The Connection Between the Pelvic Floor and IBS

Featuring an interview by pelvic floor specialist, and Nashville-based physical therapist, Jen Le Coguic, PT, DPT, OCS.

Jen Le Coguic, PT, DPT, OCS is a pelvic floor physical therapist practicing at Susan Underwood Physical Therapy in Nashville, TN. She completed her Doctorate of Physical Therapy at Belmont University in 2011
and received her Board Certification as an Orthopedic Specialist in 2013. She completed her training as a pelvic floor specialist through the Herman and Wallace Institute.

I find it absolutely beautiful how our bodies are created to work together. As someone who lives with and works with IBS, I get to discover connections like this all the time. While every connection can add another layer to an already complicated IBS puzzle, they present opportunities for us all to grow and understand our bodies a little better.

One connection I have been diving into for the last few months is the pelvic floor. It’s not surprising that the pelvic floor is connected to our digestive process, but understanding how is fascinating. The pelvic floor refers to the layer of muscles that stretch along the bottom of the pelvis, extending from the tailbone to the pubic bone (front to back). These muscles work like a hammock to support the pelvic organs, including the bladder, bowels, and uterus (for women). The pelvic floor has openings for the urethra, anus, and vagina (for women), and the pelvic floor muscles work with the anal and urethral sphincters to keep these passages shut. This allows us to have control over the bladder and bowels to determine when we release urine, feces, and faltus (wind). The pelvic floor also plays a major role in sexual function for both men and women, and they work with the abdominals and back muscles to support and protect the spine.

That’s a lot of important stuff, right? So why don’t we hear more about the pelvic floor? Generally, the pelvic floor muscles do what they need to do. But, when they become weak or damaged, which can happen from a variety of causes including childbirth, this can lead to urinary incontinence, fecal incontinence, and/or pelvic organ prolapse (where the pelvic organs “drop” through the vaginal canal). When the pelvic floor muscles are too tight (a healthy muscle is able to both contract AND relax), this can cause constipation, straining during bowel movements, and incomplete defecation/emptying.

Many people with both IBS-D and IBS-C could be experiencing an issue with their pelvic floor that may not get recognized due to the symptoms being a “result of their IBS.” While pelvic floor dysfunction may not be the sole cause of your digestive issues, it could play a major role. And if you’ve been living with IBS for a long time, you may have more damage to your pelvic floor as a result of your symptoms.

To learn more about the pelvic floor, I had the honor of interviewing a local physical therapist, Jen Le Coguic, that specializes in this area.

Erin : In the most simple way, can you explain what pelvic floor physical therapy is?

Jen: Pelvic floor physical therapy is a specialized form of physical therapy with emphasis on the muscles, nerves, and connective tissues within the pelvis. These muscles encircle the openings and form a muscular support layer that runs from your pubic bone, out towards your sits bones, and back to your tailbone. These muscles help control your bladder, bowel, and sexual function, and they are an integral part of the body’s core stability system by supporting the spine, pelvis, and hips. Dysfunction can arise if these muscles are too weak or too tight. For example, if the muscles are too weak, a woman may leak urine with coughing or sneezing. On the other hand, if the muscles are too tight or uncoordinated, a woman may have problems with constipation, urinary frequency and urgency, pelvic pain, and/or pain with intercourse.

Erin: What is the function of the pelvic floor?

Jen: The pelvic floor has a wide range of functions but can be summarized by the 5 “S”’s:

  1. Sphincters: Keep things in/ let things pass!

  2. Stability: Stabilize the spine, hips, and pelvis.

  3. Support: Support the pelvic organs in their proper position within the pelvis.

  4. Sexual: Aid in sexual appreciation and orgasm.

  5. Sump pump: Help clear fluid out of the pelvis.

Erin: How would pelvic floor be beneficial for those with IBS?

Full article and interview with Jen, including what you can do for your pelvic floor today based on your symptoms, is found in the IBS Society. Click here to start your free 2 week trial today and keep reading!