Just an observation

however, have noticed several people suffering from lower back pain also suffer from IBS. Could there be any connection? Have suffered from both conditions for over forty years. Often wondered if there was a connection, been pooh-poohed by Drs, but am interested in the amount of posts I've read with both conditions mentioned.

Best wishes to all.

31 Replies

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  • Yes and no. Yes there is definitely a connection between inflammatory back pain (IBP, that can lead to a spondyloarthritis diagnosis) and inflammatory bowel disease (crohns or colitis), but there isn't a connection between ordinary mechanical or injury related back pain and IBS. Irritable bowel syndrome (IBS) can happen with anyone, and mechanical back pain can happen with anyone, and are likely more common than inflammatory back pain or inflammatory bowel disease.

    What you need to do first is assess whether you have inflammatory or mechanical back pain (the checklist for inflammatory back pain is on the nass.org.uk website). IBS (irritable bowel syndrome) also shouldn't really be diagnosed until other possible problems are excluded, including coeliac disease. Doctors in the UK do seem to be rather quick to dismiss gut problems as irritable bowel rather than check for inflammatory bowel problems though. If you do think your back pain is inflammatory, then definitely go back to your GP, tell them all the signs you have from that inflammatory back pain checklist, and ask for a referral to a rheumatologist - especially if you have a family history of autoimmune disorders. Also, if you haven't ever been screened for coeliac disease, ask for that too, as GPs are now meant to do that before they diagnose IBS. You do need to make sure that you have been eating a normal amount of gluten (in wheat, bread, etc) for probably at least 6 weeks before getting the coeliac blood test or you will get a false negative result. If you do get a referral to a rheumatologist, make sure you tell them about the gut stuff too, as that will give them more clues that point to spondyloarthritis (ankylosing spondylitis or psoriatic arthritis, or reactive arthritis), and also allow them to choose a treatment that will also help your gut.

  • Thank you for your reply, have had camera's up and down so anything nasty was illuminated many years ago. My bowel went into spasm whilst under the ether, however, explosive bowel syndrome was diagnosed and went under the all familiar label of IBS.

    Am still very interested in the amount of people that have both problems, and will continue to read and explore.

  • I have mechanical back pain. I know that when it is particularly bad, I get constipated.Sorry ! TMI ! I think the large bowel ( colon ), the part that runs across the lower abdomen, is affected. Perhaps because muscles tense up. Its important to try and keep the bowel moving, in my experience of my pain.

  • Again, thank you for responding. Have the opposite problem (the continuous diarrhoea) is a challenge whilst the back is bad form!

    Can I ask, what is mechanical back pain? are you an automaton! lol.

  • Ha ha! If I were an automaton I wouldn't have back pain! Just wind me up and let me go! Mechanical back pain is a commonly used medical term to indicate joints and movement.

  • Excellent reply, I just didn't know the terminology! made me giggle

  • As calceolaria says, an expanded full bowel can irritate mechanical back pain, by pressing on the sore back from the inside. Also hormonal changes during a period can loosen joints and the swollen uterus can press on the back from the inside too.

    The trigger poInts under the ribs at the back are directly linked to the digestive and urinary nerves, they cause pain, nausea and digestive blips like constipation. They also cause a pain like a kidney infection, dull ache accross the lower back. Many a time I've been to the dr for kidney infections and they found none. It was my sports physio who showed me how to switch off the trigger and stop all these symptoms using accupressure. Not the easiest one to do your self but it is possible. Often wondered if IBS is partly caused by this trigger too. It's not something I've had.

  • Thanks for reply, can rule out periods, kidney infections and the such. Will continue the quest, am still baffled.

  • In my experience, the answer is yes

    You've got some really really good replies already, which bear out my version of this, especially as most definitively diagnosed during the past 3 years

    I've been managing an undiagnosed variety of IBS all my life + infant onset systemic lupus + endometriosis + ehlers danlos type hypermobility...but only my chronic spine pain had been focused on by all my drs & consultants...they chose to think pretty much all my other health probs were down to my spine probs (spondylosis due to injury & hypermobility mainly)...but even when these spine probs had finally benefitted from effective treatment (bilateral facet joint denervations & IMS), the IBS etc etc symptoms remained...of course all those decades I was conscientiously lifestyle managing all my symptoms with at least some success so that life was sort of bearable (the Alexander technique & pilates have been key)

    Now I'm 60, and, thanks to a brilliant rheumatologist, have spent the past 3 years on a vvv effective treatment plan for systemic lupus which has minimised ALL my symptoms including my version of IBS + any lingering synovial spine joint pain....I feel virtually reborn

    So, I think your observation is a vvvv good one

    Thanks for getting this vvvv helpful & interesting discussion going

    Take Care

  • Barnclown, how pleased I am to hear of your improvement, good on you, it must feel marvellous to feel well after so many years of discomfort.

    For myself, I believe having spent some time travelling in the middle east and contracting salmonella in my twenties weakened the bowel. Having said that my back condition (slipped disc, trapped bulging nerve) has exasperated this condition. The back conditioned started in my seventeenth year and the IBS a few years later.

    I wish you well on the way to a full recovery.

    Your reply was very helpful.

  • You're vvvv welcome. Does help just to have put together a narrative that really can make some sense out of it all...everything we live through. Am wishing you all the vvvv best too

    For me, there is a terrific irony in having been so effected inutero by the powerful artificial oestrogen DES, that now, 60 years on, I'm finally finding a version of rebirth thanks to the effects of 2 powerful drugs (an antimalarial + an immunosuppressant). Who knows how long I'll feel this good...the main thing seems to be making the most of this phase, however long it lasts

    AND Your kindness has given me THE FIRST MOMENT of imagining:

    YES, who knows? Maybe SLE remission IS possible. Am v grateful

  • Hi Barnclown,sorry for delay but you askef me recently elsewhere(cant find it) for more details on my daughters plaquenol and palindromic arthritis. She was diagnosed 5 years ago aged 23.To put you in the picture apart from PDD she has no other health problems.Her symptoms have so far been confinef to her fingers, thumbs and wrists(both hands).Shr was diagnosef quickly and prescribed plaquenol twice daily for minimum of 2 years.(Dont know what strength).This is mecessary not only to reduce attacks but their is clinical evidence that those using plaquenol have a chance of delaying progression from palindromic arthritis to rheumatoid arthritis or lupus.Tha current statistics for PA are 10 percent full remission within 10 years^/40 percent remain palindromic,30 percent develop RA,15 develop lupus,5 percent othet autoimmune diseases. It may be worth mentioning I have an autoimmune condition(Graves).The idea was to come off plaquenol after 2 years and monitor, going back on it if necessary or trying anotherDMARD drug.Sounds simple this is ehere I need to explain my daughter!On meeting her the first think you will notice is she is breathtakingly beautiful(not just a mums but everyones opinion), the second on getting to know her she is almost phobic of anything medical.Hence she completely ignored advice and regused to believe there is anything wrong with her, doesn't go to hospital, doctors or even a chemist,.Therefore refused to take plaquenol.After months of me researchinh she took one pill got a rash and hence her beliefs about meds strengthen. The attacks continued more often than she would ever let on we mot allowed to discusd it only sometimes I notice it.Her fingers swell and go bright red and itd obvious they are v painful.Her partnet had said he thinks it is noe in her shoulder . Apparently she has now surrended and is taking one tablet a day so only half a dose and only sometimes but it is a start.I despair.

  • Many many thanks pippins. Am vv grateful for these details. Am vv sorry I've absentmindedly forgot we'd been in touch...My memory is not great, but I do 'hear a bell ringing' now you've reminded me! Will PM you briefly, hope that's ok

  • Yes I am one of them. My IBS started after a hysterectomy in my early 30's or so I thought but then I started to look back and realise that earlier than that I had had lower back pain and also bouts of a funny tum or so I thought. When I started on Pregablin the IBS seemed to get better and when I mentioned this to the doctor he said there are nerve endings in the bowel and that was the reason. Unfortunately lately the lower back pain has got worse and is constant and the IBS seems to be every day as well. The people who say eat 5 a day or even 8 a day have never suffered with IBS.

  • Hi rosewine, how I agree with you, any high fibre is horrendous to me. I have tried many times and the rush to the loo is something else! particularly when the back goes in free fall! Most medication I take makes the condition far worse.

    Wishing you well.

  • Yes, Backisbad,

    I'm inclined to think you might be onto something there and there may indeed be a direct link between backpain and IBS because my IBS is supposedly linked to my Fibromyalgia which in turn initially presented itself as Sciatica.

    I'd be very interested in finding out more if you decide to pursue this line of research.

    Wishing you good health and positive outcomes.

  • Hello Reykua, Will do my very best to research . Have a lifetime problem with both issues and it has totally changed my world.

    Only looking at some posts on here made me think more, having said that have been thinking for years if there was a connection.

    I too wish you the best of health and hope one day it will help the sciatica the same problem drives me round the bend, first thing in the morning is horrendous.

  • Hi

    Has your doctor ever discussed referred pain with you, I suffered extreme back pain alongside stomach pain. Kept going to the doctor about my stomach and kept being told it was indigestion. I thought I was being a baby about it. After five years I asked him why I got back pain at the same time. You could see the penny drop as he realized he had been fobbing me off for years. He know realized it was gall stones. Had tests immediately and operated on very quickly,. back pain stopped straight away. The important part of the diagnosis was the referred pain to the back. Also suffered back pain alongside period pain also told this was referred pain. This pain in my back also stopped after a hysterectomy proving the link. Some people seem to get more referred pain, with myself I don't know if there is a link to my fibromyalgia or not.

    Talk to the doctor about referred pain, it might shed some light on the back pain.What medication are you taking for you IBS .I also suffered from IBS which also gave me back pain until I had a new pain med and it vanished

  • Hi iona64. Thank you for your reply, appreciated. I take so much medication ( 17 pills a day) and am sure none of them help with the IBS. They aggravate my condition, however, once again am told the lesser of the two evils. Nice answer but my life is on hold and has been for years. Have been given pills in the past to counteract the effects of the other pills, it's on going.

    Please explain, what is referred pain? am familiar with both words, however, the context has me baffled.

    Thank you in anticipation.

  • Hi backisbad

    Definition: Referred pain is the phenomenon of pain being felt in an area away from the actual source of the pain.

    If you look it up on google there are several articles most indepth seems to be on wikipedia.

  • There may be lower back pain with IBS. This does not mean that the IBS is causing the back pain. However the overload to the body's engineering system may on occasion push the stress on the body to a stress greater than the stress breakdown limit. The result can be back pain.

    The IBS does not cause the back pain. The extra stress on the body produced by the IBS may lead to back pain. The body when under stress often responds with tighter muscles. The tighter muscles in certain areas cause back pain.

    Hope this explanation helps.

  • Again, thank you johnsmith, am talking slipped disc/trapped nerve pain, with respect , not speaking of a niggle in the back am talking cannot walk/get to the bathroom kinda pain. How do I get in the shower/go shopping/not cry when my family visit. Tight muscles can hurt, agree with you, bless you, It all helps.

  • Try a weekly gentle full body massage. Too hard and the muscles will tighten again. Gentle and they should gradually unwind themselves. It looks like your nerves are letting in too many signals causing feed back to the brain to the muscles etc etc which causes tightening. This is why the stretching is also important. Best if you can get a specialist Physio to do myofascial massage and to teach you and supervise your exercise. I have been through this: started screaming, pain now mostly under control if I respect it. Good luck, you can be better than you are now.

  • I am also talking about such things. Tight muscles can do more than just hurt. They can cause trapped nerves. They can pull vertebra out of alignment. They can play havoc with the digestive system. They can push the blood pressure up.

    Muscular feedback loops can be very complex. Breaking a feedback loop instigated by a tight muscle can be very difficult to break and change. Have a look at the performance stress curves that are available on the internet.

    I do have experience of cannot walk/get to the bathroom kinda pain. In some cases I have learnt to pick up the muscular warning signs "the little niggle in the back" that if not pampered to will result in full blown sciatica type pain as a result of a muscular feedback loop.

    Hope this helps

  • Thank you once again. Am at a loss at times to understand hanging out washing is so painful when it's my lumber region in trouble. The aches across my shoulders and mid back section is debilitating.

    You appear to be far more informed than myself on the subject. Maybe I should do more research and not just soldier on!

    Best wishes

  • Thanks for the reply. Research is difficult, where does one start? You are dealing with muscles. Much that has been written on the subject has been written by academics who have no experience of doing yoga, T'ai chi, karate and other physical activities. Much has also been written by researchers who engage in physical activities. It is very difficult to determine which books and research papers can be of benefit and which are not.

    You need to do research on yourself. What happens when I do this and what happens when I do that. Look in the mirror. How is my head balanced on top of my spine. How does the balance of the head on top of my spine effect my every day activities. The head balance will effect the pain in the arms and shoulders. The tension in the arms and across the shoulders will effect the legs. How? Investigate yourself and see. Allow your self time to develop the skills of doing this.

    If possible seek out an Alexander Teacher who can help you with the research into yourself.

    Join a meditation class. Have a look at Meditation - A Way of Awakening (2011) by Ajahn Sucitto. It has no copyright.

    cittaviveka.org/index.php/t...

    cittaviveka.org/files/books...

    The book on meditation is the best I have seen so far and it gives detailed instructions on Meditation which someone of any or no religious persuasion can follow. I have re-read this book many times. I also read exerts of this book to the meditation group I go to.

    Hope this helps

  • Hi Johnsmith: I really like the way you're explaining this HUGELY important stuff.

    Most recently, I've realised just how important the condition of our ligaments & tendons also can be to this 'pain aggravated by soft tissue tightening' thing.

    in my case there is global ligamentous laxity and global tendon tightening (began at birth, aggravated by a lifetime of systemic lupus going untreated). 60 yrs, of lifestyle management (inc bespoke foot orthotics+Alexander technique+pilates+tai chi) helped a lot. but, even so, the condition of my feet had progressively deteriorated causing persistent disability by 2008. The diagnosis process found mortons neuromas, but it wasn't until last nov when a hero prof ortho surgeon prescribed full-on gastrocnemius stretching (40min per day, alternating legs every minute) that my condition began to significantly improve: 25 weeks on of this arduous stretching, I can walk again without a cane, and have been able to hike for up to 2 hrs at a time...& the tendons in my feet have gradually stretched enough to clear up long standing forefoot CRPS (last year, 2 forefoot steroid injections were also part of the treatment plan)

    NOW my health team tell me this same global ligamentous laxity & tendon tightening has always played a huge part in my chronic spine pain (spondylosis + injury).

  • Thanks for the reply. The information you have given is very useful. I am impressed with your ability to do the required exercises. I struggle to do the stretching exercises my chiropractor tells me that I should do. I continually struggle with the idea that I should be getting instant results when I know that it will take some period of time.

    I can now think of a time scale of 25 weeks to get an improvement from a stretching routine that the chiropractor tells me I should do.

  • Yes there is a connection. It is explained better than I can on

    Institute For Chronic Pain. Google that ie Institute for Chronic Pain

  • Thank you Bowbells am on my way there

  • There most definitely is a connection. I was diagnosed with psoriatic spondylitis and told that back pain and ibs/ibd is linked.

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