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IBS vs PFD (Pelvic Floor Dysfunction)

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Posted 1/29/2010 3:22 AM (GMT 0)
I have been suffering from constipation for the past 8-9 months. There has been no definite diagnosis, but IBS has been the favorite so far. The constipation definately gets worse with stress.

Recently, I have made aware of PFD (pelvic floor dysfunction). While this is predominately a female affliction, I am a male and based on research, I believe it is possible this is a more accurate diagnosis for me. In male victims, PFD symptoms include constipation as well as the urge to urinate frequently and amitriptolyne agrovates rather than helps, all of which are relevant to my problem.

Has anyone found that PFD has been the real problem after originally being diagnosed with IBS?
Posted 2/6/2010 2:20 PM (GMT 0)
DO you mean you are constipated and can not go for days at a time? Or do you mean you "can't get it out"? Or feel like you are having incomplete moves?
Posted 2/15/2010 7:06 PM (GMT 0)
Have you ever had a sitz marker test done for the consipation?

Do you have pain or discomfort?

a side effect of amitriptyline is constipation and they usally give it do d people. It can work for some people with IBS, but not all.

This is an informative site

http://www.aboutconstipation.org/

Pelvic Floor Dysfunction 

http://aboutgimotility.org/site/about-gi-motility/disorders-of-the-pelvic-floor/pelvic-floor-dyssynergia

Motility Disorders of the Pelvic Floor and Rectum

http://aboutgimotility.org/site/about-gi-motility/disorders-of-the-pelvic-floor/

 

Posted 3/20/2010 12:07 PM (GMT 0)
I had a similar experience. My doctors kept telling I had IBS for almost a year and my condition persisted, until my latest doctor suggested PFD. After due research on the internet, I concluded this is what I had. It has been 3 and a half months since I've been doing things to cure my PFD, but the progress is quite slow. I take warm water tub sittings twice a day, do pelvic floor exercies/kegels and take a lot of fibre (psyllium husk helps a lot). I'm now even thinking of consulting a therapist if I could speed up the recovery.
Posted 3/21/2010 12:30 AM (GMT 0)
im new to this site and am terrible with computers, but lets see how this goes:

 

im 26 years old and female. been suffering from awful constipation since i can remember. i finally got a good doctor to take my problem seriously over 2 years ago. i was originally told ibs and was put on different combinations of rx laxatives for over a year with no improvement. i started seeing a physical therapist at my doctors suggestion after tests kept coming back negative for any problems. my therapist says i have high tension pelvic floor dysfunction, and she specializes in treating it. i dont know if its more common in females as she tells me most of her patients with pfd-constipation are males. i dont doubt i have pfd, but therapy has been unsuccessful. im seeing a surgeon next week to discuss subtotal colectomy surgery since everything else has failed. im currently having to take valium suppositories every night to relax the muscles and give myself an enema every morning, as well as visiting the therapist every week for internal and external muscle releases. im also told i have to not exercise, as any type of toning can worsen the issue. this apparently normally works for people if you want to look into it with someone who specializes in treating pfd in your area. my therapist has been helpig people for about 25 years (mostly males) and says shes never had someone she couldnt help. she doesnt know why im not responding and therefore thinks surgery may be the answer now, though shes wary of it. all i know is im doing everything right and i think there must be a more serious problem.

 

i dont know if that helps you at all, but if you have any questions about what therapy involves feel free to ask :)

Posted 7/16/2010 4:43 AM (GMT 0)
Hi... I have bee recently diagnosed with Pelvic Floor Dyssynergia. I have had chronic constipation for as long as I can remember. I was diagnosed with IBS in 2005, and was put on Zelnorm. Zelnorm helped, but a month later I had some chest pain, not sure if it was related to the meds or not, but Zelnorm has since been pulled off of the market. May- June of 2010, diagnosed with Pelvic Floor Dyssynergia, after completing both stiz marker (balloon tests). I am just SO tired of it. I am in chronic pain, bloated constantly, and just sad. In September 09, I moved back to my home city, and since then the constipation has gotten so bad. I have gained weight due to the lack of energy, and just feeling like crap...literally. which makes me not want to eat as healthy as I used to. I get the urge to go to the bathroom, and have really bad pain, but nothing ever comes out. currently I am on a suppository every night, and 2 senna laxatives, and 1 stool softener, and 17 grams of Miralax every day. I also take magnesium citrate drink every 5 days. I am also going through physical therapy - biofeedback. I have been doing it for about once a week, for about a month so far. The only thing that has changed is my awareness to my issue. I am still keeping positive about the therapy, because I feel like it is still new. on Monday when I went the machine registered incorrectly, which kinda freaked me out a little, therapist, just told me that the machine was picking up my abdominal muscles. I am just so frustrated. I was told to not completed my ab workout, and target muscle strength, but can continue to do cardio. in Sept of 09, I used to be in great shape. Six pack, and 122lbs. Now, not nearly that weight, and def no six pack. Do you have any suggestions on how I can get my motivation up? I am a young 30 year old woman, and I just feel like I am in a rut with all of this stuff. I am just fed up. Just reading what you had wrote helped me. It is nice to know that someone else has this issue as well. Do you do anything special to get your mind off of it? anyway.. it will be nice to hear from you or someone, if anyone would like to comment. thank you. =)
Posted 7/18/2010 4:53 PM (GMT 0)
you can have ibs and PFD, just fyi.

Pelvic Floor Dyssynergia

http://aboutgimotility.org/site/about-gi-motility/disorders-of-the-pelvic-floor/pelvic-floor-dyssynergia


Motility Disorders of the Pelvic Floor and Rectum

http://aboutgimotility.org/site/about-gi-motility/disorders-of-the-pelvic-floor/


Disorders Related to Excessive Pelvic Floor Muscle Tension

http://www.iffgd.org/store/viewproduct/109


more info

http://www.aboutconstipation.org/search/?query=pelvic+floor+&x=19&y=5
Posted 7/19/2010 3:52 PM (GMT 0)
dear strain,

 

im very sorry to hear what youre having to deal with. i am 27 and had to suffer with extreme pain/bloating for a very long time due to my severely chronic constipation. i wish i could tell you that i led a happy life and knew all the secrets to ignoring the problem but thats just not the case for me. i can tell you that the best thing to do is keep on your doctor(s) to make you well. theres no reason that anyone should have to be living in misery due to this issue. i was ignored for a long time but i finally found a specialist who was willing to really listen and get me the help i needed. it was a looooong process. there was tons of testing, therapy, and medicine along the way. it wasnt cheap or easy. but you have to keep pushing to get well.  and i promise you it will be worth it. i had a total colectomy in april and since ive recovered i have been living the best life ever! i had no idea how much pain i was really in until it all went away. you live with it for so long that you just get used to it, but you shouldnt have to live with it. im not saying you should have your colon removed, but my point is you need to find someone who can figure out the right treatment you need. if youre not getting anywhere with one doctor then go to another one. youre still young, and i promise youll be able to get back into shape. you just have to be feeling well enough to be able to do it. now that im not hurting all the time i never sit still. its so nice to be able to do anything i want- even if its just running to the grocery store- without being in terrible pain. just try not to give up. i know where youre coming from and its very frustrating and extremely emotionally draining. i wanted to call it quits so many times and just accept that this is the way my life is and its not worth fighting anymore. but IT IS WORTH FIGHTING FOR! good luck :)

Posted 7/20/2010 12:23 AM (GMT 0)
This is a presentation from the last chat with the experts from the UNC center for functional gi and motility diosorders, one of if not the top center in the country.

Biofeedback for functional gi disorders. Dr Whitehead is one of the leading doctors on consitpation and works there, although this is from one of the doctors that does the actual biofeedback.

https://uncfunctionalgi.net/xmedia/player.php

Strain, although this might sound odd at first one thing they have used very effectively for moods and symptoms is gut directed hypnotherapy or Cognitive behavirol therapy. This can be an issue also that can need attension and even contribute to the symptoms. So there are things to do and try.

Let me know if I can help.

Posted 7/20/2010 12:27 AM (GMT 0)
in fact Dr Whitehead, was featured in the new gastroenterology magazine on biofeedback for the treatment of Levator Ani Syndrome.

http://www.gastrojournal.org/article/S0016-5085(09)02237-9/abstract
Posted 7/20/2010 12:31 AM (GMT 0)
There is also an article in here on

Clinic Corner: What is Pelvic Floor Biofeedback?
Article by Mary Scholz, RN, Phd

http://www.med.unc.edu/wrkunits/2depts/medicine/fgidc/collateral/digest/Spring_2010_Digest.pdf
Posted 7/20/2010 12:41 AM (GMT 0)
COMPREHENSIVE OVERVIEW OF CONSTIPATION

http://www.med.unc.edu/medicine/fgidc/comprehensive_overview_of_constipation.pdf

Constipation Causes and Treatments - D. Maier

http://www.med.unc.edu/medicine/fgidc/constipation_causes_and_treatment.pdf
Posted 9/19/2010 7:27 PM (GMT 0)
I was lucky enough to find a pelvic floor therapist through my gynocologist. I can't say I'm symptom free (I don't have MS or IBS) but I have had about a 50% improvement in my pain and ability to have a bowel movement. She used biofeedback and exercises, and taught me some massage techniques that might be useful for some symptoms. I also have an electronic stimulation machine (that sounds weird I know) but really does give me improved function. I highly recommend finding a pelvic floor therapist, they are few and far between, but they are highly trained in physical therapy and well worth the cost. I did eventually have surgery (for other pelvic floor problems) and am healing pretty well using the techniques I learned.
Posted 10/15/2010 1:00 AM (GMT 0)

Hi there

I have had PFD for 10+ years. In the last 3 years I was made aware of bio feedback training. This was a god-send. It does make a difference, but it takes a long time to notice improvements. I figure over a few more years more gains could be made. (Will never be 100% again, but 70-80% would be great if not awesome.)

I have a question for the group:

I've visited my specialist for treatment of an anal fissure and he made an interesting comment, he said that having a lateral sphincteroctomy to treat the fissure would also assist with relief from the symptoms of Pelvic Floor Dyssnergia. The theory is relaxed outlet helps relax the PFD symptoms overall.

I have never heard this before. Has anyone heard this?

 I would like to hope this would work, but I'm not convinced it would make any significant difference to PFD in the long run.

 Any thoughts would be appreciated.

Peter

Posted 10/15/2010 1:17 AM (GMT 0)
Pete, welcome and glad it helped you.

I will try to ask the experts tomorrow on your question if I can reach one of them on a Friday. If not I will try next week.

Posted 10/20/2010 2:43 PM (GMT 0)
Nitroglycerin cream can be use on the anus area to relax it.

It has to be prescribe by a doctor because i think it can increase heart rythm.
Posted 11/7/2010 2:34 AM (GMT 0)
This is a story with a happy ending. Don't accept your IBS diagnosis. Find out what is really causing your problems.

For seven years, I was diagnosed with IBS, my only symptoms being gas and feelings of incomplete evacuation. No constipation, no diarrhea, no pain, but some stupid doctor diagnosed me with IBS because she didn't know what was really wrong. After trying a million things, I finally read an article on pelvic floor dyssynergia. I brought it to my doctor (not the same one--I got rid of her six years ago!), who referred me to a holistic physical therapist. I began physical therapy with biofeedback to relearn how to move my bowels, which helped. My muscles for elimination were working all out of whack because, following anal fissures, I was afraid to relax and poop. The PT also concluded that I had a very tight anal sphincter as well, also probably from the fissures, and between the two problems, I could not move my bowels properly. So I had PT for both, beginning in June. Then I increased my magnesium dose to 800 mg. I have been having normal bowel movements for the past six weeks, and am so relieved!

So the moral of this story is to not accept your diagnosis, but find out what is really causing your problem. Only then can you fix it. Good luck!
Posted 11/8/2010 8:35 AM (GMT 0)

This is an excellent posting. Great to hear of a happy ending.

Yes, the bowels can be re-trained to function normall (or near normally). Therapy is the best option in all cases.

I'd like to repeat my question for the group. I have PFD and am being sent off to have a lateral sphincterocotomy to treat a long term fissure that will not heal. (PFD makes fissure healing a nightmare)

The surgeon claims that the lateral sphincterocotomy has a double effect 1. Allows fissure to heal better, 2. Helps counter the spasms of PFD.

Point 1. I accept as true,  but point 2. I believe is only wishful thinking. Does anyone have any scientific evidence to back up point 2.

Thanks

Peter

Posted 11/8/2010 6:13 PM (GMT 0)
Isla,

"Don't accept your IBS diagnosis."

what about the people that actually have IBS?

Yes, PFD conditions need to be looked at, but there are pretty specific symptoms for an IBS diagnoses and most of the time its IBS. Also some people can have more then one problem.

IBS is however a real and distint entity and that is important as well.

I am glad your doing better and someone's helping you figure it out.

Pete, I have been trying to contact and expert and see if he knows anything.

 

Posted 11/8/2010 6:21 PM (GMT 0)
Pete

I asked an expert and although he is not a surgeon he is an expert on PFD. He actually wrote the material above Dr Whitehead.

He said that was a reasonable approach and might help and if your were still having issues after the procedure, to perhaps try the biofeedback.

Hope that helps.
Posted 11/9/2010 1:21 AM (GMT 0)
Thans for that. Very helpful.

From what I've seen on the web people who suffer from Crohn's disease have reported that a lateral sphincterocotomy hasn't been much help in the long run as the problem is deep set and unrelenting. I guess PFD share some of these traits too.

Maybe some docs are published on the topic.

Anyway, thanks again

Cheers
Posted 11/17/2010 7:48 PM (GMT 0)

anonymuswi said...

<FONT color=#008000>im very sorry to hear what youre having to deal with. i am 27 and had to suffer with extreme pain/bloating for a very long time due to my severely chronic constipation. i wish i could tell you that i led a happy life and knew all the secrets to ignoring the problem but thats just not the case for me. i can tell you that the best thing to do is keep on your doctor(s) to make you well. theres no reason that anyone should have to be living in misery due to this issue. i was ignored for a long time but i finally found a specialist who was willing to really listen and get me the help i needed. it was a looooong process. there was tons of testing, therapy, and medicine along the way. it wasnt cheap or easy. but you have to keep pushing to get well. and i promise you it will be worth it. i had a total colectomy in april and since ive recovered i have been living the best life ever! i had no idea how much pain i was really in until it all went away. you live with it for so long that you just get used to it, but you shouldnt have to live with it. im not saying you should have your colon removed, but my point is you need to find someone who can figure out the right treatment you need. if youre not getting anywhere with one doctor then go to another one. youre still young, and i promise youll be able to get back into shape. you just have to be feeling well enough to be able to do it. now that im not hurting all the time i never sit still. its so nice to be able to do anything i want- even if its just running to the grocery store- without being in terrible pain. just try not to give up. i know where youre coming from and its very frustrating and extremely emotionally draining. i wanted to call it quits so many times and just accept that this is the way my life is and its not worth fighting anymore. but IT IS WORTH FIGHTING FOR! good luck :)

Hello Anonymouswi,

This is Strain30, I had to register again because I had forgot my username and password. I just wanted to thank you for your reply. My situation has progressively gotten worse. Now my GI specialist had refer me to another specialist because he has done all he can do, he stated that he doesn't specialize in "Pelvic Floor Dysynergy" That was back in Sept. 28 2010, which after that conversation he told me he would have his secretary fax my info to a new specialist. Well as of Nov 12th the new specialist never got my paperwork from him. OVER 2 MONTHS! I had to call them again Nov 16 and today the 17th just to make sure they finally faxed it over. But now that the new specialist has my paper work the appointment booker told me that he might or might not see me, and he is booked a year and a half out!.... I told her this morning that she will be hearing from me everyday until I get an appointment. It is so out of my character to be pushy, but if all of this has taught me anything, you are absolutely right, I need to be the one to follow through because I have had this pain for 30 years now! I am so over it, I have done all the testings, and I am still on this crazy laxative regiment that sucks. I am in pain 24/7. I always feel sick, and it is getting worse. This morning I had my second to last appt with my Physical therapist, because insurance will not cover anymore. She had already put in for an extension, but today she told me that she would not do another extension, because she feels I need more help than she can give me... due to me seeing her since May, June 2010 and no improvement. and in my last post I had put how the machine was acting freaky. well the following appointment, my therapist said that she was concerned so she hooked the machine up to herself and it was fine. she indicated to me that the "freakiness" was just my over acting muscles. So now it is Nov 17th and I actually order a home biofeedback machine, and my therapist had it this morning in her office. well, I was in such pain that I literally broke down... while she was showing me how to use it. it has just been a tough day. I now have to fight with the insurance company to pay for the machine... and then... what if it's not just PFD? This is just so hard to deal with. I am trying to take just one day at a time but it is very difficult with the constant reminder of pain, bloating, and my weight gain has just gotten worse. Have you or anyone else have weight gain too? My energy level is so slow, I just want to go to sleep. I am sorry that I am being so negative... I never used to be so sad...I just have a lot on my plate. I have to keep positive. Again, just knowing that someone else out there has this too makes such a difference.
Thank you for sharing
Posted 11/18/2010 5:20 PM (GMT 0)
Shawn,

I just got out of my third meeting with my Pain Management doctor. You had mentioned this in an earlier post to me. She is working with me on cognitive behavioral therapy. today she mention the hypnotic therapy. Has anyone ever tried it? I am open minded, and I am and have been staying away from prescription pain meds. I don't agree with them, and I strongly believe that they will make it worse. So I am leaning toward alternatives... so what are your thoughts on hypnotic therapy? Seeing someone for this is all very new, I have been living with IBS and PFD for 30 years now, and recently been diagnosed with PFD. So I have my share of pain... I am ready to finally be able to get some help with dealing with it.
Posted 11/18/2010 5:39 PM (GMT 0)
anonymous724

I personally use a home program that worked really weell for me and its been one of if not the best thing I have ever done for my severe IBS.


For IBS gut directed hypnotherapy has shown to be highly effective for most people.
An important thing here is they know how to treat IBS, its not just hypnotherapy but a specific kind of hypnotherapy for IBS.

some links

http://www.aboutibs.org/site/about-ibs/management/hypnosis

http://ibshypnosis.com/

These two docotrs are two of the top doctors on researching IBS and hypnotherapy.

The one I used was the first home treatment program from one of the top guys in the UK.

I personally highly recommend trying it.

Hope that helps. If you have any questions let me know. I am freinds with some of these doctors and therapists.
Posted 11/18/2010 8:41 PM (GMT 0)
Thank you Shawn.

Im glad you mentioned specific for IBS or PFD because I did not know there was a difference. My chronic pain doc seems good so far. But again PFD is not always heard of, I find myself having to explain what it is. This is the third time I met with her, and the first time I did have to explain PFD. I made an excuse for her considering she deals with cognitive behavior therapy, dealing with pain, not so much anatomy. unfortunately with the PCP doctors I have had, some of them have never heard of PFD. I have not been back to those doctors and I am still trying to find good PCP that is familiar with PFD, I am also or trying to find a PFD specialist because my GI specialist referred me to a mobility specialist and he has a wait list of a year and a half! If you know of any good ones I will take the recommendation.
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