The Spine and Irritable Bowel Syndrome
Last updated: April 2023
A recurring theme for me in advocating on IBS and other health issues, is how often they intersect with each other. For many years, I have had back pain, that I believe used to be mainly due to a combination of IBS and endometriosis, as well as a general propensity of my muscles to go into spasm. However, in more recent years, it would seem that my back -- or more specifically, the spine itself -- has developed its own problems that can at times intensify my IBS and other gut issues.
The screaming spine
While I've always had some back problems, they tended to wax and wane, with weeks, if not months, of relative relief. However, beginning in the winter of 2015, the pain in my back began to endure -- never really going away. It became incessant. I remember one morning in the summer after months of pain trying to sit up suddenly in bed, and screaming because my back reacted as though it had been pulled. I could barely move the rest of the day.
I decided to go to the doctor and demand further workup, which included an MRI. The MRI showed I now had Degenerative Disc Disease (DDD) in my low spine as well as the beginning of stenosis (when the spinal column narrows). After a year, two of the discs that were degenerated had also herniated (which means they burst sort of like the way a jelly doughnut would if you pressed down on it, spurting its innards) and bulged out of their columns -- with one disc bulge pressing hard on my S1 nerve, causing (what I now think is irreversible) damage to it. I also developed two Tarlov cysts, which are filled with spinal fluid and nerve fibers (and so cannot be removed) in my sacrum area, with one also pressing against my S1 nerve.
While I've been fortunate that my back problems did not mean I did a full-scale backslide (pun intended!) into a prolonged IBS flare of the type I had in my early years preceding and just after its diagnosis, I did notice that putting too much exertion on my back, could indeed aggravate a GI flare. This meant it became important to do all I could to take care of my back because its pain could impact my IBS issues.
Rule out spine issues
This is not just an observation, many of the nerves in the spine directly control signals to the bladder and bowels, so damage to the spine can adversely impact the function of either or both. A study from 2014 found that IBS patients had "significantly more findings in the physical examination indicating nerve involvement from spine segments...than people without gastrointestinal disorder."1 In the case of this particular study, it had to do with the thoracic spine (which is the middle back), whereas my spinal issues are in the lumbar spine (lower back) and sacrum. Nonetheless, another study noted that L5/S1 herniation can lead to "bowel dysfunction."2
If you are experiencing bowel problems and also have notable back pain and muscle spasms in the back (and others symptoms like leg numbness/tingling, sciatica), you may want to rule out issues with your spine before your doctor thinks IBS is the only reason. Again, I've been fortunate that my disc issues haven't made my IBS any worse than it already was -- so the best I can do is keep up with my IBS diet and try to be gentle with my back.
Which of the following symptoms of IBS do you experience most frequently?