Can bowel problems cause leg pain? (+7 factors)

In this article, we will discuss whether bowel problems cause leg pain. We will also discuss some factors which may cause leg pain and some management techniques to lessen the severity of leg pain.

Can bowel problems cause leg pain?

Yes, bowel problems may cause leg pain. The most common causes of leg pain due to bowel problems include:

• Inflammatory bowel disease (IBD),
• Irritable bowel syndrome (IBS), and
• Constipation

Inflammatory bowel disease (IBD)

Inflammatory bowel diseases, including Crohn’s disease, ulcerative colitis, and diverticulitis are known to cause leg pain. Joint and leg pain is an indication that inflammation associated with IBD is now present outside the intestine (non-gut ailment).

Sweet’s syndrome is the rare extraintestinal manifestation of IBD which affects the legs and arms. Sweet’s syndrome is more common in immunocompromised patients and is characterised by leg and joint pain, arthritis, muscle pain, fatigue, headache, and inflammation (1). 

Rheumatological disorders associated with IBD, known to cause leg pain and other associated symptoms, can be divided into four clinical categories (2).

Some studies also suggest that IBD can worsen the condition of restless leg syndrome, causing burning, tingling, and pricking sensations in the leg. These painful sensations worsen at rest but improve with movement (3).

Irritable bowel syndrome (IBS)

Patients with IBS often report extraintestinal symptoms such as leg pain, lower back pain, headache, muscle pain, chronic somatic pain, heartburn, and dyspareunia. It may also cause altered visceral perception of pain and temperature (4).

Constipation

Constipation may lead to lower back pain because the mass of faeces presses on the nerves, known as sacral nerves, present in the lower back. Lower back pain may lead to leg pain. The buildup of waste in the intestine may also cause muscle and leg cramps.

What does research suggest?

In one of the case reports, a 31-year-old woman presented with leg pain, spasms, and intermittent abdominal pain. Her medical history signified Crohn’s disease and multiple bowel obstruction and adhesions (5). 

In another case study, a 7-year-old presented with leg pain, difficulty in bearing weight, recurrent fever, loss of appetite, and mild diarrhoea. He reported no injury or leg trauma. On proper examination, the boy was diagnosed with Crohn’s disease (6).

In another case, a 38-year-old presented with bilateral leg pain three months before the appearance of abdominal symptoms associated with Crohn’s disease. One month before visiting the doctor, the patient experienced abdominal pain and loose stool (7).

In one of the cross-sectional studies, the researchers established that the prevalence of restless leg syndrome was more common in IBD patients (21.5%) as compared to healthy people (9.7%) (3).

What are other symptoms of bowel problems apart from leg pain?

Other common symptoms which may happen due to bowel problems include:

• Diarrhoea,
• Constipation,
• Bloating and gas,
• Abdominal pain,
• Weight loss,
• Fatigue,
• Dehydration.

Some rare extraintestinal symptoms associated with bowel problems include:

• Arthritis,
• Reactive and specific lesions,
• Nutritional deficiencies,
• Vitiligo,
• Retinal vascular disease,
• Corneal ulcers,
• Delayed sexual maturation, and
• Metabolic manifestations such as gallstones and fatty liver (8).

What other factors may cause leg pain with bowel problems?

 Some other factors which may cause leg pain include:

How to manage leg pains with bowel problems?

If you experience leg pains with bowel problems, you may consider taking the following steps:

Consult your doctor

If you think leg pain and cramps are occurring due to bowel problems, consult your doctor immediately. Your doctor will take a medical history and establish the true cause of leg pain. Sometimes leg pains can be an early sign of bowel problems.

Self-care

Minor leg pains are often treatable at home. You may adopt the following modifications to lessen the severity of leg pain:

• Stay off your legs as much as possible and do not stand for too long.
• Do not indulge in strenuous exercises or long walks till your leg pain goes away.
• Raise your legs whenever you sit down and do not keep them dangling.
• You may put an ice pack on the affected area.

Medication

In severe cases, you may need to take medication to get relief from leg pains. Some examples include lidocaine, diclofenac gel, oral acetaminophen and ibuprofen. These drugs are available over-the-counter (OTC) at the pharmacy.

However, if you feel intense pain and swelling then you should consult your doctor. A high dose of ibuprofen is available for such conditions only on prescription. OTC and prescription ibuprofen have different doses and dosing frequency. 

Get treatment for bowel problems

For IBS, your doctor may recommend OTC medicines, including anti-diarrheal drugs (such as bismuth subsalicylate and loperamide), and antispasmodics (such as trimebutine and hysocine bromide). 

For IBD, your doctor may prescribe aminosalicylates (such as sulfasalazine and mesalamine), corticosteroids (such as prednisolone), and immunomodulators. Sometimes antibiotics can be given to clear infection and abscesses (9).

In my personal experience, constipation does actually cause leg and lower back pain. As a pharmacist, I would suggest you get proper treatment for bowel problems. You should never ignore changes in your normal bowel routines. 

References