Dilating Triggering IBS-D Flare-ups

[Leena]

Hi all. I have had a lot of problems with IBS over the years, starting as IBS-C but then going more towards IBS-D since I had a c diff infection. I would have IBS-D flare-ups, mostly due to food and also at times to stress, but then often would get quite constipated again afterwards. After my procedure in May 2005, I was easily able to dilate with 4 at night and 5 in the day (I had trouble with severe burning beginning a few months after the procedure, which I shared in another thread, wondering if it had to do with the wearing off of the Botox). A side benefit seemed to be that dilating seemed to help me have more regular bowel movements. But over time, this turned into IBS-D flare-ups, which are awful. As a result, I have not been able to dilate without a flare-up for months and have also gone way off schedule due to needing to wait for my IBS-D episode to pass and then not dilating due to fear of having it happen again, as well as it happening every time I dilate, even with the # 1 dilator. I am pretty desperate because I came so far and conquered so much, and now I am scared that I will lose my progress. Now, when putting the #1 dilator in, I could feel the tightness at the opening and it hurt, but I was able to get through that due to my treatment and my knowledge of myself that I have gained through treatment; however, after sleeping with it I had a flare-up. If anyone has feedback, I would really appreciate it.

[mazemelissa]

Since vaginsimus is a type of pelvic floor dysfunction, it makes sense that it can trigger an IBS flare up, since the pelvic floor muscles are so close to the intestines. When you have pelvic floor dysfunction, you don’t have as much control over the pelvic floor muscles.

When you are dilating, you are triggering something in the intestine that is giving you the urgency, and frequency for defecation. When you were more constipated, this was a good thing, because it aided in your ability for a bowel movement. Now that you are more on the IBS-D side, you are getting more diarrhea flares, because I am guessing the dilation is some how irritating the intestine, and causing a spasm.

Since you have been dealing with IBS for many years, I am guessing you are already doing all the conservative treatments (fiber, diet changes, food diary). Sometimes increased anxiety can cause more flares, I for sure see vaginismus and anxiety linked together. If you feel that your anxeity level is higher than prior, you might want to investigate treatment for that. I see many patients who start a low dose anti-anxiety medication and that helps tremendously with treating their vaginimsus, it might also help with the IBS.

You can also start one of the new IBS-D medications and see if that helps control sx better, so your dilation doesn’t give you a flare.

Pelvic floor PT may also be really helpful as well. They will work on over all pelvic floor function and it can be very helpful for women with IBS and vaginismus.

Hope this helps.

[Leena]

Thanks so much, Melissa, for these tips. I will definitely pursue those that I have not already tried. Your answer is incredibly helpful, as well as validating.

[Heather34]

Hi Leena. I just replied to your other post. I think Melissa’s tips are so good here and pelvic floor PT may be really, really helpful. I found an article that addresses this as well and wanted to share. I hope this helps.

http://www.bodystressrelease.co.uk/index.php/body-stress-release/bsr-for-vulvodynia-vaginismus-vistibulodynia
Excerpts include:
“Body Stress Release practitioners have worked with many women suffering from vulvodynia / vestibulodynia / vaginismus and other related conditions. The majority of them have achieved significant relief from their pain and discomfort, which in some cases, they had been experiencing for many years.
BSR practitioners have noticed in some women that there is a common link between a previous back and/or coccyx injury and the subsequent onset of vulval pain. We have found that releasing tension in the lower back, sacrum, coccyx and pelvic areas encourages the vulval and pelvic floor muscles to relax, which in turn leads to a reduction in pain.
A significant proportion of the women we have seen also reported other symptoms of stored stress including IBS, indigestion, constipation, recurring urinary infections and cramps, all of which have improved with Body Stress Release.
Some examples of past injuries sustained include falling down stairs, falling off a horse, slipping on ice, and skiing and sporting accidents. A few women have also developed vulval pain or vaginismus following surgery. For some women, a substantial period of time elapsed between injury and the onset of vulval pain or tightness when their bodies reached a state of stress overload. A high percentage of women were originally diagnosed and treated for either cystitis or thrush.
The pudendal nerve is the motor nerve originating from the sacrum carrying signals to and from the urethra, genitals and the anal area. Tight or painful muscles that originate in the middle and lower back also insert into the pelvic area and may exert pressure on these nerve pathways. Tension in any of these areas may result in a burning feeling, loss of sensation, numbness, tightness, a stabbing, knife-like or aching pain.”

[Leena]

Thanks so much, Heather! It is good to “see” you again. I really appreciate this info.

[Heather34]

Hi Leena. Please, please let me know how it goes. In thinking about PT, I just wrote a post with a book recommendation from a Physical Therapist who commented in the past on here (see link to post). This may be helpful too. Sending you big hugs today!!!

//mazewomenshealth.com/forums/topic/moving-the-dilators/

[Rachel Hercman, LCSW]

Hi Leena,

Melissa and Heather mentioned some great suggestions– as I was reading your posts I was thinking that perhaps it may be helpful to try meditating a little bit each day. When our bodies go out of whack we can feel really disconnected from ourselves, angry, hopeless, etc., and all those emotions can show up in our bodies and how we feel. Meditating can be helpful in bringing us back to ourselves and finding a centered place even when we are dealing with the distress. Especially for vaginismus, where there is often a sense of detachment and feeling like the vagina is just not doing what it is supposed to do, taking a few pauses and being able to be there and present can be really helpful. Keep us posted!

[Rachel Hercman, LCSW]

Hi Leena,

Melissa and Heather mentioned some great suggestions– as I was reading your posts I was thinking that perhaps it may be helpful to try meditating a little bit each day. When our bodies go out of whack we can feel really disconnected from ourselves, angry, hopeless, etc., and all those emotions can show up in our bodies and how we feel. Meditating can be helpful in bringing us back to ourselves and finding a centered place even when we are dealing with the distress. Especially for vaginismus, where there is often a sense of detachment and feeling like the vagina is just not doing what it is supposed to do, taking a few pauses and being able to be there and present can be really helpful. Keep us posted!