IBS and Bladder Problems

What to Do When They Happen at the Same Time

Sign pointing to public restroom
Photo: Robert Lang Photography/Moment Open/Getty Images

Are dealing with double trouble? Bowel and bladder problems at the same time? Frequent urination alongside your irritable bowel syndrome (IBS)? You may find some small comfort in learning that you are not alone - many people experience bladder problems and IBS at the same time. Let's take a look at the overlap between the two and what might be the underlying reasons behind your double distress.

Bladder Symptoms and IBS

There is a surprising overlap between bowel and bladder problems.

Some researchers have estimated that urinary symptoms may be experienced as many as 50 percent of people who have IBS. These symptoms include:

  • Frequent urination
  • Incomplete emptying of the bladder
  • Nocturia (need to get out of bed to urinate)
  • Urinary urgency

There is also some evidence that women who suffer from IBS also may be more likely to experience urinary incontinence than women who do not have IBS.

Why the Overlap?

Researchers do not know for sure why people who have IBS are at higher risk for urinary problems and vice versa. Their work into underlying factors may eventually lead to a better understanding of all of the factors at play. Certainly, the proximity of the organs responsible for elimination suggests that there is interaction among the various nerves and muscles of each system. Other possible reasons for the overlap between bowel and bladder symptoms include shared inflammation and/or shared central nervous system dysfunction.

Having a better understanding of the underlying causes can lead to more effective treatments, offering well-needed symptom relief. 

It may be heartening to know that researchers have found some evidence that improving the functioning of one of the two systems can lead to an improvement in the functioning of the other.

Urinary Conditions that May Co-Exist with IBS

The following health conditions each may affect the functioning of the bladder and/or the bowel:

  • Interstitial Cystitis:
    Otherwise known as painful bladder syndrome, interstitial cystitis (IC) is a condition in which a person experiences frequent urination, and chronic pain and discomfort associated with the bladder. Both IC and IBS have been associated with visceral hypersensitivity. In terms of identifying causes to explain an overlap between IC and IBS, researchers have been looking at the role of inflammation, a "cross-sensitization" among the nerves of the gut and bladder, and other possible centralized dysfunction. If you have IC alongside IBS, work with your doctor on a treatment plan that addresses both conditions. This may include medication, diet changes, and treatments such as physical therapy or biofeedback.
  • Pelvic Floor Dysfunction:
    Pelvic floor dysfunction (PFD) is another condition that could result in both IBS and frequent urination. In PFD, the muscles found within the pelvis that are responsible for coordinating urination and defecation do not work as they should. Having such a dysfunction might well explain why a person would suffer bowel and bladder symptoms simultaneously. If you are diagnosed with pelvic floor dysfunction, speak with your doctor about treatment options, as a wide variety of options are available depending on the severity of your symptoms. 
  • Chronic Prostatitis/Chronic Pelvic Pain Syndrome:
    Some men may find themselves with the misfortune of suffering from this chronic form of prostatitis alongside IBS. Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) results in a variety of symptoms, including urinary pain, urinary urgency and incontinence. There are medications available for easing the symptoms of CP/CPPS, so be sure to work with your doctor on a treatment plan.
  • Urge Incontinence:
    This urinary disorder results in symptoms of urinary urgency and involuntary urine passage. Unfortunately, there is not a lot of research regarding this overlap. Urge incontinence requires a complete medical workup, as a variety of different health conditions may be at the root of symptoms. 

What to Do If You Have Both

The most important thing to do if you are experiencing both bowel and bladder symptoms is to make sure to bring both to the attention of your doctor. Because of old-school stigma regarding "bathroom symptoms" many people are too shy to discuss their issues with their doctors. Don't be embarrassed - elimination is a normal part of being human, as your doctor well knows. Your doctor will help to come up with a diagnosis and provide you with a plan to address each problem.

Your doctor will tailor your treatment plan according to which bladder problem you are experiencing. If your double problem appears to be related to pelvic floor dysfunction, your doctor may recommend physical therapy or biofeedback. If your symptoms appear to be more related to visceral hypersensitivity, they may recommend a medication that targets the nervous system (in particular the neurotransmitter serotonin). Another option is the use of a medication that has anticholinergic effects. As you can there are a variety of different things that can be tried to bring you symptom relief, so be sure to tell your doctor what you are dealing with in terms of your "bathroom issues."

Sources:

Ya-Jun Guo Y, Ho C, Chen S, Yang S, Chiu H, Huang K "Lower urinary tract symptoms in women with irritable bowel syndrome" International Journal of Urology 2010 17:175-181.

Malykhina AP, Wyndaele J, Andersson K, De Wachter S, Dmochowski RR. "Do the urinary bladder and large bowel interact, in sickness or in health?" Neurourology Urodynamics 2012 31:352-358.

Persson R, Wensaas K-A, Hanevik K, Eide GE, Langeland N, Rortveit G. The relationship between irritable bowel syndrome, functional dyspepsia, chronic fatigue and overactive bladder syndrome: a controlled study 6 years after acute gastrointestinal infection. BMC Gastroenterology. 2015;15:66.

Wang J, Varma MG, Creasman JM, Subak LL, Brown JS, Thom DH, Van Den Eeden, SK. "Pelvic floor disorders and quality of life in women with self-reported irritable bowel syndrome" Alimentary Pharmacology & Therapeutics 2010 31:424-431.

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