Lower back pain and irritable bowel syndrome

Lower back pain and irritable bowel syndrome

Is there a connection between back pain and irritable bowel syndrome? Researchers have long argued that IBS can be caused by abnormal functions of the nerves and muscles of the intestines. It is never specified or explained why this malfunction might occur. To my knowledge there is insufficient evidence to support this assumption. Furthermore, I have not seen, heard, or read any studies conducted specifically to test this hypothesis. Based on my own observations about my own IBS symptoms, I tend to believe and support this hypothesis.

Some of us who suffer from irritable bowel syndrome have tried unsuccessfully for years to eliminate the often debilitating effects of this mysterious disorder. Generally, those who suffer have spent a lot of time and money running test after test only to find nothing conclusive.

Often, after years of diagnostic procedures and expensive studies, patients are told that there was nothing wrong with them. Your complaint about symptoms is dismissed as imaginary or medically better expressed than psychosomatic. Given the ever-increasing number of patients complaining of the same general list of symptoms, the medical community has been forced, at least in a small part, to recognize the disease as little more than imaginary symptoms of hypochondria.

So what can we assume about IBS? It is a condition or a disease in and of itself? Or is IBS a condition that is caused by or is a symptom of another physical, neurological or possibly even psychological problem that has not yet been recognized or diagnosed as relative to the IBS condition? I find this to be a more plausible conclusion and will provide insight into my personal belief that IBS is a secondary condition rather than a condition in itself.

For years, doctors have proposed the concept of secondary disease in relation to irritable bowel syndrome. Unfortunately, they have not yet been able to successfully document evidence to definitively say what the root cause of IBS may be. Furthermore, I believe that there is not just one cause, but multiple causes, all with the same secondary symptoms, that make up what is referred to as IBS.

Please do not think that I intend to say that the IBS condition is not real or that the symptomology is psychosomatic in nature. I know from painful experience that the condition and symptoms of IBS are very real. I would also say that due to the sheer number of cases reported, the medical community has been forced to reevaluate its approach while dealing with patients who have complaints of symptoms such as irritable bowel syndrome. I will simply express what I have personally discovered about another possible cause of IBS that may be overlooked by the medical community.

I would also like to point out that IBS, with its list of many symptoms, can be a traceable progression of symptoms based on a single cause. I believe in my case this is a very valid assumption. I have not been able to get a doctor to agree with me, at least until I took the position on the record.

Before I continue, I think it would be a good idea to review a partial list of symptoms of irritable bowel syndrome. IBS can be characterized by a combination of any or all of the following symptoms:

o Abdominal discomfort or pain, usually in the lower abdomen

o Changed bowel habits

o Chronic or recurrent diarrhea, constipation, or both. Can be mixed or alternating.

o Bloat

o Heartburn

o Nausea

o Abdominal fullness

o Urgent feelings to evacuate the intestines

o Feeling of “incomplete” bowel emptying

o Lower back pain

o Headache

o Fatigue

o Muscle pain

o Sleep disorders

o Sexual dysfunction

It is generally believed that the symptoms of IBS are caused by abnormal functions of the nerves and muscles of the intestines. Personally, I increasingly agree with this as a valid and plausible perception of at least one of the causes of irritable bowel syndrome. With some personal observations, I hope to shed light on why I believe this is a possible cause for many IBS sufferers. Unfortunately, what I assumed was the cause of my particular brand of IBS will certainly not be a diagnosis for all cases of IBS.

I think we who suffer from irritable bowel syndrome tend to minimize our symptoms and pain. We have come to believe that there is nothing we can do other than common sense when it comes to diet and exercise because there is no cure. Many people who suffer will suffer in silence for years before seeking medical treatment. By then, and I am in this group, we may have unconsciously diminished or even set aside some of the lesser symptoms that IBS causes, focusing only on the ones that cause the most pain and discomfort.

Worse, we are less likely to bring symptoms to the attention of a doctor if we simply assume that it is just another facet of our complex disorder. This could become a dangerous scenario for anyone suffering from IBS. We may ignore persistent symptoms that have become more intense or new symptoms that just seem related because we become discouraged when we are told that no one can do anything.

Doing things like this can result in serious life-threatening symptoms being missed. Symptoms of conditions that, unlike IBS, can be treated if caught early. Things like colon cancer, stomach cancer, esophageal cancer, or many others might be missed because we want to ignore our IBS symptoms after so many doctor visits.

My story of IBS begins over 20 years ago, when I was a young man of 26. While I was helping lift a very heavy cast iron wood stove from the bed of a pickup truck, the other person lost his footing and the load shifted downhill onto my back. I felt my back give way as the stove fell to the floor at my feet. I knew I had suffered a serious injury. I couldn't stand up from the 90 degree forward position I was in. I literally had to pull myself up by pushing my hands and arms against the side of the pickup.

When I was 26 and stubborn and thought I was invincible, I let my wife help me home and to bed without bothering to go to the emergency room. I had some leftover painkillers that numbed the pain enough for me to sleep. When I woke up in the morning I was horrified when I couldn't feel my legs. They were both cold and numb. I could move her, I just couldn't feel her. After about 30 minutes of exercise, feeling returned to my legs and at that point I knew it was time to go to the doctor.

After the exam and x-rays, what the doctor had to say was not pleasant to hear. He told me I had two options. One was to go to a surgical specialist and perform fusion surgery on several of my lower lumbar vertebrae because the discs between them were severely compressed. He mentioned that such surgery would affect my physical mobility by up to 30% or more. At best, he explained, the surgery is about 40% effective.

My other option, he told me, was time...time for my body to try to heal itself. He explained that I would probably never be as good as I was before the accident, but that over time my body should partially heal itself. He told me that the inflammation that was causing the pain and partial paralysis should subside. At age 26, permanently losing 30% or more of my mobility was unthinkable. At least the second option offered hope for recovery. He gave me muscle relaxants and painkillers and that was it.

I trusted this doctor...we were good friends. We had a good personal and professional relationship. I took him at his word. By today's medical standards his medical advice probably wouldn't hold water, but over 20 years ago it was most likely a very good perception of my problem.

For the next 6 months I woke up every day with cold, numb legs, but as he said, the symptoms gradually improved. I was so focused on improving my back injury; I didn't worry about other, smaller things that had become annoying.

The first and most common symptom was a change in my bowel habits. Not a huge change, but it seemed that instead of daily exercise it was now once every other day and it took a little more effort. But with the earlier issue it seemed minor in comparison and appeared to be the only symptom for several years. My back kept getting better, but my bowels never returned to normal.

In 1986, at age 26, I was always a large person: I weighed about 220 pounds and stood 6 feet tall. Slowly my weight began to increase. I attributed my initial weight gain to a reduction in physical activity in the first year or two of my back problem. By the end of the second year, my physical abilities and activities had almost returned to normal. I learned to deal with the pain and my legs no longer became numb. I was able to function pretty well. Only occasionally would the pain in my back become such that I was unable to function in my "new" normal way, and usually only lasted a day or two. I had now added 70 pounds to my weight with no real explanation.

Only in the last few years (over 20 have passed since my back injury) have I begun to think about the original injury, which was related to my intestinal and stomach problems. Because I believed there was little I could do to correct the situation, I did everything I could to mentally ease the pain. I did this well until the pain in my back worsened to the point where my legs became numb again. Not that this happened all the time, it was just occasional, but these bouts of pain have gotten much worse.

Only now, when the back pain is impossible to ignore, have I realized the cycle of events that have taken place. Now, when I notice my legs becoming numb more often, I have also noticed an increase in my IBS symptoms. More frequent and painful symptoms seem to begin with chronic constipation that lasts for many days. This is followed by gas exhaustion, headaches, bloating, acid indigestion, heartburn and finally explosive diarrhea. Along with other symptoms all interwoven into a cycle, I now believe they are directly related to some type of nerve injury due to my original back injury.

I have since gone to a neurosurgeon and been diagnosed with severe disc compression and degeneration as well as spinal stenosis in the lower lumbar region. Treatment still needs to be planned, but I now have at least one doctor who agrees that many, if not all, of my symptoms may be directly related to nerve dysfunction resulting from my current spinal condition.

If you have suffered a back injury or have IBS with lower back pain, it may be wise to have a spinal study to determine whether an underlying back problem may be involved in the cause of your IBS symptoms. It is obvious that if there is an injury to the spine or lower back, from which the nerves that control the function of the lower bowl come from, intestinal dysfunction can also occur. In the case of intestinal dysfunction, the progression of symptoms in a logical order to the top of the digestive tract would be a very plausible scenario.

If you have IBS and lower back pain, you really have nothing to lose and everything to gain by undergoing a spinal exam. At least you can determine that there is no problem with your spine, eliminating another source.

Inspired by Scott Best