The Gut Check: How Pelvic Floor Physical Therapy Can Help With SIBO, IBS, and Other GI Conditions

When you think of pelvic floor physical therapy, you probably think of issues like leaking urine, pain during pregnancy, or postpartum recovery. But did you know it can also play a major role in treating gastrointestinal conditions like SIBO (Small Intestinal Bacterial Overgrowth) and IBS (Irritable Bowel Syndrome)?

Before diving into the “how,” we first need to talk about what the pelvic floor is. (Hint: It’s not just for women, and yes—men have one too!)

What Is the Pelvic Floor?

The pelvic floor is a group of muscles located at the base of your pelvis. These muscles act as a foundation for your core, connecting to your hips, spine, and deep abdominal system. The best way to understand the role of the pelvic floor is by remembering the 5 “S”s:

1. Support – Holds up the pelvic organs (bladder, uterus/prostate, rectum)

2. Sphincter – Helps control bladder and bowel movements

3. Sex – Plays a role in sexual sensation and function

4. Stability – Works with your core and hips to stabilize your spine and pelvis

5. Sump Pump – Helps circulate fluids and mobilize internal organs—including your intestines

   
   

The last “S” (Sump Pump) is key when we’re talking about gut health. Let’s break it down.

Why the Pelvic Floor Matters in Digestive Conditions

People with SIBO, IBS, chronic constipation, bloating, or abdominal pain often don’t realize that the pelvic floor may be playing a major role in their symptoms. That’s because the pelvic floor and GI tract are neighbors—and teammates.

Here’s how dysfunction in the pelvic floor can contribute to GI issues:

• Pelvic floor tension can limit movement in the gut and contribute to bloating, constipation, and incomplete evacuation

• Poor coordination of pelvic floor muscles can make it hard to pass stool or fully empty the bowels

• Chronic straining can lead to pelvic organ prolapse or worsen symptoms of IBS

• Nerve irritation (especially the pudendal or vagus nerves) can heighten GI sensitivity and lead to pain, urgency, or cramping

• Pressure dysregulation in the abdomen affects digestion and motility

  
  

What Does This Mean for SIBO and IBS?

Conditions like SIBO and IBS are often driven by more than just food triggers or gut bacteria. While diet, stress, and lifestyle matter, mechanical factors like the way your abdominal and pelvic muscles move (or don’t move) can significantly impact digestion.

For example:

• Someone with SIBO may experience bloating and gas due to poor gut motility and tension in the abdominal wall and pelvic floor

• A person with constipation-dominant IBS may have a hypertonic (tight) pelvic floor that can’t relax during bowel movements

• Many people unknowingly brace their abdomen or clench their pelvic floor throughout the day due to stress or posture—this can disrupt normal digestive flow

  
  

What Happens in Pelvic Floor Physical Therapy?

When you see a pelvic floor physical therapist for GI issues, you’ll receive a holistic assessment that might include:

✔️ Postural evaluation – How your rib cage, spine, and pelvis are aligned

✔️ Breathing pattern assessment – Diaphragmatic breathing is crucial for digestion and pelvic floor coordination

✔️ Abdominal massage and visceral mobilization – Gentle hands-on work to help improve gut mobility and reduce abdominal tension

✔️ Pelvic floor muscle assessment – Internally or externally, we check for tightness, weakness, or coordination issues

✔️ Bowel mechanics education – Learn how to poop without straining (yes, there's a better way!)

✔️ Relaxation techniques – For calming the nervous system and improving vagus nerve tone, which directly impacts digestion

All of this helps improve motility, reduce bloating and constipation, and restore your body’s natural rhythm of digestion.

The Nervous System Connection

Many GI conditions are influenced by the gut-brain connection, which is regulated by the autonomic nervous system. Stress, trauma, and chronic illness can dysregulate this system, making your gut hypersensitive or sluggish.

Pelvic floor PT includes tools to rebalance your nervous system, such as:

• Diaphragmatic breathing

• Nervous system down-training

• Gentle movement to activate the parasympathetic “rest and digest” response

• Jaw and neck tension release (yes, your jaw is connected to your pelvic floor!)

  
  

When Should You See a Pelvic Floor PT for GI Issues?

You don’t need to wait until symptoms become severe. Consider pelvic floor PT if you experience:

• Chronic constipation or straining

• Bloating that worsens with stress or posture

• IBS symptoms that haven’t responded to diet changes alone

• Rectal pain, incomplete bowel emptying, or fear around bowel movements

• A diagnosis of SIBO that keeps recurring despite treatment

• Pelvic or abdominal pain that has no clear medical cause

  
  

Final Thoughts: It’s All Connected

Whether it’s your digestion, your core, your breath, or your brain—your pelvic floor is involved. If you’ve been chasing solutions for your gut issues and haven’t yet explored pelvic floor physical therapy, it might be the missing link you’ve been looking for.

A trained pelvic floor PT will treat you as a whole person, not just a diagnosis. We’ll work together to calm your gut, support your core, and help you feel like yourself again—because digestion should be natural, not a daily battle.

Want to learn more? Reach out today to schedule a pelvic floor assessment and start moving toward better gut health from the inside out. You don’t have to do this alone—there’s a path forward, and pelvic floor PT can help.