Lower Back Pain and Irritable Bowel Syndrome

Is there a correlation between lower back pain and Irritable Bowel Syndrome? Researchers have long argued that IBS may be caused by abnormal functioning of the nerves and muscles of the bowel. No indication or explanation is ever given as to why this malfunction might occur. To my knowledge there has been no adequate evidence to support this assumption. More over, I have not seen, heard of or read about any studies which were specifically implemented to test this hypothesis. Because of my own observations about my own IBS symptoms, I am inclined to believe and support this hypothesis.

Some of us who suffer Irritable Bowel Syndrome have tried for many years, without success, to eliminate the often debilitating affects of this mysterious disorder. Generally those who suffer have spent a great deal of time and money, having test after test only to be told that nothing conclusive was found.

Often after years of diagnostic procedures and expensive studies, patients are told there was nothing wrong with them. Their complaint of symptoms are brushed off as imaginary or more properly put in medical terms, psychosomatic. But with the ever increasing number of patients complaining of the same generalized list of symptoms, the medical community has been forced, in at least a small part, to acknowledge the malady as something more then imaginary symptoms of hypochondria.

So what can we surmise about IBS? It is a condition or disease in and of itself? Or is IBS is a condition caused by or a symptom of some other physical, neurological or possibly even psychological problem that is as yet undetected or undiagnosed as being relative to the IBS condition? I find this to be a more plausible conclusion and will provide some insight for my personal belief that IBS is a secondary condition rather then a condition unto itself.

For years doctors have proposed the secondary condition concept in relation to Irritable Bowel Syndrome. Unfortunately, they have not yet been able to successfully document any evidence to conclusively say what might be the root cause of IBS. Moreover, I believe there is not just one cause, but several causes, all with the same secondary symptoms, which make up what is termed as IBS.

Please don’t think that it is my intent to say the IBS condition is not real, or the symptomology is psychosomatic in nature. I know from painful experience the condition and symptoms of IBS are very real. I also would venture to say because of the sheer number of reported cases, the medical community had been forced to re-evaluate their approach while dealing with patients with complaints of Irritable Bowel Syndrome-like symptoms. I am merely going to express what I personally have concluded about another possible causation for IBS which may be overlooked by the medical profession.

I would like to also toss up for consideration that IBS, with its list of many symptoms, may be a traceable progression of symptoms stemming from a single causation. I believe, in my case, this is a very valid assumption. I have as yet been unable to get any physician to agree with me, at least to the point of taking up the position on the record.

Before going any further, I think it would be a good idea to review a partial list of Irritable Bowel Syndrome symptoms. IBS may be characterized by a combination of any or all of the following symptoms:

o Abdominal discomfort or pain, usually in the lower abdomen

o Altered bowel habit

o Chronic or recurrent diarrhea, constipation, or both. May be mixed or in alternation.

o Bloating

o Heartburn

o Nausea

o Abdominal fullness

o Feelings of urgent need to evacuate the bowel

o Feeling of “incomplete” bowel emptying

o Low back pain

o Headache

o Fatigue

o Muscle pain

o Sleep disturbances

o Sexual dysfunction

More and more it is generally believed that the symptoms of IBS are produced by abnormal functioning of the nerves and muscles of the bowel. More and more I personally 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 give light as to why I believe this to be a possible causation for many IBS sufferers. Unfortunately, what I have come to believe as the causation for my particular brand of IBS, most assuredly will not be a diagnosis for all cases of IBS.

I think we who have suffered Irritable Bowel Syndrome tend to minimalize our symptoms and pain. We have been led to believe that other than common sense changes to diet and exercise there is nothing we can do because there is no cure. Many people who suffer will suffer in silence for years before seeking medical treatment. By then, and I include myself in this group, we may have subconsciously lessened or even put aside some of the lesser symptoms that IBS causes, focusing only on the ones that cause the most pain and discomfort.

Worse yet, we are less likely to bring symptoms to the attention of a doctor by mere assumption that it is just another facet of our complex disorder. This could become a dangerous scenario for anyone who suffers from IBS. We may ignore persistent symptoms that have gotten more intense or new symptoms that seem to be related only because we are discouraged by being told there is nothing anyone can do.

Doing these kinds of things could lead to serious life threatening symptoms being overlooked. Symptoms of conditions that, unlike IBS, can be treated if caught in time. 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 trips to the doctor.

My story of IBS starts over 20 years ago when I was a young man of 26. While helping lift a very heavy cast iron wood burning stove from the back of a pickup truck, the other person lost their grip and the load all shifted down hill onto my back. I felt my back give way as the stove went crashing to the ground at my feet. I knew I had sustained a serious injury. I couldn’t erect myself from the 90 degree bent forward position I was in. I had to literally pull my self up by using my hands and arms against the side of the pickup.

Being 26 and stubborn and thinking that I was invincible, I had my wife help me home and to bed, not bothering to go to the emergency room. I had some left over pain killers which numbed the pain enough to allow me to sleep. When I awoke in the morning I was horrified as I could not feel my legs. They were both cold and numb to the touch. I could move them, I just couldn’t feel them. After about 30 minutes of movement the feeling began to return to my legs and at that point I knew it was time to get to the doctor.

After the examination and x-rays what the doctor had to say wasn’t pleasant to hear. He told me I had two options. One was to go to a surgical specialist and have fusion surgery on several of my lower lumbar vertebra because the discs between them had been severely compressed. He mentioned that having this type of surgery would reduce my physical mobility by as much as 30% or more. At best, he explained, the surgery was about 40% effective.

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

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 would wake up to cold, numb legs and each day, but as he said, the symptoms gradually got better. I was so focused on my back injury improving; I didn’t pay attention to other, minor things going on which had become bothersome.

The first and most prevalent symptom was a change in my bowel habit. Not a big change, but it seemed that instead of a daily movement, it was now once every other day, and it took a bit more effort. But with the back issue, it seemed minor in comparison and for several years seemed to be the only symptom. My back continued to get better but my bowel never did return to normal.

I have always been a large person, in 1986 at the age of 26: I weighed about 220 pounds, standing 6 feet tall. Slowly, my weight began to rise. I attributed my initial weight gain to a lessening of physical activity over the first year or two of my back problem. By the end of the second year, my physical ability and activity had almost returned to normal. I learned to deal with the pain and my legs no longer went numb. I was able to function fairly well. Only occasionally did the pain in my back become such that I was unable to function in my “new” normal fashion, and usually only lasted a day or two. I now had added 70 pounds to my weight with no real explanation.

Only in the past couple of years (over 20 have passed since my back injury) have I begun considering the original injury being related to my bowel and stomach problems. Because I believed there was little I could do to rectify the situation, I have done as well as I could to manage the pain mentally. I did this well until the pain in my back started to worsen to the point that again my legs started going numb again. Not that this happened all the time, it was only occasional, but these bouts of pain have gotten much worse.

Only now that the back pain is impossible to ignore have I come to realize the cycle of events which have taken place. Now when I notice my legs are beginning to go numb on a more frequent basis, I have also noticed an increase in my IBS symptoms. More frequent and painful symptoms seem to begin with chronic constipation, lasting for many days. This is followed by the gas distress fatigue, head aches, bloating, acid indigestion, heartburn and eventually explosive diarrhea. Along with other symptoms, all interwoven into a cycle I now believe to be 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 disk compression and degeneration and spinal stenosis in the lower lumbar region. The treatment is as yet to be mapped out, but I now have at least one doctor who agrees that many, if not all, of my symptoms could be tied directly to nerve dysfunction resulting from my present spinal condition.

If you have sustained a back injury, or have IBS with lower back pain, it may be prudent to have a spinal study, to find out if an underlying back problem might be involved in the causation of your IBS symptoms. It stands to practical reason that if there is injury to the spine or lower back from where the nerves controlling lower bowl function stem, there could also be bowel dysfunction. With bowel dysfunction, the progression of symptoms in logical sequence right up the line to the top of the digestive tract would be a very plausible scenario.

If you have IBS and low back pain you really have nothing to lose and everything to gain by having a spinal examination. At the very least you may find out that there is no problem with your spine thereby eliminating one more source.