Overactive Pelvic Floor: Gastrointestinal Morbidities

The gastrointestinal symptoms which often coexist with an overactive pelvic floor are related to the defecation dysfunction provoked by a non-relaxing perineum. Such dysfunction is often the result of learned behaviors in childhood or can be induced by severe psychological distress, fear of pain or of incontinence. Such referred visceral pain encountered in irritable bowel syndrome (IBS) can induce perineal muscle pain. Constipation, obstructive defecation with strain, and deep pelvic pain may be the main clinical expression of IBS. The diagnosis is based on history and clinical examination. Pelvic floor investigations are needed to rule out other organic diseases. The treatment rests on rehabilitation of pelvic floor function.