Irritable bowel syndrome and pelvic floor: all you need to know

This article is inspired by the interest and questions of the members of our support group with Irritable Bowel Syndrome.

The starting point is how can gastrointestinal disorders affect the pelvic floor and its organs.

Actually, dysfunction of the pelvic floor and the organs it houses is one of the side effects (complications) of IBS in many cases.

To understand the mechanisms that underlie this complication, it is useful to remember the processes that develop in parallel in the case of IBS.

1) the dysbiosis of the microbiota that is at the root of IBS and that constitutes, with the inflammation of the enterocyte wall, the vicious circle effect that places the patient in a spiral of successive and progressive aggravations, leading to a drastic reduction in immunological competence. Subjects with IBS (even more so if this problem has been present for a long time) are therefore in a situation of greater fragility and exposure to opportunistic infectious pathologies

In women in particular, this sensitivity of the pelvic level can occur in urological (cystitis, urinary frequency), gynecological (fungal infections, vaginosis, menstrual cycle disorders, etc.) and perineal (fissure, lichen, herpes, eczema, etc.) disorders.

2) transit alteration leads to:

– a worsening of digestive dysbiosis with the appearance and proliferation of strains (fungal and bacterial) potentially more aggressive and pathogenic for the organs close to the intestine (bladder, vagina, prostate)

– a massive colonization of the perineum by these urogenitopathogenic digestive microorganisms during defecation (either IBS with diarrhea or constipation) with, therefore, a greater probability of colonization of the pelvic floor organs with consequent collateral infections

3) inflammation of the intestinal wall generates the release of many inflammatory mediators that, through mechanisms that can be considered “radiative”, spread to nearby organs and cause a generalized pelvic inflammatory state. Here we can mention not only organs such as the bladder, vagina and prostate, but also the muscle bundles, ligaments, pelvic joints, etc.

4) the painful symptomatology that forces the subject to adopt analgesic postures leads to develop malpositions of the pelvis, contractures of the pelvic muscles and “blocks” of certain joints

5) the phenomenon of intestinal hyperpermeability that allows the “leakage” of metabolic and digestive waste out of the digestive lumen and also endogenous bacterial migrations, increases the risk of collateral pelvic inflammation and infection

6) pseudo-allergic responses caused by this inappropriate presence of “foreign” substances in the pelvic tissues lead to massive mast cell recruitment and histamine release (MCAS and histaminosis) in the pelvic floor, subsequently contributing to inflammation, susceptibility to infection and resulting symptoms

For all of these reasons, IBS is often responsible for pelvic floor disorders, whether mechanical, inflammatory, or infectious.

When such discomfort, pain or pathologies coexist with an IBS, therefore, they must be seen as part of a whole and managed in parallel with the IBS for a resolution of both the causes and the consequences to break the “vicious circles” that maintain and feed the different facets of this one and only problem.

The important thing is above all to define a personalized approach that combines not only the correct measures but also a dosage that is feasible over time. In this sense, as always, we can support you if you wish.

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