Does Pelvic Floor Therapy Help with IBS?
- ereul93
- Apr 10
- 4 min read
Hi friends! This month is IBS Awareness Month. Irritable Bowel Syndrome (IBS) is a chronic disorder that impacts the large intestine (called the colon), causing symptoms like bloating, abdominal pain, cramping, gas, diarrhea, and constipation and affects and estimated of 10-15% of individuals (Goodman, 2009; Irion, 2010). But what many people don’t realize is that IBS and pelvic floor dysfunction often go hand in hand. Improving pelvic floor health can be a powerful, but often overlooked, part of the healing process with IBS.
The pelvic floor is a group of muscles at the base of your pelvis that span from the pubic bone in the front to the tailbone in the back, and these muscles work to support the bladder, uterus, and rectum. These muscles play a role in bowel movements, bladder control, and even sexual function. When you experience symptoms from IBS (like cramping, constipation, or diarrhea) your pelvic floor can become overactive, overstretched, tight, or uncoordinated.
Some individuals with IBS experience:
Difficulty emptying the bowels (especially with constipation-predominant IBS)
Urgency and frequency that feel out of sync with actual bowel movements
Pain in the pelvic region from holding or straining
Pelvic organ prolapse from repetitive straining
Involuntary tightening of the muscles when trying to pass stool
Anal incontinence, often associated with diarrhea
Over time, this can lead to pelvic floor dysfunction—where the muscles are weak and/or they don’t relax or contract properly—which can worsen IBS symptoms and create a frustrating cycle.
IBS is often classified as one of three subtypes: diarrhea predominant, constipation predominant, or mixed with symptoms of both diarrhea and constipation (Mayo Clinic, 2017).
So how does pelvic floor therapy help? Pelvic floor physical or occupational therapy offer a holistic, evidence-based approach to managing the muscle component of IBS in several ways.
1. Muscle Coordination and Relaxation We assess how your pelvic floor muscles are functioning and teach techniques to relax or retrain them. During bowel movements, the muscles need to be able to lengthen to allow stool to pass through. Throughout the day, the muscles need to be strong and have good endurance to stay closed to stop any leakage. The key to healthy pelvic floor muscles is having them be able to do the right thing at the right time.
With constipation, involuntarily squeezing the muscles or bearing down can cause the muscles around the anus to contract, making it hard to pass a bowel movement through. Techniques like biofeedback and muscle down training can help these muscles learn the proper coordination. Frequent bearing down can also put excess pressure on the muscles and ligaments and overtime cause pelvic organ prolapse. Prolapse is when one or more of the pelvic organs (typically the bladder, rectum, or uterus) start to fall into the vaginal canal and over time can progress to coming outside of the vaginal opening.
2. Manual Therapy Hands-on techniques can release tight muscles, reduce pelvic pain, and improve blood flow. This is especially helpful when there’s chronic tension from long-standing IBS symptoms.
3. Breathing and Pressure Management We teach diaphragmatic breathing and body mechanics to reduce intra-abdominal pressure, which can ease symptoms like bloating and discomfort.
4. Lifestyle and Behavior Coaching IBS can be impacted by stress, diet, and habits like "just in case" bathroom trips or overuse of laxatives. Therapists can work with patients on behavioral strategies and collaborate with nutritionists or GI providers when needed. Tools like the Squatty Potty or Femmeze can help reduce straining and make passing bowel movements easier.
It’s important to recognize that IBS is not just a digestive issue. It affects and is affected by the entire body—including the pelvic floor. Pelvic floor therapy won’t cure IBS, but it can significantly reduce the discomfort, improve bowel function, and break the cycle of pain and dysfunction.
If you're struggling with IBS and haven’t yet considered pelvic floor physical therapy, now is the perfect time to start. Ask your provider for a referral or find a therapist near you at www.mypfm.com/find-a-pt.
To learn more about your pelvic floor muscles, check out these great resources:
Watch our YouTube video on How to Poop When and Where You Choose
Learn more about your pelvic floor on our Instagram
Visit our Amazon store for our favorite pelvic health products
Learn more about the pelvic floor muscles with our book: My Pelvic Floor Muscles The Basics: Learn where the pelvic floor muscles are, what they do, and how they work
For providers, check out myPFM Academy to learn more so you can better help your clients. With two membership options, you have access to courses, a growing library of patient handouts, hundreds of custom sharable images and infographics, and multilingual resources.
Written by Emily Reul, PT, DPT
References
Goodman CC, Fuller KS. Pathology: implications for the physical therapist. 3rdedition.2009. Saunders Elsevier St. Louis, MO. P 850-861
Irion JM, Irion GL. Women’s Health in Physical Therapy. Lippincott Williams and Wilkins; 2010.
The role of lifestyle-related treatments for IBS. Mayo Clinic. https://www.mayoclinic.org/medical-professionals/digestive-diseases/news/the-role-of-lifestyle-related-treatments-for-ibs/mac-20431272 . Published March 28, 2017.