Upper Gastrointestinal Evaluation Related to the Pelvic Floor

Gregory F. Bonner

Pelvic floor dysfunction is not traditionally associated with upper gastrointestinal (GI) disorders. However, most of the major pathways of the brain-gut axis, which are so critical to pelvic floor dysfunction are the same as those innervating the upper GI tract. Although sacral nerve trunks are limited to the pelvis, the vagal and splanchnic innervation is the same. Dysfunction of the enteric nervous system in the upper GI tract leads to a variety of disorders in many ways similar to those disorders more traditionally associated with pelvic floor dysfunction.

As with pelvic floor dysfunction, related upper GI disorders often manifest as disorders of motility. They can generally be categorized into esophageal motility disorders, functional dyspepsia, and disorders of biliary spasm or dyskinesia. As with other functional GI disorders, patients with these conditions often show alterations in visceral sensation such as increased sensitivity to balloon disten-tion in various locations in the GI tract. As outlined below, there is often overlap of symptoms and presentation of the conditions.

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