This form of physical therapy targets the muscles of the pelvic floor, which can play a crucial role in both bowel and bladder function.
Irritable bowel syndrome (IBS) is a common gastrointestinal disorder that affects the large intestine, causing symptoms such as abdominal pain, bloating, constipation, and diarrhea. Many people focus on dietary changes, stress management, and medication to manage their symptoms.
Pelvic floor therapy may help support pelvic muscle strengthening, relaxation, and coordination. To start pelvic floor therapy, you may work with a trained physical therapist to learn the exercises.
The pelvic floor is a group of muscles located at the base of the pelvis that support your bladder, rectum, and uterus or prostate. Contracting and relaxing these muscles allows you to control your bowel movements, urination, and, for people with vaginas, sexual intercourse.
For people with IBS, the pelvic floor can sometimes become overly tense (hypertonic) or weak (hypotonic), leading to difficulty coordinating muscle movements.
For instance, people with IBS-related constipation (IBS-C) may experience difficulty relaxing their pelvic floor muscles during bowel movements, a condition also known as dyssynergia. On the other hand, some people with diarrhea-predominant IBS (IBS-D) may have pelvic floor muscles weakened by repeated episodes of loose stools, leading to compromised control.
Some of the ways pelvic floor therapy can help include:
- Biofeedback training: One of the most commonly used techniques in pelvic floor therapy, biofeedback, involves sensors to monitor muscle activity. A therapist guides people in learning how to relax or strengthen their pelvic floor muscles effectively. A 2023 study notes that biofeedback may improve symptoms in people with dyssynergia by training the muscles to function harmoniously during bowel movements.
- Manual therapy: A skilled pelvic floor therapist may use hands-on techniques to release trigger points, reduce muscle tension, and address any pelvic pain. This approach may help those with hypertonic pelvic floor dysfunction, as it may alleviate discomfort and improve overall muscle flexibility.
- Breathing and relaxation techniques: People with IBS may experience heightened stress and
anxiety , which may impact the muscle tension in their pelvic floor. Therapists often teach diaphragmatic breathing and relaxation exercises to promote a healthy mind-body connection and reduce tension in the pelvic floor and abdominal region. - Education and bowel retraining: Pelvic floor therapists also provide valuable education on bowel habits and posture to optimize bowel movements. This may involve guidance on timing, positioning (such as squatting posture), and creating a routine to promote regularity and minimize straining.
Pelvic floor therapy for IBS typically begins with a
The initial evaluation involves reviewing your medical history, understanding IBS symptoms, and performing physical exams to gauge pelvic floor muscle strength, tone, and coordination. The therapist will then develop a customized treatment plan tailored to address your specific needs.
Consistency and active participation are key to achieving improvement with pelvic floor therapy. You may need to attend regular therapy sessions over weeks or months, alongside practicing prescribed exercises or relaxation techniques at home.
Pelvic floor therapy is not exclusive to those with IBS, but it can be particularly beneficial for those whose symptoms involve pelvic floor dysfunction. It’s an excellent option for people with IBS-C managing incomplete bowel movements or those with IBS-D experiencing control issues or urgency.
Additionally, IBS patients who also have pelvic pain or other related conditions, such as interstitial cystitis or chronic pelvic pain syndrome, may find added relief through this approach.
Pelvic floor therapy is a promising and effective intervention for managing IBS-related symptoms. By addressing the underlying issues in the pelvic floor, this therapy may help those with IBS symptoms improve their overall quality of life.
If you suspect pelvic floor dysfunction is playing a role in your IBS symptoms, consult your healthcare professional or a pelvic floor specialist to explore this supportive treatment option.