2/18/12

IBS (Irritable Bowel Syndrome) and Leg Pain: Causes


Having pain in your leg and wondering if this is related to your irritable bowel syndrome? For this article I consulted with Pejman Katiraei, DO, FAAP.  

He is an integrative physician who specializes in IBS, and will be launching and heading up the IBS Program at LifeSpan Medicine, which will be open to both children and adults as of June 30, 2011.

My one question to Dr. Katiraei was: Can IBS cause leg pain? He responds, “Yes!  The underpinnings of IBS are fascinating, and this underpinning helps explain the leg pain.  To start, we must recognize that people with IBS have inflammation in their intestines.  Inflammation means that there is increased immune activity in a part of the body.”

An example of this would be the redness that occurs around a cut in your skin, or the swelling of a sprained ankle. “People with IBS have inflammation in their intestines,” continues Dr. Katiraei.  “This inflammation typically involves a specific type of immune cell called mast cells.”

A doctor may give an endoscopy to a person with IBS, but tell that patient that all is normal … because pathologists are not able to see the mast cells via standard biopsy analysis. 

The problem is there, says Dr. Katiraei, but it goes unseen. This is why people with IBS are often told that nothing is wrong.

But Dr. Katiraei continues, “If doctors used very sensitive tools like electron microscopes or very specialized immune stains, they will find these changes in the intestines. In the bowel, sitting right next to these mast cells are nerve cells that take information from the intestines to the spinal cord.”

During an inflammatory process, the mast cells release chemicals that can irritate nerve cells. “The irritated nerve cells then send signals to the spinal cord that there is something very wrong,” says Dr. Katiraei.  

“Our brain interprets this signal as pain.  It so happens that the nerves from the legs merge in the spinal cord in the same area as the intestines.  The signal from the gut and the legs gets mixed up.”

This is called viscerosomatic convergence and it tricks the brain. “The pain signal from the intestines gets mixed up as a pain signal from the legs.”

So indeed, a person with IBS can definitely experience a perception of pain in the legs. The leg pain here is actually from the intestines. Dr. Katiraei adds, “When the inflammation in the intestines calms down, so does the inflammation in the joints, and the pain disappears.” 


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