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IBS Complications: Back Pain, Hemorrhoids, Anxiety, and Other Health Issues

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Last updated September 22, 2022

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What are IBS complications?

Irritable bowel syndrome (IBS) causes abdominal pain and a change in bowel movements (diarrhea or constipation or both). People with IBS may also have other symptoms or complications of the condition, like depression, anxiety, back pain, pelvic pain, hemorrhoids, or mucus in the stool.

These issues can make having the condition more challenging. There are several treatment options that can help, such as physical therapy, medications like antidepressants, and dietary changes.

See all IBS treatment options

Pro Tip

IBS affects an estimated 5–10% of the general population. It is also one of the most common reasons for people missing work. —Dr. Judy Kim

1. Back Pain

Symptoms

Cause: Upper and lower back pain is a common issue for people with IBS. It may be referred pain, meaning that the pain from gassiness or constipation may radiate (spread) to the back. Or it may be that people with IBS are more likely to have other chronic pain syndromes.

Treatment

  • Physical therapy to strengthen and support back muscles
  • Exercise
  • Weight loss
  • Treatments for constipation, like laxatives
  • Treatments for bloating, including probiotics, simethicone, and peppermint oil

2. Pelvic pain

Symptoms

  • Sharp or dull pain in the pelvic area (low abdomen)
  • Pain during sex
  • Altered bowel movements

Cause: Many people with IBS also have chronic pelvic pain (CPP). It’s not clear why, but pelvic pain may be a response to psychological stress, according to a study in the Journal of Clinical Gastroenterology. If you have IBS and pelvic pain, it’s important to see a gynecologist and a gastroenterologist (digestive tract specialist).

Treatment:

  • Physical therapy
  • Hormone therapy (birth control pills)
  • Antidepressants

Pro Tip

Some people worry that IBS can lead to colon cancer or inflammatory bowel disease. This is not true. —Dr. Kim

3. Hemorrhoids

Symptoms

Cause: If you regularly have hard stool and constipation, you can develop hemorrhoids. When you strain to have a bowel movement, the blood vessels and tissue around the anus can swell and bulge. This pressure can cause hemorrhoids. Hemorrhoids can also be caused by sitting on the toilet for too long.

Treatment

  • Eat more fiber
  • Take sitz baths
  • Use topical ointments around your anus (such as Preparation H)
  • Laxatives can help improve constipation
  • If severe, you may need procedures to shrink hemorrhoids or cut off their blood supply, such as sclerotherapy and banding.
  • Surgery to remove hemorrhoids

4. Mucus in stool

Symptoms

  • White or yellow discharge with stool

Cause: A small amount of mucus in stool is normal because it helps lubricate stool, allowing it to pass through the colon. About half of all people with IBS complain of increased mucus in stool, though it’s not understood why this occurs. Mucus in stool is usually harmless unless you have an overlapping condition, like a stomach bug (gastroenteritis) or inflammatory bowel disease.

Treatment

  • Avoid potential dietary triggers like lactose (found in dairy products), which may increase mucus in stool.

5. Anxiety and depression

Symptoms

Cause: People with IBS are more likely to have anxiety and depression than those who don’t have IBS. The brain and gut are in constant communication with each other, and disruptions in the gut-brain connection are believed to contribute to IBS. This connection may go both ways. This means that changes in mood can cause GI symptoms, and also that irritation in the gut may send signals to the brain that trigger certain emotions.

Treatment

  • Cognitive behavioral therapy (CBT)
  • Antidepressants or anti-anxiety medication
  • Exercise

6. Pregnancy and IBS

Women with IBS who become pregnant may notice that their symptoms change. The hormonal changes that occur during pregnancy can change your GI function and make IBS symptoms worse. For example, high levels of estrogen and progesterone can slow digestion and lead to constipation, according to a study in the American Journal of Gastroenterology. Pregnancy can also cause increased stress, which may worsen IBS symptoms.

Treatment:

  • Dietary changes, such as increasing fiber
  • Cognitive behavioral therapy
  • Medications that are safe during pregnancy, including some laxatives. Talk to your doctor to make sure that your medication is safe to use during pregnancy.

Dr. Rx

Ask your doctor:  What are some of the new prescription medications that have been approved for IBS? What are the specific benefits and what are the side effects associated with these therapies? —Dr. Kim

Can you get cancer or other serious complications from IBS?

IBS doesn’t make you more likely to develop more serious diseases. While some worry that IBS could increase their risk of colorectal cancer, this is not true. You may get more medical tests that expose you to low levels of radiation, but this doesn’t affect your risk of developing cancer. Also, IBS does not increase the risk of inflammatory bowel disease.

Can IBS symptoms change over time?

IBS symptoms can change over time. Some people may just have constipation or diarrhea at first and later it becomes IBS-mixed (having alternating constipation and diarrhea). Complications of IBS, such as hemorrhoids and back pain, may also develop over time. For others, IBS symptoms may actually improve as they get older.

See all IBS treatment options

Share your story
Dr. Kim is a Gastroenterology Fellow at New York Presbyterian Hospital/Columbia University where she also completed her residency training in Internal Medicine. She received her medical degree at Washington University in St. Louis and earned her BA in Biology at Harvard College. Her specialty is Gastroenterology, with a research interest in gastric cancer and clinical outcomes.

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