The Link Between Pelvic Floor Dysfunction and IBS Symptoms

Is there a connection between pelvic floor dysfunction (PFD) and irritable bowel syndrome (IBS)? PFD is a condition in which the muscles in the pelvic floor weaken, but so far research does not show a clear connection between the disorder and IBS.

However, PFD can be associated with constipation and fecal incontinence, which are symptoms that often occur with IBS.

The 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:

• Fecal incontinence
• Pelvic pressure
• Urinary urgency

PFD and Constipation

PFD can lead to constipation through a process 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 healthcare provider. There is a possibility that you might also have PFD, which could be contributing to your symptoms. Your healthcare provider may recommend that you undergo a procedure called anorectal manometry. During 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. This problem can occur with either IBS or PFD. 

The pelvic floor muscles coordinate bowel movements and control the action of the anal sphincter. Dysfunction of these muscles, which occurs in both conditions, can result in fecal incontinence. This type of muscle dysfunction can also contribute to incomplete evacuation, which can increase the chances of 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 and urgency.

What Can Be Done?

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