Restless Leg Syndrome And IBS: What's The Connection?

Those suffering from irritable bowel syndrome (IBS), a gastrointestinal disorder, are more likely to suffer from restless leg syndrome (RLS), a nervous system disorder. Sources indicate that the prevalence of RLS in European and North American heritage populations is estimated to be between 2% and 5%. This range highlights the variability in prevalence rates across different studies and populations.

A meta-analysis published in January 2021 in "Sleep Medicine" reviewed five observational studies involving over 86,000 individuals. This research found that people with Irritable Bowel Syndrome (IBS) were nearly three times more likely to have Restless Legs Syndrome (RLS) compared to the general population.

Though IBS and RLS are not directly connected, and one does not cause the other, they share similarities in how the brain processes sensations. Both conditions are part of a category known as central sensitisation syndromes. This group includes IBS, RLS, fibromyalgia, migraines, and chronic fatigue syndrome. In these conditions, the brain or nervous system is hypersensitive to sensations, particularly pain.

For instance, individuals with IBS experience more intense sensations in their bowels, while those with RLS are more sensitive to sensations in their limbs. This heightened sensitivity means that stimuli like a prick on the skin can be felt more intensely by someone with RLS compared to someone without it.

This amplification of painful or uncomfortable sensations is a common aspect between RLS and IBS. Pain experienced in one condition can increase sensitivity to pain in the other.

Moreover, despite their names, IBS and RLS impact multiple body systems. IBS, for example, is understood not just as a gastrointestinal disorder but as a condition involving gastrointestinal and neurological interactions. This perspective highlights a bidirectional relationship between the gastrointestinal tract and the nervous system.

The Nervous System Link

Restless Legs Syndrome (RLS) causes uncomfortable sensations in the legs, which leads to an uncontrollable need to move them, according to the National Institute of Neurological Disorders and Stroke.

Studies indicate that individuals with Irritable Bowel Syndrome (IBS) are more likely to develop other pain-related and neurological conditions. For example, in research published in February 2023 in the journal "Neurogastroenterology & Motility," a survey of 775 people diagnosed with central sensitisation syndromes revealed exciting patterns. Among them, approximately 35%, or 264 individuals, reported having IBS. Notably, only 3% of those with IBS had it as their sole condition, with no other central sensitisation syndromes.

The study also found that a significant number of people with IBS experience other conditions affecting the nervous system. Nearly 75% of IBS sufferers also had migraines, and just over half reported both IBS and fibromyalgia. The research highlighted that the presence of multiple central sensitisation syndrome disorders tends to intensify the severity of symptoms experienced.

Symptom-Based Disorders

Both Irritable Bowel Syndrome (IBS) and Restless Legs Syndrome (RLS) are diagnosed primarily through the symptoms reported by patients, as there are no blood tests or imaging techniques specifically for diagnosing these conditions.

IBS manifests in various ways among different individuals. Common symptoms include abdominal pain or cramping, frequent bowel movements, gas, mucus in the stool, bloating, and often a combination of diarrhoea and constipation, as noted by medical experts.

Conversely, RLS is characterised by excessive movement of the legs, accompanied by discomfort in the lower limbs. These sensations can range from aching, throbbing, and pulling to itching, crawling, or creeping feelings. While more unusual, these sensations can also occur in the arms, chest, or head. Typically, RLS affects both sides of the body.

Despite their differences in symptomatology, healthcare professionals must recognise that patients with IBS may have a higher likelihood of experiencing RLS and vice versa. This awareness is essential for accurate diagnosis and effective management of both conditions.

Overlapping Treatments

Understanding whether someone has both Irritable Bowel Syndrome (IBS) and Restless Legs Syndrome (RLS) is important because specific treatments for IBS can worsen RLS symptoms. Specifically, neuromodulators, which are medications that modify nerve activity, including tricyclic antidepressants used for treating IBS-related abdominal pain, may intensify RLS symptoms.

Non-medication approaches are often suggested to manage both conditions. For instance, practices like yoga have shown promise in alleviating symptoms of both IBS and RLS. Additionally, cognitive behavioural therapy (CBT) and transcutaneous electrical nerve stimulation (TENS), a therapy using low-voltage electrical currents for pain relief, have been effective for both IBS and RLS.

In a study published in January 2020 in the Journal of Clinical Sleep Medicine, 13 people with RLS participated in a 12-week yoga course. Meanwhile, another 17 individuals learned about RLS through educational films over the same period. Post 12 weeks, both groups reported significant improvements in RLS symptoms, stress, mood, and quality of life, with the yoga group experiencing more significant improvements than the film group.

Another study in February 2023, published in The American Journal of Gastroenterology, investigated the impact of virtual yoga classes on IBS symptoms. Nearly 80 adults, averaging 45 years of age, were divided into two groups. Half attended eight-week virtual yoga classes, while the other half watched a 10-minute educational video on IBS, including information on the mind-gut connection and IBS management. The latter group also received various IBS-related resources.

After eight weeks, participants completed a survey about their IBS symptoms and mental health. The researchers deemed this survey's improvement of 50 points or more significant. The study found that fewer people who watched the video reported a substantial reduction in symptoms compared to those in the yoga group.

Research May Reveal Root Cause

Experts are investigating the biological factors contributing to Restless Legs Syndrome (RLS) and Irritable Bowel Syndrome (IBS). Research is focused on understanding the roles of neurobiology, the gut microbiome, and even the mucus lining in the gut in the development of these conditions.

While it's acknowledged that these are genuine, biologically driven disorders, the ability to clinically detect these connections is not yet available. This ongoing research emphasises the biological reality of these conditions, even though clinical detection methods are still being developed.

If you need help, Mobi Doctor offers a convenient and effective way to manage health concerns, providing easy access to medical advice and support from the comfort of your home, which can be especially helpful for managing conditions like IBS and RLS.