Five Ways the Pelvic Floor and Gut Impact One Another
1. Gut dysbiosis and elimination
Gut dysbiosis is when there is an imbalance in the presence of beneficial and pathogenic microbes in your gut. Gut dysbiosis can cause a number of negative symptoms, but one of the most common is diarrhea.
The frequent elimination and inflammation that occurs when one is experiencing frequent bouts of diarrhea irritates not just the rectum, but the entire pelvic floor.
The increased incidence of elimination leads involves straining that puts consistent and persistent downward pressure on the muscles of the pelvic floor and like any muscle, they can fatigue and become weak from CONSTANT pressure.
For those of you that don't know, weak pelvic floor muscles are not as effective at supporting the pelvic organs (rectum, bladder and uterus (if you have one)).
Weak pelvic floors can also cause urine and fecal leakage.
2. Poor nutrient absorption and depletion of spleen Qi.
The microbes that reside (or are supposed to reside) in your gut have the amazingly important responsibility of harvesting energy from the food that you eat.
I know you've been walking around giving yourself and your body credit for this incredible job, but sorry. Your body has LONG been outsourcing it.
There's even research to suggest that the efficiency of nutrient absorption AND how the fuel is used (is it being used as energy or stored as fat) is determined by specific strains of microbes. Citation
Poor nutrient absorption disregulates the metabolism which frequently results in cravings, consuming more calories than necessary and high BMI in patients, ALL of which can play a role in elimination struggles and pelvic floor dysfunction.
Additional, a lack of nutrient absorption in the gut ALSO contributes to reduced elasticity, tension and recovery of muscles.
Weak muscles and lack of tension/elasticity contributes to the incidence of pelvic floor dysfunction and pelvic organ prolapse. (Citation)
But what's even more amazing (to me) is that the first step in the nutrient absorption process is DIGESTION. Digestion begins in the mouth with teeth and saliva. It continues in the stomach thanks to enzymes and acid. And then continues in the small intestine.
In Chinese medicine, pelvic organ prolapse is associated with a depletion of spleen energy. The health and balance of the spleen (yang) is directly related to the health of its yin, the stomach.
When the stomach (part of the gut!) is dysbiotic (remember that means that good microbes are absent and bad ones are present) it produces less acid and inefficiently digests food.
Inefficient digestion and low acid conditions allow pathogens that should otherwise be killed and starved in the stomach to thrive and survive on the undigested foods.
Inefficient digestion negatively impacts nutrients absorption while the impaired health of the stomach ALSo negatively impacts the spleen...
"One of the most common patterns found in western people is something we call Spleen Qi Deficiency. This can arise from any number of reasons but a poor diet mixed with irregular eating patterns and stress is a common way to develop this pattern. Spleen qi deficiency involves symptoms such as poor appetite, bloating (particularly after eating), weakness of the arms and legs, fatigue and/or loose stools.
As spleen qi deficiency continues to progress a subsequent pattern may develop called Spleen Qi Sinking. This pattern is essentially the same as spleen qi deficiency but with prolapses of the stomach, uterus, anus and/or vagina along with frequency or urgency of urination. This pattern shows a more internal weakness where the body can no longer hold the organs in place." (Reference)
Come on! Now tell me THAT isn't interesting and a perfect illustration of how the health and wellness of the pelvic floor and gut are intricately intertwined!
3. Gut microbiome determined muscle wasting and insulin resistance
The pelvic floor is this amazing system of muscle, ligaments and fascia at the base of your trunk that stabilize and support your body!
In order to effectively do it's job, these muscles and ligaments need to have some bulk, elasticity and resilience.
Sarcopenia, the progressive loss of muscle mass and strength is associated with aging, cancer and other diseases but it's also highly correlated with inflammation, chronic infection and malnutrition caused by imbalanced gut micro biomes deficient in legacy keystone strains of microbes.
"One recent animal study suggests a relationship between muscle wasting and alterations in the gut microbiome. Muscle wasting induced by a model of acute leukemia in mice was reduced by orally supplementing the mice with specific Lactobacillus species.(44) The Authors suggest that gut micro- biota may influence muscle physiology through altering amino acid bioavailability; influencing metabolites such as bile acids; and modulating production of pro-inflammatory cytokines.(42)"
In 2015 Maranhao et.al., evaluated the relationship between insulin resistance and pelvic floor strength.
They found that in their small sample group that as insulin resistance increased, strength of pelvic floor contractions and ability to recruit all the muscles of the pelvic floor decreased.
We know that the gut microbiome plays a significant role in the development of insulin resistance therefore this is yet another way in which the condition of the gut microbiome could impact the health of the pelvic floor. (Citation)
4. Anxiety and mood
The research is in, the oxytocin, dopamine, serotonin, endorphins are all neurotransmitters that control stress, anxiety, mood and behavior whose production by the body is MEDIATED by the bugs in your gut.
Stress, mood and anxiety are responsible for increased pelvic floor dysfunction and pelvic organ prolapse symptoms.
The peer-reviewed literature is ALSO showing that the psychological state of an individual contributes to flare-ups of irritable bowel syndrome (IBS).
IBS is highly associated with pelvic floor dysfunction because of the strain and pressure that bouts of diarrhea and constipation place on the pelvic floor.
5. A hypertonic (too tight) pelvic floor
Over-recruiting the pelvic floor muscles via exercise or every day life makes for too tight pelvic floor muscles and results in pelvic floor dysfunction.
You can imagine that since your pelvic floor stretches from your bladder to your rectum if it was too tight it could make you feel urge to urinate frequently AND could make elimination difficult.
Health routine bowel movements and urination rely upon the pelvic floors ability to relax.
When the pelvic floor is overly and consistently tight, then elimination habits are disrupted and trouble starts.
The colon is where water is resorbed or absorbed by the stool, depending on what is necessary to create healthy, easy to eliminate stools.
When overly-tight pelvic floor muscles make it difficult for waste to be excreted, one becomes constipated.
Besides being uncomfortable and causing straining to the pelvic floor, constipation ALSO negatively impacts the gut.
When stools remain in the colon for too the toxins that are supposed to be excreted begin to accumulate. The accumulation of these toxins leads to intestinal permeability (leaky gut syndrome) in which the mucosal lining of the intestines breaks down and begins to allow various substances to leak out of the gut into the blood stream.
Constipation can also mean that metabolized hormones in the stool are hanging around (causing hormonal imbalance and inflammation) preventing the body from making fresh new hormones!
So there you have it!
If you didn't consider the pelvic floor and gut to be two parts of the body that were impacted one another AND your whole body strength BEFORE you read this article, then hopefully you are beginning to see their connection now!
The body never ceases to amaze and fascinate me.
Sarah Smith is a trainer, lifestyle coach and postnatal fitness specialist that specializes in helping women feel strong, confident and capable in their bodies!
Her specialties include kettlebells, gut health and optimization for fitness goals, pelvic floor health and function and making fitness fun! Check her out on social media here or email her!