The Link Between Pelvic Floor Dysfunction and IBS Symptoms

How the two medical conditions overlap

Unhappy middle aged woman
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Is there a connection between pelvic floor dysfunction and irritable bowel syndrome? Since the bowel and the pelvis are positioned in close proximity to one another, both the public and medical researchers have wondered if there is a link.

PFD is a condition in which the muscles in the pelvic floor don't work as they should, but so far research does not show a clear connection between the disorder and IBS.

PFD, however, tends to produce some of the same digestive difficulties that IBS does.

Is There an Overlap Between PFD and IBS?

Research on the overlap between IBS and PFD is scarce, so no firm conclusions can yet be drawn about the two. But one study did find that women who reported a medical diagnosis of IBS were more likely to also report symptoms of PFD. Women who did not report an IBS diagnosis were less likely to report experiencing the following symptoms, which are all characteristic of PFD:

Pelvic Floor Dysfunction and Constipation

PFD can lead to constipation through a condition called dyssynergic defecation, also known as anismus. If you suffer from constipation predominant IBS (IBS-C) and suffer from straining, incomplete evacuation, and/or find that you need to use fingers to aid in a bowel movement, you should talk to your doctor about the possibility that PFD is contributing to your symptoms.

Your doctor may recommend that you undergo a procedure called anorectal manometry. In this test, a flexible probe is placed in the rectum to measure the muscle contractions of the anal sphincter and rectum.

The Role of Fecal Incontinence in Both Disorders

Fecal incontinence, more commonly referred to as a bathroom accident, is a very upsetting human experience.

IBS patients have this problem, but it is also experienced by people with PFD. Due to the role of the pelvic floor muscles in coordinating bowel movements and controlling the action of the anal sphincter, dysfunction of these muscles can result in fecal incontinence. PFD can also be a contributing factor to the symptom of incomplete evacuation, which can increase the chances that someone will later develop fecal incontinence.

PFD and Diarrhea

More research has been done on the relationship between PFD and constipation, as opposed to the role of pelvic floor dysfunction and diarrhea-predominant IBS (IBS-D). A small study did find that there was no significant difference in anal sphincter dysfunction among the various IBS sub-types. Hopefully, more research will be conducted that examines the possible role of PFD in IBS-D, particularly to gain a better understanding of the phenomenon of diarrhea urgency.

What Can Be Done About Pelvic Floor Dysfunction?

If you suspect that PFD is contributing to your symptoms, speak with your doctor. If you receive a diagnosis of PFD, your doctor will discuss treatment options related to the severity of your symptoms. Treatment options include physical therapy, biofeedback, medication, and in more extreme cases, surgery.

Sources:

Cheung, O. & Wald, A. "The management of pelvic floor disorders" Alimentary Pharmacology and Therapeutics 2004 19:481-495.

Mulak, A. & Paradowski, L. "Anorectal function and dyssynergic defecation in different subgroups of patients with irritable bowel syndrome" International Journal of Colorectal Disease 2010 25:1011-1016.

Wang, et.al. "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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