Irritable bowel syndrome (IBS) is a condition that affects the digestive system of millions of people around the globe. It is a long-term condition that causes recurring pain or discomfort in the abdomen and altered bowel habits. Although it can appear at any age, the first symptoms usually appear in the early stages of adulthood for most people. Women are more likely than men to get IBS and have more severe symptoms. Symptoms of IBS may also include changes in urinary habits, such as increased frequency or urgency of urination, or difficulty fully emptying the bladder along with stomach cramps, bloating, and constipation that can come and go for days or weeks at a time.
There is no known cause or cure for IBS but there are things individuals living with it can do to manage their condition better such as changes in diet/lifestyle choices and medications if needed.
What are IBS Urinary symptoms?
Constantly needing to urinate
The symptoms of constantly needing to urinate for irritable bowel syndrome with urinary symptoms may include:
- Urinary urgency and involuntary leaking of urine
- Frequent urination, especially at night
- Difficulty controlling the urge to urinate
Sensitivity to bladder irritation
Irritable bowel syndrome with urinary symptoms (IBS-U) can cause several symptoms, including:
- Frequent urination
- Pain or discomfort in the bladder area
- Bloating and distension in the abdomen
- Abdominal pain, nausea, and vomiting
- Diarrhea
Difficulty with urination
The symptoms of difficulty with urination in irritable bowel syndrome urinary symptoms include increased urgency, nocturia (excessive urination at night), painful urination, urinary hesitancy, stopping and starting of urine stream, pain during or after intercourse or sexual stimulation, constipation straining to pass bowel movements, unexplained pain in the low back/pelvic region/genital area/rectum and side effects from certain medicines commonly used to treat IC/BPS may worsen PFD symptoms.
Feeling that the bladder is not fully empty
The symptoms of feeling that the bladder is not fully empty with IBS include:
- Frequent urination, especially at night
- Urinary urgency or the sensation of having to go immediately
- Pain or discomfort in the pelvic area or lower abdomen when urinating
- Difficulty starting a stream of urine, feeling like you have to push harder than usual to start it flowing
Urinary incontinence
The symptoms of urinary incontinence in IBS with urinary symptoms include:
- Urinary urgency: a sudden, uncontrollable need to urinate
- Involuntary leaking of urine
- Pain or discomfort in the bladder or pelvic region
- Difficulty controlling the urge to urinate
Bladder pain
The symptoms of IBS with urinary symptoms include:
- Frequent urination
- Chronic bladder discomfort and pain
- Bloating and gas
- Nausea or abdominal pain
- Abnormal vaginal discharge or itching in the genital area
Changes in bladder habits
Changes in bladder habits associated with irritable bowel syndrome with urinary symptoms include:
- Difficulty initiating urination (slow or delayed start)
- Urinary hesitancy (the need to pause before releasing urine)
- Poor bladder emptying (inability to empty the bladder)
- Incontinence (involuntary leakage of urine)
- Frequency of urination (need to go more often than usual)
The underlying cause of irritable bowel syndrome with urinary symptoms is believed to be the presence of inflammation in the gastrointestinal tract. This inflammation can lead to changes in how signals are transmitted between the brain and bladder, causing problems with coordination between these organs.
Additionally, there may be increased sensitivity in nerve endings within the bladder itself, which results in heightened pain sensations during urination. Furthermore, some people may experience constipation as a result of taking anticholinergic medications used for treatment purposes – this can further exacerbate existing issues by slowing down digestion and reducing blood flow through the digestive system.
Pelvic pain
Symptoms of irritable bowel syndrome with pelvic pain include abdominal pain, constipation, diarrhea, gas and bloating, nausea and vomiting, fatigue, and low energy levels. The condition may also cause sexual dysfunction such as decreased libido or difficulty achieving orgasm. Other common symptoms include headaches or migraines, back pain, anxiety, or depression.
GI symptoms and IBS symptoms
The symptoms of GI symptoms and IBS symptoms in irritable bowel syndrome with urinary symptoms include stomach pains or cramps, bloating, diarrhea, constipation, backache, feeling sick, tiredness/lack of energy, flatulence (gas), passing mucus in your stool and urinary incontinence.
IBS Symptoms in Women
Worsening menstrual symptoms
The symptoms of worsening menstrual symptoms in an IBS patient include abdominal pain, bloating, constipation or diarrhea, nausea and vomiting, difficulty eating or swallowing due to stomach pain and nausea, fatigue, and exhaustion.
Additionally, many women with IBS report a worsening of their IBS symptoms during certain phases of the menstrual cycle. Hormonal fluctuations may play a role in this symptom exacerbation.
Painful sex
For someone with IBS, pain during sex can be described as sharp or burning. It is most likely to occur during deep penetration and can make intercourse difficult or impossible. The pain may also extend beyond the pelvic area and into the lower back or abdomen. Sexual dysfunction in people with IBS includes a lack of desire and difficulty getting aroused, which can lead to insufficient lubrication in women and further increase the likelihood of pain during sex.
Bloating
Bloating is a common symptom of irritable bowel syndrome (IBS) that can cause an individual to feel tightness in their upper abdomen, get full faster after eating, and experience increased gas production and flatulence.
The following are some other symptoms of bloating in women with IBS: discomfort or pain in the lower abdomen, feeling full quickly after eating, nausea or vomiting, burping or belching frequently, abdominal distention (increased size of the stomach area), difficulty swallowing food or liquids.
Causes of IBS with urinary symptoms
Digestive Disorders
Irritable bowel syndrome (IBS) is a chronic illness that results in irregular bowel movements and recurrent abdominal pain or discomfort. Although it can appear at any age, the first symptoms usually appear in the early stages of adulthood for most people.
In addition to having more severe symptoms than males, women are more prone to get IBS. The causes of digestive disorders in irritable bowel syndrome with urinary symptoms include IBS itself as well as other possible underlying conditions such as endometriosis, Crohn’s disease, ulcerative colitis, and constipation or diarrhea due to dietary changes or medications used for the treatment of these conditions.
Inflammatory Bowel Disease
Inflammatory bowel disease (IBD) is a group of chronic conditions that affect the gastrointestinal (GI) tract. It is characterized by persistent inflammation of the intestines, which can lead to pain, discomfort, and changes in bowel habits such as diarrhea or constipation.
Irritable bowel syndrome (IBS) is a disorder characterized by abdominal pain and altered bowel habits, including diarrhea and constipation. IBS often coexists with other GI conditions such as Crohn’s disease or ulcerative colitis, both of which are forms of IBD. The cause of IBD is unknown; however it may be related to genetics, environmental factors such as stress or diet changes, immune system dysfunction, and gut microbiome imbalances.
This inflammation can cause the walls between the organs in the GI tract to break down causing pain symptoms in those areas along with impaired digestion leading to poor absorption of nutrients from food sources resulting in malnutrition among other side effects like fatigue or joint pain. Meanwhile, irritable bowel syndrome with urinary symptoms may occur due to increased pressure on the bladder due to abdominal discomfort caused by inflammatory bowel disease.
Chronic Pain Syndromes
Chronic pain syndromes that can cause irritable bowel syndrome with urinary symptoms include:
1. Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS): CP/CPPS can result in urinary pain, urinary urgency, and incontinence.
2. Irritable bowel syndrome (IBS): IBS is characterized by abdominal pain, constipation, or diarrhea as primary symptoms.
3. Inflammatory bowel disease (IBD): IBS is characterized by abdominal pain, constipation, or diarrhea as primary symptoms
4. Anxiety and Depression: IBS has been linked to mood and anxiety disorders, such as depression. The numbers of men and women with IBS who report having depression and anxiety are similar, but more women report experiencing stress than men. This increased risk of other diseases such as migraine, fibromyalgia, depression, and anxiety can lead to an increase in urinary problems such as overactive bladder syndrome (OAB) and interstitial cystitis in both men and women with IBS.
5. Intestinally Induced Urinary Symptoms: IBS can also lead to lower urinary tract symptoms such as increased urination frequency, urgency and nocturia. This is due to the fact that irritable bowel syndrome can affect the functioning of the autonomic nervous system which controls involuntary functions such as digestion and bladder function. Therefore, people with IBS are more likely to experience intestinal-induced urinary symptoms than those without it.
6. Abnormal Gut Sensitivity: Irritable bowel syndrome is a digestive disorder that can cause abdominal pain, diarrhea, and/or constipation. According to the theory of abnormal gut sensitivity, there is a miscommunication between the nerves in the brain and the gut which may lead to overreaction to various aspects of digestion.
This results in symptoms such as pain, diarrhea or constipation when digesting any type of food. Additionally, it may cause an overly sensitive response to gas or just passing poop. (PS, you may download a poop tracking app here.)
7. Bladder Sensitivity: The relationship between bladder sensitivity and irritable bowel syndrome is a cause-and-effect one. Studies have shown that there is significant hypersensitivity of mechanosensitive bladder afferents and alterations in the excitation and channel properties of bladder-innervating DRG neurons both during and following colitis.
These changes may be caused by direct sensitization of dichotomizing afferents, sensitization of DRG and spinal pathways, as well as an indirect sensitization of peripheral afferents following the breakdown of the epithelial barrier and induction of neurogenic inflammation.
Furthermore, there is ample evidence to suggest that alterations in neuronal sensitivity underlie symptoms associated with OAB or IC/PBS; therefore it is possible to exploit these neuronal pathways for treatment purposes.
8. Interactions Between the Gut and the Brain
9. Bladder Muscle Dysfunction: Bladder muscle dysfunction (BMMD) is a condition where the muscles that control bladder and bowel function do not work properly. It can lead to a variety of urinary tract conditions, such as interstitial cystitis (IC), pelvic floor dysfunction, urge incontinence, overactive bladder (OAB), chronic prostatitis and other related conditions.
The relationship between irritable bowel syndrome (IBS) and bladder muscle dysfunction is well established. Studies have shown that women with IBS are over 33% more likely to develop overactive bladder than those without IBS symptoms. Additionally, many IBS patients report experiencing urinary symptoms such as incomplete bladder emptying, frequent urination and nocturia (urinating at night).
Scientists believe that the close proximity of the nerves and muscles of the bowel and bladder may contribute to this link between BMMD and IBS with urinary symptoms due to their interaction on some level.
Treatment Options to Manage Urinary Symptoms
1. Diet and lifestyle changes
For irritable bowel syndrome with urinary symptoms, doctors may recommend dietary changes such as avoiding gluten, following low fermentable oligosaccharides, disaccharides, monosaccharides and polyols diet (known commonly as the low FODMAP diet), eating more fiber, taking medications to treat pain, diarrhea or constipation and taking probiotics. It may also be helpful to reduce stress and try mental health therapies.
For example, a patient with IBS with urinary symptoms may benefit from avoiding foods that increase urine production such as caffeine-containing beverages or foods high in sodium. They could also consume more fluids throughout the day to help prevent dehydration due to increased urination associated with their condition. Learn more about diets for IBS here.
2. Medications
Medications available for irritable bowel syndrome with urinary symptoms include anticholinergic medications, such as oxybutynin (Ditropan), tolterodine (Detrol), and trospium (Sanctura). Other drugs may include tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), and immune system modulators such as prednisone. Additionally, doctors may recommend lifestyle changes such as giving up smoking, losing weight, exercising regularly, and following a diet that restricts caffeine intake and acidic foods.
Bladder retraining can also be beneficial in some cases by encouraging patients to urinate at regular intervals. Finally, pelvic floor muscle training may be used to strengthen the muscles around the bladder area which can help reduce symptoms of urgency or incontinence associated with irritable bowel syndrome with urinary symptoms.
3. Physical therapy
There are a variety of physical therapy treatments available for irritable bowel syndrome with urinary symptoms. These include: Manual therapy or massage:
Manual therapy takes time and patience and may require one to three sessions per week, depending on the technique used and the patient’s response to treatment. Internal massage can also help release nerves.
Skin rolling: This technique involves applying pressure on the skin overlying a muscle group in circular motions, helping to increase blood flow and reduce pain.
Deep tissue massage (myofascial release): This type of massage focuses on releasing tight spots or “knots” within muscles by applying pressure directly onto them while stretching them outwards.
Trigger point therapy (for nerve release): This technique aims to reduce pain by locating areas where nerves are becoming irritated or inflamed and then applying pressure directly onto these points in order to relieve the discomfort they cause in surrounding areas. Joint mobilization:
Joint mobilization involves moving joints through their full range of motion while supporting them with pillows or towels in order to decrease stiffness caused by IC/BPS.
4. Psychological therapy
Psychological therapies available for irritable bowel syndrome with urinary symptoms include cognitive behavioral therapy (CBT) and mindfulness-based stress reduction (MBSR).
CBT focuses on changing thought patterns and behaviors in order to improve symptoms. It helps patients identify the factors that contribute to their pain, such as stress, anxiety, or negative thoughts about their condition. Then they can work together with their therapist to develop strategies for coping with these factors better.
MBSR is a type of meditation that helps reduce stress levels by focusing on the present moment instead of worrying about the past or future events. By practicing mindfulness exercises such as yoga or deep breathing regularly, patients can learn how to remain in control of their emotions when faced with difficult situations related to their condition.
5. Relaxation techniques
Various relaxation techniques are available to help relieve stress and anxiety. These include:
- Counseling therapies such as Cognitive Behaviour Therapy (CBT), hypnosis, and relaxation training
- Using warm baths twice a day
- Maintaining good posture to keep pressure off the bladder and pelvic organs
- Using stretching or other techniques such as yoga to avoid tightening other pelvic muscles
- Low doses of muscle relaxants such as diazepam (Valium), 2 mg three times a day
6. Probiotics
The benefits of probiotics for irritable bowel syndrome with urinary symptoms include:
- Balancing the “gut flora” and preventing the overgrowth of harmful bacteria in the colon.
- Decreasing inflammation in the digestive system and reducing abdominal pain, bloating, gas, and other IBS symptoms.
- Helping to maintain normal bowel movements by boosting the production of certain nutrients needed for healthy digestion and elimination.
- Reducing constipation by stimulating peristalsis (the rhythmic contraction of muscles that moves food through the digestive system).
7. Anti-inflammatory drugs
Anti-inflammatory drugs for the treatment of irritable bowel syndrome with urinary symptoms include:
- Antidiarrheals such as Loperamide (brand name Imodium)
- Anticholinergic drugs such as Dicyclomine (brand name Bentyl)
- Alpha-blockers such as Flutamide (brand name Eulexin) and Tamsulosin (brand name Flomax)
8. Surgeries
There are several types of surgeries that are available:
- Laparoscopic surgery: A minimally invasive surgical procedure that allows a physician to get a direct view of what’s going on inside the pelvis. It can be used to diagnose endometriosis or other potential causes of bladder and bowel issues.
- Gastrointestinal procedures: Procedures performed by a gastroenterologist to treat gastrointestinal issues such as constipation or diarrhea associated with IBS. These may include treatments such as medications, dietary changes and lifestyle adjustments.
- Urologic procedures: Procedures performed by a urologist aimed at treating bladder issues associated with IBS such as incontinence or pain while urinating; these may include injections or medication therapies, among others
In Summary
Irritable Bowel Syndrome with urinary symptoms can be managed through a few different methods. Cognitive Behaviour Therapy and Mindfulness-Based Stress Reduction focus on changing thought patterns and behaviors, while relaxation techniques such as counseling therapy, warm baths, stretching or yoga help reduce stress levels. Probiotics balance the gut flora and reduce inflammation in the digestive system, while anti-inflammatory drugs and surgery can help address more severe cases. To keep track of IBS symptoms, it is helpful to use a symptom tracker such as CareClinic, you can download it for free here. With the help of you health care provider, you can slowly work towards better outcomes!
