – at least 3 - 6 months and up to 12 months to make them permanent. Progress is monitored and the training programme adjusted over time.  The average number of sessions is 3 - some people will need less and some more. 


Most people (70%) benefit significantly from completing a full programme and by working consistently every day at home.  Improvement can be maintained long term with continued attention to the strategies learnt.


See link “Physiotherapy and Bowel Behavioural Treatment

Conditions treated:

  • Functional Constipation

  • Irritable Bowel Syndrome

  • ●  Funconal Bloang

  • ●  Funconal diarrhea

  • ●  Funconal Abdominal pain

  • ●  Faecal and Flatus Inconnence

  • ●  Faecal urgency

  • ●  Pelvic floor Dyssynergia, incoordinaon and perineal descent syndrome

  • ●  Pre and post‐operave care – colorectal cancers, Anorectal surgeries

  1. The Happy bowels therapy program

    I have put together is a highly evidenced based and experienced program that includes:

    • ●  Subjecve and objecve assessment via digital rectal exam, transabdominal and transperineal ultrasound of the exisng problem(s) and possible contribung factors

    • ●  The program Aims:

      • ○  Provide paent with educaon about the condion and strategies for managing it on a

        daily basis, normal bowel funcon and correcng misinformaon about bowel funcon

      • ○  Establishing a regular bowel habit and corrects defecaon dynamics to eliminate

        straining, pelvic floor muscle awareness and training for strength and relaxaon. A personalised programme designed to improve the funcon of the pelvic floor muscles involved in effecve bowel emptying and/or effecve bowel control.

      • ○  These are pracsed daily at home and may include Correcng posture & breathing paerns, Improving control of the abdominal muscles, Improving control of the pelvic floor and sphincter muscles

      • ○  Assistance with diet and medicaon – learning how to manage without bowel medicaons/laxaves or how to use them more effecvely

      • ○  Low FODMAPs diet assessment, eliminaon and fodmap rechallenge and individualizaon/implementaon of the FODMAP diet and long term management, Meal plans and eang out opons

      • ○  Dietary therapies – fibre, caffeine/fat/alcohol, Food chemical, Meal paerns, dietary triggers, Non‐celiac gluten sensivity

      • ○  Rectal balloon training ‐ This is a type of biofeedback and is used to teach the muscles (and the brain) how to perform the correct acons of ‘emptying’ or ‘holding on’. It also helps to train bowel sensaon – recognising a proper urge to go to the toilet. This treatment is safe and evidenced based and is able to detect clinical change in symptoms and improvement.

      • ○  Non‐diet therapies‐ cognive behavioural therapy, gut‐directed relaxaon: Relaxaon strategies using training in Mindfulness Based Cognive Therapy

      • ○  Ceasing/reducing laxaves, enemas, suppositories