• Emily Reul, PT, DPT

Irritable Bowel Syndrome (IBS)

If you have irritable bowel syndrome (IBS), you know what we mean when we talk about a “sensitive stomach.” You may feel like your bowels control your life. You don’t want to go to social events because you are worried about pain, gas, and leaking, or you may be worried about intimacy with your partner for the same reasons. Don’t feel hopeless! The prognosis is good for controlling symptoms of IBS through lifestyle changes (Goodman, 2009). This week we are going to dive into what irritable bowel syndrome is, how it affects the pelvic floor, and what treatment options you have.

IBS is one of the most common gastrointestinal disorders in the United States affecting 10-15% of individuals, and it is the most common reason for a referral to a gastroenterologist (Goodman, 2009; Irion 2010). IBS is more prevalent in women than men (Goodman, 2009). It is important to note that IBS does not cause changes in bowel tissue, does not have an inflammatory component, and it does not increase the risk of colorectal cancer like inflammatory bowel disease (IBD). Since IBS and IBD have similar symptoms (and similar names), it is important to see a healthcare provider to determine which you have. A healthcare provider can also help to rule out other conditions with similar symptoms like parasites or cancer.

What are the Symptoms of IBS? (Mayo Clinic, 2020)

  • Cramping

  • Abdominal pain

  • Bloating

  • Gas

  • Diarrhea, constipation, or both

IBS is often classified as one of three subtypes: diarrhea predominant, constipation predominant, or mixed with both diarrhea and constipation (Mayo Clinic, 2017).

What Causes IBS?

While the exact cause of IBS is still not known, researchers think it involves both the motor and sensory systems of the gastrointestinal tract and the central nervous system (your brain and spinal cord) (Irion, 2010). IBS is thought to be caused by abnormal contractions of the smooth muscles in the intestinal tract in response to certain triggers like emotions, stress, or certain chemicals in foods (like caffeine or lactose) (Goodman, 2009). It may also be cause by an imbalance of the “good bacteria” in the gut or an imbalance of the neurotransmitter serotonin (Goodman, 2009).

How does IBS affect the pelvic floor? (Irion, 2010)

The symptoms of IBS can cause a cascade of events that lead to pelvic floor dysfunction. Constipation and diarrhea can lead to anal incontinence (unable to hold in gas, poop, or both). IBS is also associated with chronic pelvic pain. Chronic pelvic pain can lead to incoordination and weakness of the pelvic floor muscles causing a variety of symptoms like:

  • Urinary frequency and urgency

  • Dyspareunia (pain with sex)

  • Low back pain

IBS is also associated with sleep difficulties, fibromyalgia, chronic fatigue syndrome, and temporomandibular joint (TMJ) dysfunction which can indirectly impact pelvic floor health (Goodman, 2009)

What Are My Treatment Options for IBS?

Keep in mind that this is not medical advice. This information is for educational purposes and can be used to guide conversations with your individual providers.

  • Regular exercise can help improve bowel motility and reduce overall stress (Irion, 2010; Goodman 2009)

  • Getting enough fiber in your diet, either through whole foods or supplements like psyllium husks or