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Could Pelvic Floor Dysfunction Explain IBS Symptoms?

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Updated March 06, 2013

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Question: Could Pelvic Floor Dysfunction Explain IBS Symptoms?
Answer:

Due to the close proximity in the body, it is understandable to wonder if pelvic floor dysfunction (PFD), a condition in which the muscles in the pelvic floor don't work as they should, might be a contributing factor in irritable bowel syndrome (IBS). Research to date does not show any clear connection between the two disorders. However, as you will see, PFD can result in digestive symptoms similar to those seen with IBS.

Is There an Overlap Between PFD and IBS?

Research on any overlap between IBS and PFD is scarce, and therefore, no firm conclusions can yet be drawn. One study did find that women who reported they were told by a doctor that they had IBS were more likely to report the following symptoms, all of which are associated with pelvic floor dysfunction, than women who did not report having been given a diagnosis of IBS:

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 in order to measure the muscle contractions of the anal sphincter and rectum.

Pelvic Floor Dysfunction and Fecal Incontinence

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

Pelvic Floor Dysfunction 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 looking at 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.

DISCLAIMER: The information contained on this site is for educational purposes only and should not be used as a substitute for diagnosis or treatment rendered by a licensed physician. It is essential that you discuss with your doctor any symptoms or medical problems that you may be experiencing.

  1. About.com
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  3. Irritable Bowel Syndrome
  4. Symptoms
  5. Causes of IBS
  6. Pelvic Floor Dysfunction and IBS

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