Pelvic Floor Dysfunction and IBS
It's come to my attention that many people--and in particular, women--who suffer from IBS also tend to have a propensity for either having or developing pelvic floor dysfunction, which is when the pelvic floor muscles are not functioning either because they are too weak or too tight (or both).
Pelvic floor dysfunction diagnosis and treatment
I myself was diagnosed with pelvic floor dysfunction over a decade ago. I had already had my IBS diagnosis for over eight years, and had recently started developing bladder symptoms that were eventually ascribed to overactive bladder and Interstitial Cystitis, or IC. However, the uro-gynecologist I saw also noted that I had a very tight pelvic floor that was susceptible to frequent spasms, to which she also attributed my urinary issues. As a result, she sent me off to an 8-week program of intensive pelvic floor physical therapy, that focused on learning to relax my pelvic muscles with the assistance of biofeedback. What resulted was not only a vast improvement in my bladder symptoms, but also in my IBS symptoms.
The connection between pelvic floor dysfunction and IBS
This might be because, as it turns out, IBS and pelvic floor dysfunction (PFD) tend to intersect in many patients. In fact, there have been cases where what was thought to be IBS was in fact PFD--as one woman found out after years of trying IBS diets and treatments to no effect.
Research supports the overlap of PFD and IBS--especially for those more prone to constipation. For instance, a study published in 2010 of 50 female patients with constipation found that most of them exhibited at least some symptoms of "pelvic floor dyssynergia." And while IBS-C may be their genuine diagnosis, the study still concluded the IBS-C patients could benefit from biofeedback to address that pelvic floor issues they were experiencing and perhaps alleviate some of their constipation symptoms.1
Another study from 2009 noted that pelvic floor disorders have been associated with IBS in women and can adversely impact their quality of life. The study concluded that there does seem to be a relationship between IBS and other pelvic floor conditions--though whether one causes the other could not be ascertained. The study did refer to prior research that found that those with pelvic organ prolapse were nearly three times more likely to have IBS than those who had not had prolapse. A prominent theory regarding the connection between prolapse and IBS--or more specifically, IBS-C--is that the straining people do when they have constipation may make their pelvic floor weaker over time and therefore more susceptible to prolapse.2
The Mayo Clinic notes that as many as half of those who have dealt with chronic constipation are likely to have or develop some kind of PFD.3 Though I always personally tended to be more on the IBS-D than IBS-C side of the spectrum, I have experienced enough constipation in my life (particularly through my college years and early 20s) to think it may have played a role in my eventual development of PDF.
If you have had constipation or even other forms of IBS, you may want to check and see if PFD is also playing a role in your intestinal issues and abdominal pain. An assessment can make that determination and if so, physical therapy and pelvic floor retraining can possibly reap some benefits for your IBS.
Do you think there is enough awareness of IBS?