IBS and Irritable Bladder: A Connection
Through my early and mid-twenties, my bathroom issues were restricted almost entirely to GI stuff. My bladder functioned just fine and it didn't even occur to me to be grateful for that. I just assumed it would stay that way. Even before I developed IBS in college, I always had a bit of sensitive gut, so it seemed I was primed to eventually get full blown IBS. However, even with endometriosis scattered all inside my abdominal cavity, my bladder remained unfazed. Yet, when I hit my late twenties and entered graduate school and everything changed.
A few months before moving from the Washington D.C. area to Burlington, Vermont to pursue my Master's degree, I began to get a lot of mid-cycle bleeding, often painful and sometimes heavier than mere spotting. By September, I noticed I was also experiencing a lot of frequency and urgency to empty my bladder, even when it wasn't even half-full. Even more alarmingly, if I put off going to the bathroom and sneezed or something like that, I would leak. I even wet my bed one night, something I had never done before, even as a young child.
I went to a gynecologist, who sent me to a specialist--who determined that I had about a dozen polyps in my uterus via an ultrasound. No doubt, these growths, which I had removed surgically right before the holidays, were putting some pressure on my bladder. But even after their removal, my bladder symptoms continued and I was referred to a uro-gynecologist. This doctors diagnosed me with overactive bladder. She made a mistake of telling me to do 50 kegels daily, which actually severely exacerbated my symptoms.
She then put me on medication that had such serious side effects (migraines, nausea and blurred vision), I could only take them twice a week. My bladder symptoms definitely eased considerably, but did not completely abate. I finally went to a different uro-gynecologist, who instead noticed that I had a very tight pelvic floor and did not need to strengthen, but rather relax, my pelvic muscles, which were often in spasm. She did a more thorough diagnostic work up that included a cystoscopy (when a thin scope is put through the urethra into the bladder in order to view it) and determined I had pelvic floor dysfunction and Interstitial Cystitis (IC). I was sent to a special physical therapist for eight weeks of pelvic floor therapy along with weekly bladder distillations (where the bladder is filled with a liquid combination of baking soda and lidocaine to relax inflammation).
Connection between IBS and irritable bladder
I began to feel much better from my treatments, and also became more careful about what I ate, avoiding overly acidic foods (which can also aggravate my IBS anyway). The pelvic floor dysfunction and irritable bladder symptoms were likely impacted by the trauma of my endometriosis and IBS. It turns out that the intersection between IC and IBS is relatively common, especially in female patients. In particular, the Interstitial Cystitis Association reports approximately one-third of IC patients also have IBS.1
Additionally, a 2010 peer review study in the Journal of Urology found that of a self-reported survey of 205 patients with IC, 38.6% also had IBS compared to only 5.2% of a control group without IC. In fact, IC patients in this study had IBS in higher amounts than other disorders the researchers compared for overlap, including fibromyalgia (17.7%) and chronic fatigue syndrome (only 9.5%).2 While the connection between IBS and IC isn't entirely clear or known yet, it makes some sense when you think about the close proximity of the bladder and bowels in the body and how they may be impacted by similar/the same traumas or issues that affect motility and can cause spasm.
Do you suffer from irritable bladder symptoms or IC, as well as IBS? How have you handled reconciling treatments for both disorders?
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