The IBS/SIBO-Psoas Connection and Why It’s Important for Highly Sensitive People

Note to the reader – this is one motherload of an article. Grab some coffee and a low-fodmap cookie and let’s dive in.

In my personal experience with SIBO (small intestine bacterial overgrowth), back and hip injury, and with my experience working with highly sensitive people (HSP) with similar issues, a pattern has emerged that feels much too important not to talk about. So far, I haven’t really seen anyone having this conversation (not to say that it isn’t happening, I just haven’t come across it yet) so here I go, in hopes of starting one.

My lens as both an Ayurvedic health counselor and an energy medicine practitioner is one of seeing the body holistically, of noticing how different parts of the physical body interact, how different parts of the subtle body interact, and how the physical and subtle bodies interact. When working with digestive issues like IBS and SIBO, taking a big picture look at how the systems of the body interact is important. Through my lens as a highly sensitive person I have come to see the nervous system and subtle body as the center of the highly sensitive world – the central point which governs everything and through which all issues or discomforts must be addressed.

Other HSP experts have noticed common physical issues that HSP’s, as a group, tend to share. These include things like connective tissue disorders, scoliosis and other spinal issues, pelvic issues (bowel, bladder, menstrual, low back), digestive issues (IBS, SIBO, food sensitivities, leaky gut), and gut flora imbalances. Because the nervous system is the main focus with high sensitivity, we must start here when seeing how these issues may be linked for the HSP. The nervous system is incredibly complex and literally connects everything in the body together through a system of communication. It is also through the nervous system that us HSP’s take in sensory information and process it. Deeply.  This very strong microphone of a nervous system, which connects to everything in the body, must be considered a central anchor in regards to physical and subtle issues in the HSP body.

If we think of the nervous system as the network of information that connects the body together, similar to our global information system, then we can start to see how the infrastructure through which the nervous system operates is important for the function of the whole system. Having a blocked infrastructure can cause problems with communication. Conversely, too much communication in the system (additional stress in the nervous system, for example) can short-circuit the infrastructure (kind of like running too much power through an energy circuit – you can flip a breaker). Consider using this metaphor as we look at the ways in which our muscle, connective tissue and digestive distresses are linked and how this can be a bigger problem for HSP’s.

In my Sensitive Self Intelligence course (soon being renamed as Flight School), we cover a lot of these connections. Here, I’ll mostly just be talking about the connections between IBS/SIBO and the Psoas.

Getting to Know the Psoas


The Illiopsoas Complex

Two muscles, the psoas major and the illacus, together make up what is known as the illiopsoas complex or simply, the psoas. This muscle group is one of the most important in the entire body, and especially so for the HSP body. Because of its location, it is one of the major muscles that allows us to stand upright, connecting our spine to our legs from the front. The psoas begins at the long head of the femur (thigh) bone and wraps up over the front of the pelvis. The illiacus then attaches to the inside of the pelvis, while the psoas major draws back and connects to the sides of our lumbar vertebrae. Functionally, this is the muscle that pulls our knees towards our chest. It is also one of the main core muscles involved in body’s “fight, flight or fetal” response. (*Note – this response is called the “Red Light Reflex” in the study of Somatics. I highly recommend reading Somatics by Tommas Hannah for more information).

Our body has a physical response to stress that prepares the body to fight, flee or go fetal – curl into the fetal position. The psoas is the muscle responsible for all three – readying our body in a fighting stance, driving our body forward in a run, or curling us into a tight ball.

Additionally, large nerve bundles (transmission lines) that supply the digestive system with nerve impulses (communication/information) must pass through the psoas muscle, giving it an even more important job – messenger muscle, or, referring to our metaphor – an environment through which our transmission lines run. Liz Koch, an expert in pelvic wellness, says:

Although the psoas has been thought to serve the spine as a guide wire creating stabilization, its main job is to message subtle changes in weight, location, and safety. The psoas bridges the belly enteric brain, central, and autonomic nervous systems. The large nerve ganglion located within the belly core going to the digestive and reproductive organs passes over, embeds into, and through the psoas. Serving as messenger of the core our psoas translates and transmits all expressions of safety, harmony, and integrity; signaling whether or not we are centered and congruent or encumbered and vulnerable.i

When the psoas muscle is constantly charged with feelings of fear, or it’s holding a past trauma, it may become chronically short, tight and dry. It can also react this way when there is dysfunction in the pelvis – the psoas will react to take up any slack in pelvic stability. So if the pelvis is weak from inactivity, singular repetitive movements or trauma, the psoas will step in and do the job of stabilization, while continuing its more primitive and important work as messenger.

Many HSP’s suffer from low back pain, scoliosis and other spinal problems. While there is no major research on the link between HSP back pain and the psoas, I see more HSP clients with psoas issues than any other sub group of yoga students.

Stress affects the psoas, shortening it and pulling the body forward. The psoas provides the basket in which the digestive organs sit.vIf you think of the psoas as the bowl in which our softest most primal organs sit, you can see that it forms a sort of foundational layer within our body. This foundation, related in energy medicine to our first, second and third chakras, are often the areas that HSP’s struggle with most – issues with survival and money, trouble in identifying like-minded tribe or family, in relating with others and in self empowerment. Physically, a tight psoas can affect how well we digest food, the comfort of our menstrual cycle and how well we eliminate and remove waste from the body. When looking at issues in the gut, including IBS/SIBO, I think the psoas may be a big contributor.

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A bit about Connective Tissue

HSP’s tend to have more connective tissue disorders, or problems with the fascia, than hardy people. Fascia is a type of connective tissue that acts like a spiderweb or network in the body. Fascia surrounds all of our organs and covers all of our muscles, effectively connecting our innards together in a web-like sheath, kind of like plastic wrap. But different from plastic wrap is the way that fascia acts like a network of information, relaying nerve impulses and reacting to stress and tension in the body. When flexible, our fascia is healthy and unrestricted. When unhealthy, the fascia becomes restricted and sticky.

Mainstream medicine still considers fascia a relative mystery, and largely ignores it in treatments for physical pain. What is known, but not really understood, is that within the body, fascia has a slippery quality, holding the organs but allowing them to glide over one another – allowing what visceral manipulation practitioners call “mobility” of organs. When fascia is unhealthy, largely due to inflammation or injury, it becomes sticky and can form adhesions – areas of drier tissue, causing tension that you can imagine by stretching plastic wrap tight around an object, then pinching it on one side – it stretches and gets tighter in some areas to account for the pinch.

Many sources cause the inflammation that leads to adhesions, the most obvious being direct injury or trauma. Other factors include infection, repetitive movement, poor diet, toxins, poor posture and emotional stress. Because fascia provides the atmosphere through which nerve interactions happen, it responds to stress and tension. Additionally, during an injury, it’s common for fascia to constrict around the injury in order to provide structured protection, tightening the whole fascial system and potentially causing pain and discomfort in an area of the body not associated with the injury.

For HSP’s with digestive and/or other pelvic imbalances, considering inflammation or stress-induced adhesions may be an important factor for treatment and relief. As we’ll see as we look at IBS and SIBO specifically, the small intestine is really long and loops its way through the abdomen, connected to our insides through several connection points. There are many opportunities for small adhesions to bind up the small intestine and inhibit motility and mobility. For example, the right sacro-illiac joint is the attachment point for the end of the small intestine. When the sacrum is out of place, the end of the small intestine can’t empty properly into the colon – and this works both ways. Disruptions in the psoas can cause inflammation, leading to small internal adhesions anywhere in the gut, and likely in some of the meters of small intestine. This sticky connective tissue can pull on the side of the sacro-illiac joint, internally causing rotation.

The Digestive System-Nervous System Connection

Remember that we are using the nervous system as an anchor or lens through which to link the psoas and digestive disturbances. I believe that a huge part of the reason HSP’s experience increased digestive discomfort (like IBS) is because of how the nervous system and gut communicate and because of the environment through which the transmission wires reach the digestive system. As stated earlier, the nervous system rules the roost; it plays a huge role in several digestive system processes. Some of the control the nervous system has over digestion comes from links between the digestive system and the central nervous system (CNS), however, the digestive system also has its own, local nervous system. This is called the enteric or intrinsic nervous system. We are only beginning to understand the complexity and magnitude of this immense nervous system – but we do know that it contains as many neurons as the spinal chord.ii

The enteric nervous system is part of the autonomic nervous system, along with the sympathetic and parasympathetic nervous systems. The enteric nervous system has two main networks of neurons (transmissions) embedded into the wall of the digestive tract from esophagus to anus. These exert control over the motility of the digestive tract (how well each organ moves of its own accord – primarily the act of pushing food and digestive juices through it) and in sensing the system environment in order to regulate blood flow and control cell function.

Within these plexuses are several types of neurons (communication centers) which receive sensory information from the mucosa and the muscle and respond both to the internal, chemical stimuli like digestive fluids and muscular stimuli like stress and tension. Other neurons respond to the motility and secretion of the digestive organs, and others integrate this information.

The enteric nervous system functions autonomously (without us thinking about it), but requires communication between this system and the CNS through sympathetic and parasympathetic fibers connecting the two (transmission wires). Through these links, the two systems can speak to each other. For example, when we see appealing food (sight is a sensory information coming in through the CNS), it signals the stomach to start secretions. Generally, sympathetic stimulation (usually a stress response, indicating activity) inhibits gastrointestinal secretions and causes the digestive tract to constrict or close down. Parasympathetic stimuli (our “rest and digest” system) stimulates digestive activities.

Stress and Digestion 

What this tells us is that when we are chronically stressed, we don’t digest food as well. Additionally, because us HSP’s continuously take in sensory information, when we eat, we aren’t just digesting the food – we are digesting the entire atmosphere of the room, including conversation, emotions and the look and feel of our location. Eating in a stress-free environment is SO important for proper digestion and absorption of food, especially for HSP’s. The first and easiest thing can do to reduce gut disturbances is to learn how to manage stress and eat undistracted in a calm atmosphere. 

When we experience chronic stress to the point that our fight, flight or fetal response is triggered, even at a low level, for long periods of time, the psoas muscle become short, dry and tight. Remember that the psoas is like the basket for our digestive organs and provides the atmosphere or environment through which our nerve transmissions run from our CNS to our enteric nervous system. If our psoas is short and tight, it signals to the CNS that we are somehow not safe, secure or calm. This information will be relayed to the enteric nervous system and be present as we eat. If we are continuously stressed or otherwise not managing our gift of high sensitivity well, our gut may be consistently receiving messages to shut the system down (so that we can run or fight or fetal).

The IBS/SIBO Connection

IBS was once thought to be a diagnosis for gut disturbances that didn’t have any other cause. When flexible fiberoptic cameras became the rage in the endoscopy world, the whole practice shifted to focus on diseases that you could see with the naked eye. Patients whose problems couldn’t be identified via scope were often thought of as difficult because answers took effort and solutions were less lucrative; they were often diagnosed with IBS. Due to new research primarily being conducted by Dr. Mark Pimentel at the Cedars-Sinai Medical Center, we are now developing a new understanding of the causes of IBS.

Even though I just got done talking about digestion and stress, I want to clarify that I don’t believe that stress is the cause of IBS – in fact, it’s been proven not to be. However, especially for HSP’s, management of both the psoas muscle and stress-induced inflammation in connective tissue are a piece of the puzzle that remain important for healing and management, especially for those IBS sufferers who also deal with low back/hip/pelvis issues.

IBS is now thought to primarily be caused by bacterial overgrowth. The theory goes something like this: At some point, an otherwise healthy person gets food poisoning. Due to factors that are not yet understood (possibly genetics), the body does a poor job of completely eradicating the offending bacteria. This bacteria sticks around and its first order of business is to disrupt the cycle the regular cleansing waves of the digestive system. The digestive system must cleanse itself through peristalsis in order to move food through the system and repair. After these waves are disrupted (resulting in either too many or not enough), not only does food back up in the system but also the bacteria, colonizing in areas where few bacteria should live – namely, the small intestine (bacteria should primarily be found in the large intestine). Once bacteria have moved into the small intestine, they act as little thieves, stealing nutrients meant for the host and feeding on highly fermentable foods. Their by-product is methane. This whole process results in either too much or too little movement in the gut (diarrhea or constipation, or a combination of both) and severe bloating.

When people are diagnosed with SIBO, attention is usually put on the overgrowth of bacteria. While this is a problem, it’s not the main problem – the main problem is that the motility of the digestive organs is out of whack. The bacteria have messed with the nervous system impulses needed to keep the system moving. Yes, we must get rid of the bacteria, but only as a starting point. The real issue is in restoring motility so that the the whole problem doesn’t happen again.

In step one of SIBO treatment, an antibacterial drug or herbs are given. This is often the focus of treatment, but again, I want to reiterate that this is really just the starting point – this is how we wipe the slate clean in order to restore the system. Once the bacteria are gone, we can move into the important process of restoring proper digestion. This is where things like digestive enzymes, which work internally to restore proper digestive juices, come into play. One may also be prescribed an internal motility agent like small doses of erythromycin. This is also the phase of healing where management of stress as it pertains to the psoas and connective tissue comes into play.

Addressing Additional Causes of Poor Motility

While bacteria may have been the leading cause of poor motility within the system, there may be other factors. As HSP’s, there is a good chance that small adhesions within the fascia and/or a tight, dry psoas could be contributing to poor digestion and/or lack of motility. The primary ways I have found to address these is through regular (for me, this means monthly) trips to a good visceral manipulation therapist and through practicing constructive rest pose.

You can find a certified visceral manipulation therapist through the Barral Institute website. If you are in the Seattle area, I recommend Michael Hahn – he books out a month in advance but is well worth it.

Constructive Rest Pose 


Constructive Rest Pose

This position, coined by somatic educator Lulu Sweigard, is a position that uses gravity to release muscle tension in the psoas in order to support a neutral spine. Remember, tension in the psoas can build up over time and is often caused not just through physical activities, but through stress and feelings of tension, or lack of safety and security. Because of this, we are likely releasing tension that has been stored for a very long time.

CRP is done laying down with knees bent and feet on the floor. Place your hands just inside of your front hip bones to draw attention to the layers of muscle and tissue within the pelvis. If this is uncomfortable, place arms along your sides. If this position causes back pain, you may put your feet up on a chair or block, creating a 90 degree angle with your knees (not pictured). You may also put a small towel (no more than 1 ½ inches high) under the head.

Separate feet hip-width apart. Make sure your head is neutral and does not tip forward or back. Allow your eyes to gently close or remain soft but open. Rest for 10-20 minutes. As you rest, allow yourself to notice the sensations within the deeper layers of your tissue. Because the psoas will release excess primal energy, there is the potential for sensations of vulnerability, emotional pain or memory to flow through the body. Stay centered and allow for this release to happen. Notice what they are but do not become absorbed by them. Balance internal sensations by noticing sensations in your outer world, like air currents, warmth, comfort, sounds, smells, etc. Through moving between the inner releasing world and outer present-time world, you’ll create a balance of stimuli in the body.

If at any time your body spontaneously moves, flinches or changes positions, do not change it or tidy it up. Allow the muscles to guide their own release. You can do this pose any time. The best times are in the morning and before dinner, as it can help you release tension in the digestive system and energize you.


Congratulations, you made it all the way through is thesis of a blog post. Whew! You better stand up and stretch your psoas and thank your body for getting you through it! But in all seriousness, the connections that I have laid out here just scratch the surface of connections that can be made between the nervous system and high sensitivity, IBO/SIBO, the psoas and connective tissue and stress. There is so much information to learn and to put together. My hope with this article is that I have made connections for at least one person who might be struggling to find that missing, elusive piece to their recovery. I know that understanding this piece has been critical in my road to recovery and in my continued healing.

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iKoch, Liz. Psoas, Instinctive Responses & The Healthy Pelvis.1 November 2011 <> 16 February 2015

iiBowen, R. The Enteric Nervous System. Control of Digestive System Function. <> June 24, 2006.

141 Comments on “The IBS/SIBO-Psoas Connection and Why It’s Important for Highly Sensitive People”

  1. Thank you, thank you, thank you! I now know why I keep getting SIBO. I hemorrhaged post partum which caused severe pain consistent with injury to my psoas. I then continued to have psoas related pain with every menses (my gyn made the diagnosis). Fast forward a few years after I delivered my twins and I was plagued with recurrent SIBO. I have been through 4 rounds of Rifaximin. I am low FODMAP/Paleo with only minor improvement. I can’t wait to find a visceral manipulation therapist. Could this really be the answer to my SIBO? I hope so. I can not begin to thanks you enough for this blog post.

    1. Hi Lori, I’m so glad I had some answers for you. I hope that working with this piece of the puzzle helps you as much as it has helped me! Love and Light to you ~Anna

      1. Yes, Jane, absolutely. It was a key piece of the puzzle. In fact, it helped so much that although I don’t struggle so much with sibo and motility anymore, I’ve continued with visceral manipulation as monthly maintenance for my body. It’s been a savior for my pregnancy and for general aches and pains.

  2. This is so great! I know I posted before about how happy I am to have found someone writing about this, but I’ll say it again…yay!! Thank you for all your insights. While I am about to start the SIBO protocol with diet and medication, I am continuing to work on the healing and strengthening journey I’ve been on for my scoliosis. I was feeling really overwhelmed by it all and going round in circles focusing on my gut, then my back, then my gut again knowing there was a connection, but having trouble wrapping my head around it all. I’m now able to see everything in a more holistic way and can focus on healing myself altogether. I know it’s a slow process (for life with my scoliosis :)), but I’m so glad I found you and this blog. Don’t feel so alone now. Thank you!

    1. Hi Cheryl, HSP stands for highly sensitive person. Since my website is written towards highly sensitive people, sometimes I forget to write it out in individual articles. Thanks so much for the reminder! Best, Anna

      1. Can you get a tight psoas just on one side? I’ve had a tight/pulled feeling on my right side since 2013 and no one Dr knows what it is. In the morning when I go to the bathroom and let out a little air (sorry), it feels like the right side is tightening up or if I’m walking, all of a sudden I will feel a spasm/tightening feeling right there by my hip bone on top or in front, wherever that spasm is in that area. But like I said, it’s just on my right side. I have had quite a bit of stress since Menopause 3.5 years ago.

  3. I feel like you wrote this article just for me!! This was very informative and I appreciate your insight.

  4. This is a so great and informative. I have been struggling with Sibo for the last 3 yrs but was only diagnosed 2 months ago was. Did rifaxan for 2 weeks ( got free samples from my Dr. – in case anyone can’t get them covered, although I think I read the fda just approved them for ibs ) I have been thinking a lot about alignment issues and seeing a Chiropractor this week for some hip pain, ironically right where the ileocecal valve is – which I’ve can cause Sibo /IBS symptoms. I’m going to look into a visceral manipulation as well, thanks so much !

    1. Hi Katherine, so glad you’re getting the care you need and figuring out your SIBO connections! Best of luck to you!

  5. Pingback: SIBO Update #7: One minor set back and my healing plan outlined for easy reference. |

  6. This article just described my life for the last year and probably longer. Thanks so much. I wish I was in Seattle to go to your course!!

    1. Thanks, Kathy! Just an FYI, most of my courses are also offered online, so you can join from anywhere! Good luck on your journey!

  7. This is such a great article thanks for addressing these seemingly unrelated issues! I have been seeing a gastro for 10 years regarding IBS-D, was diagnosed with iliopsoas tendonitis about a year ago, and have severe facial pain caused by poor posture. I am currently seeing an acupuncturist for help with my hip pain and IBS and also a physical therapist for my face pain. Today, my physical therapist told me about the link between fascia in my back/neck and my gastrointestinal symptoms. I am so happy to have found this article which sheds some light on these connections.

  8. Dear Anna
    My beautiful nineteen year old daughter has been suffering with this awful condition (SIBO) since birth control pills for a mere 45 days destroyed her life!! Seriously. There is so much wonderful information that I have read on various SIBO blogs and posts but I commend you for your organization of thoughts and truly providing such valuable and clear insights. She has been on the antibiotics regimen for the fifth time this year and I am just at my wits end for this poor girl who is whittling away. Would there be any way to speak to you personally. I do not mean to insult you but I will be beyond happy to pay for your time. I just don’t know who to turn to anymore — 17 doctors and naturopaths later. I cannot even believe that you found someone that knew so much about what to do re SIBO. We live in New York and can’t find real “experts”. Please let me know if you might consider accomodating my request

    1. Hi Ann, I’d be happy to speak with you. I sent you an email to that address but haven’t heard back. You can email me using the Contact form found in the Menu.

  9. Dear Anna, I came across this artical while looking for a recipe for Sibo friendly Muffins, and have been in tears for the last hour reading and rereading. Thank you so much this is the connection I have been trying to put together. The Sibo is a giant pain in the ass but the pain in my back and hips is sometimes unbearable. I will add constructive rest pose to my daily practice, and I think now I will admit to being a HSP. Thank you.

    1. Hi Faye, I’m glad you found me! Sibo is a giant pain in the ass, and I wish you all the best in getting through it. Stick around – I’ll be announcing a new SIBO healing program really soon! Love and Light, Anna

  10. The whole psoas connection popped in my head yesterday and I began doing some specific stretching for it. Not until this morning did I google it and found your article. Thank you! Now I’m curious to know if having a C-section may play into this somehow..? After all, they cut through MANY layers to get those babies out. (Twins in my case too). I could be way off, but for some reason it came to mind. I am certainly a HSP and have been putting more effort into relaxation as I carry all my tension (good and bad) in my gut. I’ve had low back and hip pain for YEARS, so that all makes perfect sense. And I had food poisoning back in the late 90’s. Wow. Thanks again for the article.

    1. Hi Diane, You’re welcome – I’m glad you found this article. Yes, a C-section could totally play into your symptoms. Surgery is one of the ways that our fascia can get traumatized or injured, making it sticky rather than slippery and causing adhesions. These adhesions then may lead to motility issues in the gut (and back pain!) and limit digestion. Luckily, there are solutions! Best luck in your healing! ~Anna

  11. My 21 year old daughter has been struggling and found this article today. She injured her hip flexor / psoas while playing sports in high school. I would never have correlated that to the SIBO she is being treated for now. Thank you! Food is a big issue right now because there seems to be no one perfect diet for her to follow. She found a great acupuncturist and we also will connect with a visceral manipulation therapist in our area. Any further tips about how to piece together SCD, low FODMAPS etc would be great! Thanks again!

    1. Hi Julie, sorry your daughter is struggling! I’m glad you have found some help. SIBO can be tricky because research is ongoing and doctors really have to stay up to date on what’s out there. Monash University is one of the few places actively testing foods for reactivity with SIBO. They’ve also found that the low-fodmap diet is more important to follow than the SCD (information I got too late, too, after trying for months to combine SCD and low-fodmap to no avail). The biggest things to avoid on the low-fodmap list are garlic, onions and wheat. There are plenty of other avoids, but these are huge! I’d invite you take a look at Monash’s information, or email me privately via the contact form and I’ll send you more info on food that way. I will be launching a SIBO healing program here soon in conjunction with a local naturopath and low-fodmap chef. We’ll be giving lots of info on meal plans, self care, and emerging research for healing SIBO.

  12. Thank you this is very interesting! I’m an HSP with IBS and have always noticed that I feel much better mentally when I lie on the ground with my legs up at right angles supported by a chair from the knee down. Unfortunately you can’t go through life in this position!

  13. Thanks Anna! I was led to your great article via other psoas articles, and had started to get an inkling that the persistent diarrhea/IBS I’ve been living since May could be related. I had emergency surgery early March for a ‘volvulus’ (twisted bowel that became life-threatening’). I was shocked to learn afterward that the ascending colon was removed. Recovery went well and my persistent inflammatory gut issues of several years seemed at an end at long last, as well as clear sinuses for the first time in years. I felt the best I’d felt in a very long time. 6 weeks later I had a traumatic fall down a high staircase, hitting my tailbone/anal area with full body weight 3 times (3 step edges) before hitting the floor. I was relieved to find nothing broken, but digestive issues mostly in the form of loose stool started up and have rarely stopped since. The chiropractor has addressed this to some extent, but I’m getting the idea, from yourself and others that psoas contraction could be a factor. I’ve definitely been seeking that ‘missing piece’ to the puzzle, and this may be it, or one of them. 🙂 I do also sit a lot at work, and see that this contributes greatly to psoas contraction. So it’ll be daily CRP for me now, and any stretches that seem good, which will reduce the stress levels at the very least, and…who knows? 🙂
    Thank-you so much!!

  14. Your article is amazing!!! I will re-read it further! I’m a strict vegan and a mix between a FullyrawKristina approach and Starch based Mcdougall. Raw till 4 sort of. I have symptoms of SIBO. Bloating after meals, chronic partial diarrhea, gas, and now I’m having pain. EVERYTHING I read says treatment of SIBO is starving out starches and sugars which is everything I eat! The only diets I’ve read to treat it are meat based such as SCD or Low Fodmap which is impossible for a vegan who needs over 2,500 calories. I will not eat meat and wonder if there is ANY hope treating sibo remaining starch and fruit based. I would appreciate your reply so much as I’m very frustrated and discouraged. Thank You.

    1. Hi Emily, sorry you’re struggling. You can heal sibo as a vegetarian, but from what I know, it is extremely difficult to heal with a strict vegan diet. Starches and fruits are mostly out during the healing phases, and controlling blood sugar without nuts and beans could prove challenging. I’d suggest working closely with a naturopath to find a solution that works for you. Good luck!

    2. It sounds like bad bacteria causing bloating. Look into doing parasite cleansing. We all have them and they seem to be the at the bottom of all gut issues. If the gut wall is damaged then they enter you abdominal space causing havoc all over the body. They cause inflammation which also causes pain and could be a reason for connective tissue disfunction or visceral pain and sciatic pain. The toxins they release make you more acidic also causing inflammation and pain.

  15. Thanks for this article. I am a HSP, had left knee surgery 4 years ago, and ever since have had a tight left psoas and colon/left ovary pain and bowel irregularity. Daily yoga and hip openers help, but if I let that practice slip, the pain comes back. I am a holistic nutritionist, so I understand that aspect of it, but visceral plays such a large role, too. I also find that rolling on a body rolling ball to release the psoas helps.

  16. I have been working on my gut and horrible sciatic pain and realized last year that the sciatica was a connective tissue disorder. Its difficult to find help in fixing this so i have been on my own researching anything on connective tissue to find some releif and fix it. Stress is a huge problem in my life and at the bottom of the constain pain. Its like a vicious circle. If i could solve all my problems not related to my health the stress would go away but everytime i solve one another one pops up just as bad. I feel like I am putting out fires all the time like in a cartoon but there is no humor in this.

    1. Have you looked into false sciatica/piriformis syndrome? Stress and bad posture where my two biggest factors. Sitting all day is terrible. The position I slept in with my knees up was also terrible. A standing desk really helped as did opening up my hip flexors etc. Here’s a great book, series of videos etc: Good luck with everything!

  17. Most impressive read I do massage soaz in my practice learned much really appreciate this amazink knowlege thank you.Patricia Parker massage Therapy orlando25 yrs

  18. Connective tissue disorders can create dysautonomia, especially in the case of Ehlers Danlos Syndrome, Hypermobility type. After being misdiagnosed for 2 years, we found a group of doctors to address the IBS-C, the POTS, and the low motility. Low as in 15% of normal. The fact that my daughter is also a HSP is likely from the EDS rather than the other way around. Just reading about the psoas stretch made my back feel better. Can’t wait to share it with her.

    1. Hi CLang, Yes – you’re absolutely right. EDS Hypermobility type is it’s own kind of beast, very different from the general hypermobility (or really, ligament laxity) I was speaking to. I’ve worked with people with EDS Hypermobility type, so I understand the difference, but I’m not sure readers do so thank you for calling it out for the article and creating some clarification – it’s important. I’m so glad you were finally able to get a diagnosis (from what I understand, it takes a LOT of advocating for yourself or your child). High Sensitivity, being a neutral genetic trait, might probably have been around from birth, but, in my very limited time working with EDS, I know that sensitivity definitely increases with the disease (presumably, because it has to in order to keep up with what’s going on). Glad you found a bit of info to help your daughter. Maybe you have all the resources you need, but I know of one blog written by a woman with EDS Hypermobility type. It’s called My Tape Story – you can google it. She shares her daily life of living with EDS. Good luck with it all! Love and Light, Anna

  19. Thank you for a great informative article. I have Scoliosis , IBSC, this is very helpful for me, and I’m also a CranioSacral Therapist, so my clients will benefit .

  20. Pingback: The Psoas and Digestion link « Michelle Wald Michelle Wald

  21. Thank you for that very informative explanation of our inner hip function. I will take the advice and use it in my clinic.

  22. Thanks so much for connecting the dots in written format! Much needed understanding of how it is all connected. As a holistic Therapist including myofascia therapy and Yoga therapy the most effective technique for relieving stress is meditation I have found. Learning to engage the vagus nerve with the breath and meditation is the door opener for sustain healing and change.

  23. Anna, thank you for your post. I have recently been diagnosed with IBS after four years of searching. I’m slowly narrowing in and your article was very helpful. I suffered a pelvis and sacrum fracture in ’97 from a ski accident. I just started going to a chiropractor which was some form of voodoo where I didn’t feel chronically ill for 3 days for the first time in years. But it’s not voodoo. There is currently a major energy block somewhere in my system.

    Aside from a colonoscopy my doctor didn’t do any tests to prove I have IBS. I am wondering if I’m dealing with SIBO instead.

    – Do you recommend any tests for SIBO that I can talk to my doctor about?
    – Are SIBO and IBS mutually exclusive or can you be diagnosed with both?
    – Also, if my sacrum is out of place and my small intestines and colon are not properly aligned, do you recommend anything specific for this scenario?

    I understand if you’re unable to answer these questions as you’re not my doctor, but any information is greatly appreciated.


    1. Hi Jibran,

      Yes, there is a breath test that works decently well for Sibo – if you scan some of my other sibo articles, you should be able to see what I did. They think that sibo might be the cause for about 80% of all ibs cases, although that is disputed. You can read about that in Dr. Pimentel’s book, “A new solution for IBS.” It’s slightly outdated now, and much more updated info can be found at Stanford U, Cedar-Sinai, and Monash University. For SI misalignment from internal causes like adhesions, I recommend visceral manipulation – it’s what worked for me – but there are other modalities, as well. Keep looking for the sibo update articles and you’ll see my whole plan and what I’m doing for upkeep now that I’m mostly healed. Good luck! ~Anna

      1. Pimental’s numbers have been revised to show that when the gold standard diagnosis of culturing a jejunal aspirate the percentage of IBS individuals with IBS is less than 4%. It turns out that the use of lactulose breath test was the problem – it is an inaccurate method for diagnosing SIBO

        1. Hi Syl, Thanks for that update. Where did you find the research about Pimental’s numbers – I’d love to include an update as the research progresses. Thanks!

  24. Thanks for info, great reading. I have IBS. My way of eating became unbalanced a few months ago as I became vegetarian and hardly ate any protein at all. I began to get limb weakness, especially in my arms that would go lame for about 20 seconds every three days. This would normally happen when I had an uncomfortable feeling in my stomach, which made me feel generally weak so much so that I couldn’t walk for at least an hour. I then said to my husband that there must be done kind of link between the nervous system and digestion. I am now eating a little fish and chicken and feeling better. My blood type is B Positive of that affects anything.

  25. Thank you. I have been in a lot of hip and lower back pain. I am also living with my 94 year old mother who is fading cognitively,. This has raised lots of past trauma issues. I have done some physical therapy for this region…. but this article Isa breakthrough for me. Thank you!

  26. Hi there great blog post …. Using Bowen Therapy is also helpful … It directly works on the fascia …

  27. Thanks for the insight and article. I didn’t know what the acronym SIBO stood for. It’s not listed anywhere on this page… as far as I could tell. It may be helpful for others to list it up top.

  28. Dear Anna,

    Thanks for your wonderful insight on SIBO / IBS. I have been in pain since whole of last year, was diagnosed with IBS until recently after an colonoscopy was told I had SIBO. Have already taken 3 courses of Antibiotics this year. Seems like the food insensitivity and the humid weather gets to me. A big trigger for me is fermented food, which I have been staying away from, But my Dr. recommended fresh yogurt daily and to stay away from pure milk and lentils.
    Yesterday a portion of either lychee or oats really got me under so I have been researching and came across your blog. In regards with your Constructive Rest Pose, when you mention ‘Separate feet hip-width apart’ you mean to bend my knees horizontally (sideways) on the floor?
    Any other inputs or recommendations would be highly appreciated.
    Thanks once again and keep it going!!


    1. Hi Abhishek, Actually, when I say “separate your feed hip-width apart,” I mean that you are laying on the floor with your knees bent toward the ceiling, feet on the floor. Then, just put 8-12 inches between your two feet. I hope that helps 🙂

  29. I have struggled with symptoms of IBS, low back pain, and more recently pelvic/hip pain for the better part of 15 years. Some of what you speak to I have found intuitively on my own. Much gratitude for your work to put it all in one post and complete the connections for me! Further thoughts on fascia. … if one area is severely affected surely others are too. This is definitely true for me. Very encouraging stuff! I will continue to work toward balance.

  30. I tried following the link to the sensitive self intelligence course and got a warning that the page contained malware. I did a Google search on the course name, and got a similar warning from Google (that this site might harm my computer). I’m assuming you’re not trying to harm my computer, but maybe your site got hacked or something else is going on with it. In any case, I didn’t click through but would like to once the site is deemed safe.

    1. Hi Amy, thanks for bringing that to my attention. I just changed to a new website and have my old one ( forwarding. Both sites got hacked into recently, with the increase in hacks on WP sites. My web guy has fixed this website and is currently working on the other. No, I’m not trying to cause harm to your computer! Moving forward, the name of that course you tried to link to will be Flight School. I’ll be adding copy to that page in the next few months. Thanks!

  31. Hi. So please confirm, how do we work towards fixing this? Ive had lower pelvic issues since having my child , weak pelvic floor muscles (not leakage) and now have a vicous case of sibo. So frustrated. Who do i see to correct pelvic hip movement alignment etc? Thanks so much

    1. Hi Ella, this article was more to help you create some connections, as healing paths will all vary. I’d consider looking into ways to reduce tension in the psoas, starting with constructive rest pose. You may also want to read some of Liz Koch’s books for more information. For the sibo, you can see my other posts about healing, but I recommend finding a good ND with a proven track record of healing sibo. I also had good luck with a visceral manipulation therapist (you can search for therapists in your area through the Barral Center website) in correcting pelvic alignment. Good luck!

  32. Hello Anna, thank you for writing this article. I recently discovered TRE and I’m wondering your thoughts about it? I was finally diagnosed with SIBO in the fall of 2015 and switched from my GI MD to an ND. Long story short I treated for five months with herbs and rifaxamin and afterwards it took a month to get my gut balanced. I still haven’t started the healing phase because I need to retest but I started doing TRE and a week later taking melatonin and almost right away I noticed improvement in my digestion. Doing TRE makes me so relaxed and taking melatonin is helping me sleep. Have you heard of TRE and the connection it has to releasing trauma from the psoas?

    1. Hi Teena, I’m not familiar with TRE – what does that stand for? Is it the trauma release something? I just ordered a book about trauma release and hope to read it soon. Keep us posted on how it helps you!

  33. I love this! I can relate….being HSP with chronic pain and a weak low back that goes out without warning. I’ve had IBS, food sensitivity and fibro type pains, and low immunity for years and it all seems connected.
    I started doing the above mentioned TRE -trauma releasing exercises by David Bercelli
    and I knew it was exactly what i needed. Getting my gut in order has been my hardest challenge. Mainstream doctors do not understand gut health. You have helped me understand a bigger picture to further put together a plan of action….Thank you!!!!

  34. Hi Anna, what is your opinion of colon therapy (colonic irrigation) as a means of cleansing the colon and helping to restore and strengthen peristalsis and motility. Thanks for bringing so much information together
    in an easily accessible way.

    1. I think whether colon therapy is indicated depends on a number of things, but I am by no means an expert in this area. Generally, I find that it can be too much for highly sensitive people – having more negative consequences than positive. Sometimes, gentle enemas can help clear and strengthen the colon, especially when followed by oil enemas. In general, though, for general SIBO treatment, they’re not indicated for motility and strength, since colon therapy can be a very forceful application of fluids in the opposite direction of regular motility. I’ve found that this often confuses the body further. That being said, I’ve seen people who have SIBO plus other complications who have used a gentle form of colon therapy under the guidance of a physician with good results. I think it depends a lot on the whole picture of the body and the person – so it’s not a straight forward answer!

  35. I am a Midwife, Nutritionist, and CFT practitioner along with being a Lactation professional. Excellent article pulling all of the peices together! I would add, that people with midline defects (lip and or tongue tie) have all of these issues and more. I would suggest reading up on how these oral ties fit into the puzzle to give you an even broader perspective. It’s fascinating how the body works! I have learned so much in the last 25 years to allow me to help people find healing and health! Good for you for starting this conversation, I wholeheartedly agree with every word!

      1. I haven’t had a chance to read your entire article yet, but the last comment from Jennifer on 8/16/16 caught my eye. I wanted to share another bit of information for you regarding midline defects, they are also linked directly to the MTHFR gene mutation. Sterling Hill is one expert to look into and also Dr. Ben Lynch. You can find either one easily by doing a search with the name and MTHFR. MTHFR stands for Methylenetetrahydrofolate reductase. In a nutshell, people (there are a lot of us actually, but most people have no clue) with this genetic mutation, our bodies have a harder time detoxing. That’s just one aspect, but is one that stands out. MTHFR is also a reason for those of us who have children with Down Syndrome. My sister and I wondered for the last two decades why we both had a child with DS in our early 20s. We’ve both been tested, and we have the genetic mutation. I have known for years that I am a HSP. My personality actually changed after I was on the GAPS (Gut and Psychology Syndrome) Diet for several months. I also explored adrenal fatigue and after finding that my cortisol levels were extremely low began supplementing my adrenals. I am no longer as sensitive and the shyness that plagued me for most of my life is pretty much gone. One little example, I have loved line dancing all my life, but was too scared to try it. Are you kidding? Someone might be watching and make fun of me, and I would die on the spot! But now I not only line dance, I teach a class! Thanks for writing this and starting the conversation, and I hope this helps to connect more of the dots!

  36. Since the digestive system and nervous system are both intimately connected to and interwoven with the integumentary system (skin), I’m wondering if more skin eruptions or chronic skin conditions have been observed in HSPs?

  37. My gosh this all makes sooooo much sense and even more so why I’ve been so ill since moving (I left my wonderful chiropractor and massage /tissue therapist back in Delaware) I am an empath learning how to deal with everything that brings as well as having issues with my psoas. My MT used to te) me that I had issues with it. I also have IT Band issues. I can’t explain what a relief it is to have an understanding of what is going on. I wish I could give you a hug. Thanks for pointing me in the right direction when I have felt so lost for so long.

  38. This article describes my life for the past 15 years! I have been hand balled from doctor to doctor and have never been able to find any relief for my pelvic/ back pain and countless other ongoing health issues. I jut keep getting put in the ‘too hard basket’, meanwhile I am struggling to cope through life in constant pain. This article may just be my saviour! I live in Tasmania, Australia and am curious as to what type of health professional I should book in to see and speak about this issue with first? Any help would be hugely appreciated! Kind Regards, Kate

  39. Great article! The boxing gym where I work focuses on the using what we call “the punch path” as a healing tool. We’ve been focusing on the energy/engagement flowing through the psoas for a week or so now and have had many discussions among the coaching staff about how challenging it is to feel and work with. I’ll be sharing this article around as I think it will really help put the psoas into context and help us to gently work with our clients. The link with fight, flee, freeze is especially interesting as we part of our philosophy is to work with our boxers to transform fight into invite, flee into return, and freeze into move. In a boxing/martial arts context, this article make a lot of sense! Lots going on in there!

  40. The connection and even treatment pose is not new and has been known in Osteopathic Medicine for some time.

    Osteopathic physicians (D.O.’s) are fully licensed medical doctors able to treat and specialize in all medical specialties in all 50 States. One specialty unique to Osteopathic Medicine is called NeuroMusculoSkeletal Medicine, or NMS. Although, NMS specialists primarily focus on providing Osteopathic Manipulative (hands on) Treatment, all D.O.’s are trained and qualified to provide OMT, even D.O.’s who are OB/GYN’s, surgeons, etc.

    The connection you refer to is known by Osteopathic physicians as “viscerosomatic” and “somatovisceral” reflex. These are neural reflexes that may originate in the viscera (in this case the gastrointestinal tract) and go to the soma (in this case, the ilopsoas muscle), or the opposite, a dysfunction that originates in the soma and causes dysfunction in the viscera.

    Osteopathic physicians (D.O.’s) who utilize Osteopathic Manipulative (hands on) Treatment, might use a technique called Counterstrain, and place the patient in a similar, but more precise pose based on the patient exam findings, to treat psoas in relation to abdominal pain, inflammation, and dysfunction. A D.O. who is treating you, the patient in front of them, also might choose not to do that specific technique as they are tailoring their treatment to you, the patient in front of them.

  41. So glad to have found this blog! I’m mid-SIBO treatment. Past 14 weeks of herbal antibiotics and in 3 months of FODMAPs diet. Week ago dr. visit, he mentioned a nervous system connection. Still struggle with episodes of diarrhea. I look forward to “constructively resting” for the next 20 minutes!

  42. So glad to find you. I wonder, as a yoga teacher, do you have any must-do poses for those of us with SIBO to include in our daily routines?

    1. Hi Candi,

      Yes – the CRP I talk about at the end. I know it’s not a traditional yoga pose, but it’s so important for releasing tension in the psoas. You can think of it like a restorative pose. I often include it at the end of the classes I teach and invite students to stay there for savasana if they enjoy it.

  43. I literally cried reading this. I am a HSP with lifelong IBS/SIBO and other digestive issues. I remember in massage school the thought of letting anyone contact my psoas gave me a panic attack. I had this page open on my web browser for days before I even could read it. I suspect (genius, I know) that this is a huge problem for me. Thank you for writing such an accessible article and offering such a gentle suggestion. I think I stumbled upon this on FB. I am happy to find your blog and I will send some time reading your content.

  44. Hi Anna, I started taking magnesium supplements a few years ago, and they have changed the moisture level in my gut, increased motility, and my hips are more flexible now. I had a lot of issues with tight psoas, sore iliosecal valve area, and constipation my whole life, and this was a big shift toward healing for me. It has reduced the gas pain and flatulence I had always had. Has anyone studied magnesium as a solution for low motility? I take a combination of forms of magnesium; both citrate and malate. Many thanks for your article; it has pulled together a lot of disparate issues I have had and made sense of them.

    1. Hi Alison, Yes, I take magnesium for gut motility, which is so helpful. I haven’t played with taking the kind for muscles, but that sounds like a great idea. Thanks for sharing!

  45. Hi Anna Thank you for your article. I have always valued gut health so your focus and attention is extraordinary. I have a new grand daughter and since birth she has been suffering with excess wind. It does not seem to be mainly the burping but the other end. She is 14 weeks old and may go 7 days without a bowel movement. But the wind is very noticeable and tends to wake her continously. The baby has always been breast fed, no contact with rubber at all. Tongue tied issues have been eliminated and the mother is Vegan. We have discussed the mother eating mainly carbohydrates and she has cut out corn and wheat but sleep deprivation leads her back to Carbs as her main diet source. Thank you for your article.

  46. Hi Anna,

    I am most definitely a HSP and although I don’t suffer from IBS or SIBO I have had ongoing lower back pain on the right side and when I went to a chiro a year back was told that my right hip was tilted (can’t remember what direction). I have a tight psoas but not sure how to address this as I have read conflicting articles about stretching/releasing it. I have suffered from anxiety since my youth and wonder if this might all be linked. I used the search engine and couldn’t find any visceral therapists listed in Australia. I am located in Perth on the west coast. Thanks so much for this article. It goes a long way to explaining the issues I am having. If you know of anybody on the West Coast of Australia that is qualified in this form of treatment can you please let me know. Cheers, Daniela

    1. Hi Dani, I don’t know anyone off the top of my head, but you can search for practitioners on the Barrall Institute website, or look for someone who works with Hellerwork or Rolfing – those practitioners usually have some of the same knowledge. Good luck!

    2. Dani, there are quite a few in Perth

      Nisha Ariyaratove RM

      Perth, Western Australia 6000 Australia
      Tel: 410.852017

      Profile: none
      CranioSacral Therapy

      Trainings Completed CS1 CS2

      Joy Cooke RN

      Perth, Western Australia 6023 Australia
      Tel: 402.045266

      Profile: none
      CranioSacral Therapy

      Trainings Completed CS1 CS2

      David Evans RM

      Perth, Western Australia 6076 Australia

      Profile: none
      Visceral Manipulation

      Trainings Completed VM1

      Jason Kiely

      Perth, Western Australia 6100 Australia
      Tel: 041.771.9626

      Profile: none
      Visceral Manipulation

      Trainings Completed VM1

      Veronica Plej RM

      Perth, Western Australia 6029 Australia
      Tel: +61408826616

      Profile: none
      CranioSacral Therapy

      Trainings Completed CS1 CS2 SER1

      Jan Rodda RM

      Perth, Western Australia 6158 Australia

      Profile: none
      CranioSacral Therapy

      Neural Manipulation

      Visceral Manipulation

      Trainings Completed CS1 CS2 LT1 LT2 NM1 NM2 NM4 SER1 SER2 VM1 VM2 VM2 VM3 VM3 VM4 VM4

      1. Hi Dani and David , thanks to you’re location info, I managed to find this article with similar query – I’m in Perth too.

        I have SIBO but also Lyme disease & coinfections, EBV and viruses, multiple autoimmune diseases, neurological issues and brain inflammation, scoliosis and I’ve experienced the full shubang of mental fun stuff like panic attavks and depression. Good times!! I’m also Uber sensitive and intuitive. And I’m super proactive in looking for solutions.

        Haven’t fully read the above article yet, but hoping it proves useful.

        1. Hi Georgie,
          I also have Lyme and SIBO. But I almost recovered from Lyme with bee venom therapy- please lsearch for Facebook group – bee venom therapy for Lyme disease.
          Regarding SIBO- I had it before Lyme and I hope very much that this new information will help me to heal it as well.

  47. The Constructive Rest Pose is actually called Semi-Supine by Alexander Technique practitioners.

    Alexander Technique was developed in the 1800s as a way to use the whole body as it was intended to be used. Until the pharmaceutical industry got control of medicine, it was highly regarded by the medical profession.

    The basis is that we all learn bad habits during our lives, and these impact on how we use our bodies. For example, you might hurt your leg and have a limp. Even after it has healed, you probably still have the remnants of the limp. AT can help the body to return to its non-limp state.

  48. This is one of the BEST articles I have read in a very long time… I live in Australia Sydney… Where would I go to start my healing process… Any suggestions are helpful… Thank you

  49. Wow your blog is amazing! You explain everything so clearly

    Have you seen any of Ashley Blacks research?

    She has developed a tool so people can work their fascia in themselves

    I purchased one for my husbands lower back pain He has had great results when nothing else was working

    I am using to restore my fascia and get rid of cellulite and spider veins which is nothing more than fat and blood veins trapped in sticky unhealthy fascia

    We have been using essential oils along with the Farsi a blaster for even quicker results

    I plan to pass your article along to several people

    Thank you so much for sharing what you know to benefit others

    1. Thanks, Karen! I haven’t seen Ashley Black’s research, but I’ll have to check it out. I’m glad her method seems to be working for you!

  50. Thank you. I have been searching for this information – I just didn’t know what it was. Thank you, thank you, thank you.

  51. Hi Anna,
    Wondering if you have any advice for me. I’ve been dealing with chronic pain for 4 years and in the last year and a half concluded most of what you write about above. Diagnosed with SIBO in 09/15, I still don’t have it cleared up and the bloating and motility issues remain constant, while the right side SI joint, low back and psoas are locked up tight, with intense pelvic floor pain (I assume it’s my obterator internus). I have systemic candida, and inflammation, of course.

    I’m working with an ND and we’re digging deeper and deeper into parasite and toxic testing while treating me with accupuncture and a myriad of supplements. I’m on low dose naltrexone for motility and some extra dopamine. I’ve been on Xifaxin 3 times and multiple natural antibiotics as well as anti microbials and several digestive enzymes and nothing seems to work. Nothing. I’ve gotten 8 sessions of visceral work with no relief. I’ve had 8 sessions of constitutional hydrotherapy for motility, and nothing. My diet is so clean and has been for over a year. I’ve been gluten free most of the last 15 years. I love the CR pose (I am a Gyrotonic Trainer and Yoga teacher by the way) and find beautiful relaxation with it. However as soon as I get up and move, my right psoas takes over. My butt and hamstring muscles have disconnected and I’m literally walking from my diaphragm! My psoas connection to the lower thoracic and diaphragm is being pulled so tight that it feels like a constant knife wound. I’ve had hundred of psoas releases in my life and it doesn’t seem to make any difference.

    Also, i have had vertigo and vestibular issues for 6 years after a head trauma, which recently I’ve managed to clear up, but my brain and my eyes are still off-center. Worked with a functional neurologist/chiropractor for a while and could not get the relief I was looking for either. I had a cesarean in 1997 but no therapist has every found that scarring to be the issue. I feel like my body is being spiraled and pulled into a dark hole into my illeocecal valve and I can’t correct it. I’m also getting emotional and body counseling with an intuitive and the work has been great but still no results yet. I know that SIBO eradication is an uphill battle, but I feel like after 15 months I’m still just putting on my boots. Your article was a nice explanation for what I’m experiencing and gave me a sense of validation. The fact that I’ve had back pain and digestive issues for over 30 years may play into why it’s taking so long. I would love any feedback or advice you may offer. Thank you so much

    1. Hi Mary Jo, sorry for my late reply, and I’m so sorry you’re suffering. It sounds like a rough road, but I’m glad you’re getting good help. It seems like you are covering all of your bases. The only thing that jumped out at me were how the motility issues and the tight right SI joint are related – the right side of the SI joint has a connection to the point where the small and large intestine intersect (I usually know what that’s called, but I’ve got mommy brain right now). I think the question would be: what is driving the disfunction? Is it the internal stuff or is it something external in your musculature? Then finally, what is going on emotionally and psychologically in your life? Those things are always connected, and when the body has a long difficulty healing, that’s the next place to look. You could look in the areas of the first three chakras – safety, security, money and family; emotional fluidity, creativity, support; sense of self, power, will. Caroline Myss’ “Anatomy of the Spirit” or Anoeda Judith’s “Wheels of Life” might be helpful. I’d also be happy to do an assessment when I’m back from maternity leave in March – you can sign up for my newsletter to know when I’m accepting appointments. Good luck!

  52. I have had chronic pain (mostly neck/shoulders, jaw and hip) for decades. I’ve been working with specialists trying to solve it, to no avail. I’m currently trying different meds to treat Fibromyalgia, but haven’t found anything that works yet.
    My chiropractor is the only one who seems to be able to help. In the last few years my “guts” have been an issue, which he explained to me was my fascia basically clamping around various vital organs (including colon, diaphragm, reproductive organs and even “tubes” related to my heart/blood circulation). He performs ART (Active Release Technique) on my fascia – basically breaking up connective tissue. We’ve also done it on my hip flexors (which I have now learned is my psoas). It helps tremendously, but the problem still reoccurs many times a year.
    I have learned that fascia tangling up my “guts” has a direct impact on the rest of my body pain. Basically when the guts twist up, it’s pulling connective tissue from my shoulders, hip, neck, etc.
    Previously we correlated stress, sitting at a desk job all day, minor injuries (such as stepping off a curb wrong), and excessive alcohol (damn you, red wine!) to the fascia inflammation. I have tried several food allergy/sensitivity tests but nothing came up. I do find if I try to reduce the amount of sugar I eat that it helps with the inflammation, but my incurable sweet tooth sometimes wins over my willpower 🙂
    But recently I ate mussels and had a bad bout in the “guts” (descending colon I think it was this time). I’ve eaten them before many times in my life, but we’ve now figured out that I’m “allergic”/sensitive to shellfish and I should steer clear.
    I’ve been working on this “body math” – putting 2 + 2 + 2 + 2 together – for a long time, and your article has added even more information for me. My chiro has always been harping about diet, and I’m really starting to see why. Your article has assisted with the “how” – how it affects everything in the pelvic/guts area.
    I’m someone who can’t completely clear up my diet, but I am realizing how even minor changes can help and how I need to make it a life change and not just a short term attempt.
    Oh, how I will miss you, brownies and excess bread products, but hopefully I can find other joys in life by living with less pain!
    Thanks again Anna

  53. Great article! I had such pains on these muscles but had no idea what was going on.

    A suggestion as another seriously HSP — could you use black font on your website instead of gray? It is really difficult to read, and the font is also not easy.

    Oh, one other thing: I have suffered from IBS since I remember, and that’s 4 years old. I did have a chocolate allergy as a child, but no food poisoning. I still believe the IBS came from the HSP. And then the low blood sugar developed because of how I was eating with the IBS. What a great body I live in, hah!

    Thanks so much!

  54. Anna, I can’t believe my eyes as I’m reading this! I have to print this out, read it again and again to fully absorb what you are saying. I have had all of these issues in the past few years b/c of extremely stressful and life-changing events. It’s been one diagnosis after another and just when I think I’ve got it covered, something else comes up. Adrenals, candida, thyroid, cystitis, leaky gut, and now stage 2 pelvic prolapse. OMG. I don’t know if you can imagine how devastating this can be to a Fitness, Yoga, Pelvic Floor trainer. And yes, I understand the energy therapy as I have studied it as well. I’m a Reiki Master, Hypnotist, I took spiritual psychotherapy, Angel Card, and past life regression trainings. WHY AM I TELLING YOU ALL THIS? B/c having all of these certifications, seeing energy medicine doctors / naturopaths / TCM / biofeedback / osteopathy etc. etc., AND also having all of these health issues has been extremely depressing and shameful for me – especially after my recent diagnosis. I know we all have our issues and we are all on different paths to wholeness, but for F’s sake!! I’m at my whits end here! It was in the middle of the night last night and early this morning as I’m lying there feeling sorry for myself and my pelvic area and thinking “I really can’t take any more of this!!!” that I had a gut feeling (I think it was a message from my higher self) to seek out the correlation (if any) of all my issues. And here you are. I’m moved to tears. I am actually hopeful now. If I can figure this all out and heal myself completely then I have a lot of work ahead in re-evaluating / re-training / re-educating my clients and reaching other women who are struggling with the same issues. Maybe that’s why all of this is happening. Women need answers from other women who can empathize, re-educate them, and finally start putting the pieces altogether. I am already in the midst of revamping my website and I think this journey will now have to be part of this transformation. Thank you so much. Wish me luck. Sending you oodles love and gratitude.

    1. Sholina! Imagine if you could reverse/run-the-tape-back/and/release the tension held in this important psoas, this first-line-of-defense muscle, quite litterally, your bodyguard/sentinel/defendor…..??? Well you can and it’s dead easy, as well as entirely natural and safe (CAUTION). There’s even a version of it which matches perfectly your yoga practice. TRE (Trauma Releasing Exercises) has already been mentioned above on 3 July last year (Teena, Anna and Kristina). Google it for rich rewards, videos and sites. Get the book, dvd or even the App. By the way, it’s Berceli with one L and not two. CAUTION Sholina : because of your symptoms and conditions, please proceed very very gently – a couple of minutes each time – and listen to your body and responses as your whole body-tension unravels. Your body has done well to bring here all the way, so listen and trust it now more than ever. There may well be a practitioner near you (highly recommended to start you off). I’m in Ireland and can work by skype. Thanks Anna for a great article. Raymond

  55. This is a great article and makes a lot of sense in hindsight. I have had tight pelvic floor muscles for over two and a half years which caused my psoas to tighten up greatly. The pain was so bad at the beginning i could barely bend over. Keep in mind i am a healthy 20 year old college student, have played sports all my life and have always been active. I wanted to share my experience with this problem and how i am almost fully healed from pelvic pain/back pain. I am not sure exactly my pelvic floor problems started but i am beginning to think it started many years before i started to feel pain. Anyways i researched the internet looking for some kind of relase to these muscles. Little did i know i could find almost nothing on the subject, which was somewhat surprising to me as you can find pretty much anything on the internet. I had tried meditation, stretches, diets, basically i tried everything i could find. These options did not work for me at all not to say they might not work for others. Then i read about a TheraWand, i was skeptical about this but reading about it made sense. The wand type thing is honestly shaped like some sort of strange dildo which was a bit scary. Anyway the TheraWand is inserted into the anus(not sure if this is different from Ladies) used for internal release of these tight pelvic/psoa muscles. The wand comes with directions on how to target the different muscles inside. The goal is to push the wand against these painful muscles so that you can release them. The harder you push against the muscle the more the muscle loosens up. I would recommend doing this massage release every day ,twice a day if you can/want.Its going to hurt trust me thats okay though its almost a good pain after you start feeling the tension in those muscles go away. You control how hard or soft you want to be, i started off very slowly Ive noticed that there are mainly women on here, so my experience might differ from yours slightly. I decided to go ahead and buy the “wand”, little did i know this thing would help me more than i could’ve ever imagined. After about 8 months of internal massaging my problems are almost gone i would say i am 90% healed from this awful problem. I am writing this because i felt trapped and felt like i couldnt do anything to help myself. This was a very depressing point in my life, sexual desires were completely gone. I remember i couldnt even get semi-erect it hurt so bad i just stayed away from anything that would hurt which was basically every movement. Being a Senior in High School about to go to college this was a nightmare. I have been through this and have come out of it, this is a bigger problem than many people understand. I also want to mention i have been way more mentally alert since starting the internal massage and my depression has gone down tremendously. I have also noticed in the past week when i have been doing the massage as of late randomly i will get chills sent up my body. This makes complete sense after reading your article and how the nervous system and pelvic floor/psoas are effected by one another. I believe this tightness can cause the nervous system to become overreactive and thus affects the brains capability to function normally in some manner. I promised myself if i every did fix this problem of mine i would tell as many people as i know with similar issues. This worked for me and i believe it can work for a lot of other people. If anyone has any questions feel free to ask me i would love to help out. If you were in the same mental state that i was with this pain youll try basically anything. Please take my advice and get your body and mind feeling better than ever. You can do this!

  56. Thank you so much for this article. I’m a Highly sensitive person with sibo. Every couple years my back goes into spasms, and I have always been suspect it is my psaos. I’ve had a lot of physical and emotional trauma throughout life. I have not been able to cure my sibo yet. I have done somatic experiencing therapy work, and it’s good to know that I’m on the right track. Basically this article validates what my intuition has been telling me. I can proceed forward with a better intention of healing . I need to find a therapist who will gently work on my stomach and psoas muscle. Thanks again.

    1. Thanks so much for this article. I am HSP and have been diagnosed with SI joint dysfunction and pelvic floor issues. Am pretty sure I have SIBO though have not done testing. The connections between all of this is fascinating. I see a PT who specializes in pelvic floor work. She has worked quite a bit on my psoas.

  57. Hi Anna,
    I am a remedial Massage therapist in Perth WA and I accidently found the same links you have so clearly outlined, through my own journey and teaming up with my partner in his Remedial Massage practice.
    Through extensive reading and comparing information, we now consider the involvement of Psoas in every client and have had some really profound results.

    Thank you for sharing this information.

  58. Excellent article I hope makes its way into mainstream. I would like to add a piece that I just discovered for myself that was my main contributing factor. TEETH. I had 4 teeth pulled for braces as a teen, 4 wisdom teeth pulled in my twenties. I started with hip pain in my 50’s so by my 70’s I had SIBO and Leaky Gut.

    I am working with a neuro cranio reconstruction bodyworker and after three months feel some relieve in my hips. A biological cranio dentist noted my jaw is off by 10 mill. Which causes the cluster of too tight down my spine into my hips. I hope your work becomes mainstream as I have spent a small fortune all these years.

    I currently am also working with a highly skilled doctor of nutrition/supplements. Got over SIBO in 4 months. And I have a trained lymph massage who says in a years time I will see additional relief. My latest set of symptoms as a result is Mag Degeneration as well as inflammation of my eyes. A few years ago, it was my heart. I knew in my heart of hearts things were tied together that needed special remedies that have yet to surface for holistically people like myself could count on to climb back to good health. Your article helps confirm my findings, thank you. Now for the world of medicine to learn.

  59. Hello Anna,

    Your article is such an eye-opener! Thank you so much! I have been struggling with IBS for years, discovered last summer that I am a HSP, have a completely blocked psoas, a lot of issues with digesting food and was diagnosed with SIBO only 2 weeks ago…..
    I now see the connection. Everything comes together here.

    This will definitely help me a lot in beating it!

    Thanks again,

  60. What a great article. This was exactly what I needed to read today. Feel like I’ve been finding the last pieces to complete this crazy puzzle that is my health. Thank you.

  61. Thank you so much. I have have been researching for so long why I have had a scoliose since teenager.I am on a cure for sibi reight now and already i feel better. Have a good day

  62. Hi Anna, thank you for this article it explains a lot of mysteries with my son who has severe learning difficulties, autism and epilepsy.

    He is unable to communicate with us to know exactly what is going on with him. He developed excrutiating and chronic pain in the sacral/lumbar region after a 7 month stay in hospital. Doctors have done so many tests and have been baffled! My son ended up on Fentanyl patches (for the past 4 yrs) to control the pain but after reading your article, this seems to me to be the problem. His physiotherapist feels it is the sacroaliac joint and piriformis muscle causing the pain. He lost his ability to walk and could not weight bear due to the pain and this problem. He has severe problems opening his bowels and one particular issue is that he has problems with motility around where the colon meets the small intestine. This was highlighted when he had a colonoscopy as no matter how much bowel prep he had, the stools would get stuck in the region of the small intestine meeting the colon.

    In your article one of the paragraphs says “For HSP’s with digestive and/or other pelvic imbalances, considering inflammation or stress-induced adhesions may be an important factor for treatment and relief………. For example, the right sacro-illiac joint is the attachment point for the end of the small intestine. When the sacrum is out of place, the end of the small intestine can’t empty properly into the colon – and this works both ways. Disruptions in the psoas can cause inflammation, leading to small internal adhesions anywhere in the gut, and likely in some of the meters of small intestine. This sticky connective tissue can pull on the side of the sacro-illiac joint, internally causing rotation.”

    I hope you dont mind my asking if there is anywhere you could direct me to that explains this in a medical/physiology book or article so I can show this to my sons doctors.

    Really glad I found your post and thanks for explaining the link with the Psoas and digestion etc.

    Best wishes,


    1. Hi Emily, I’d be happy to help! Please send me an email via the “contact me” page so I can more easily link to articles and resources.

        1. Hi Elena, from my understanding of the science, I’m not sure it’s possible to “cure” sibo completely, since it’s believed to be a genetic factor that makes us susceptible to the bacteria that starts the whole thing. But I’m fully in “remission,” yes.

  63. Hi I really loved this article for pulling together connections I’ve been wondering and thinking about. I notice you saying the cns is king, and that the ens will be affected by messages running through a tight psoas from cns, but I have also learned that the ens initiates, and messages running from ens to cns are 4/5 of vagus nerve transmissions, cns to ens just 1/5. I love what you’re doing, keep going! Thank you for synthesizing and for your easy to understand layout and way of saying things. Namaste

  64. Mind. Blown. You’ve just confirmed everything I’ve been thinking for quite some time. Psoas on the right has been chronically tight/short/dry for 11–11!!!–years, due to a car accident, which left me with imbalanced hips (Im back in PT due to chronic pain).

    I am 100% a HSP. Over the last two (very stressful) years, I’ve noticed I’m bloated ALL DAY. And I know that when I apply pressure to my psoas on either side, the bloating (which feels like a blockage) goes down and my stomach no longer looks pushed forward.

    Motility is an extremely big set back for me, and my biggest complaint, aside from low back and 360 degree hip pain. The feeling of having “incomplete” BMs is so dissatisfying, and it makes the bloating worse.

    I can’t explain how helpful this information is. God….now where do I start?!

    1. Carlee…You have verbalized here I feel. And now how to calm myself down too as obviously I do notice that if I get upset and start fretting more, things get tighter and worse. but hard not to think it is something else, even though I know it is not when it just tightens up so. After PT or a massage things feel so much better. And luckiy I do not have it all the time. but I do have imbalanced hips and sometimes pelvis is tilted/ rotated and the psoas and all that is so connected. Went to the PT and she said my sacrum was lifted this week , so it is always something!! Just very frustrating. But like you said when one is going thru a flare up..”now where do I start”

  65. Thank you so much. I now have the information which can lead to healing my so called piriformis syndrome that has plagued me for over 30 years and led to many other issues as well as causing me to become isolated

  66. This is so enlightening to me. I have L4 and L5 problems and also left arch on my ankle is gone from many injuries. It throws off the right side of my body and my psoas the PT I have has said is very tight. Dr. termed it psoas tendonitis. Whatever one calls it I just am so upset when it rears its ugly head. I can go long periods of time without it happening. But when in a flare up as I am now it is very frustrating. It does affect everything you said here. And the comments are helpful too. I will be reading and re- reading this over and over again!!

    1. wanted to add : I sometimes have SI issues and sacrum is off. Basically body is out of whack from the ankle issues ( I do wear orthotics and this helps..but must be religious about them ) and also the back issues. Like I said I can go long periods of times without any of the psoas issues ….although others will arise (piraformis or IT band tightness) and sometimes have none of the issues arise (which is bliss !! ) but when the psoas is involved it just sends me into a tailspin of emotion and now I realize from your article I am doing myself harm as I activate it even more by my stress over it. But how to stop that is the issue for me..the stress over it. Just reading this has helped to calm me a bit and the comments . Thank you .

  67. So basically, if you have a slow digestion thing going on, that its not uncommon to have right sided spasms/tightness right in front of the hip bone or around that area?

  68. wow! others feel the same way I have, with symptoms my PT disregard. radiculopothy & DDD has created a spectrum of issues for my lower lumbar & my journey to self heal. the overweliming feelings of fight or flight are hard to cope with while in pain. I’m glad I finally had learned the body won’t heal under stress. my masseuse helped me learn about the soaz, SI, TI bands a few years ago, & they still give me issues. but honestly the gut wrenching abdonal pain sucks, trying to eat while inflamed or what ever. i lost so much weight, I can’t eat a lot anymore & I won’t take pain meds. (only weed) i thought I had gluten issues , so I changed my ways but still get that pain regularly. i know this is caused by my workplace injury, stress, pain. specifically my soaz. i started to prefer not to eat a lot so i drink smoothies. i will adopt any knowledge that helps me on my to path to heal from pain. i took time off to heal (workmans comp) finally making progress with yoga/weed/ meditation/ diaphragmatic breath/ intuitive dynamic movement / PT ( my bed yoga) lol it’s working!! I use every tool i have learned in this life to survive. i have trust my intuition when in meditate, to tune into my body , & more specically my nervious system to feel, adjust away from the pain, though movement & breath.( i could go on more about how i do it) i have felt the energy blocked in my misaligned spin & it’s a nightmare. like I’m stuck inside this body.. i am. focus is hard some days, cuz I’m angry a lot . my chronic pain has changed me, good & bad. I thought I was crazy, feeling ( being consciously aware.. pinpointing ) all these things at the same time. but it real & I’m special to know, understsnd & communcte this being a HSP. oh yeah i also have non surgical fusion in my neck. the doctor didn’t believe me until he saw my xray. anyways I been planking for 2 months & that’s seems to help my soaz cramps & ability to eat a little better. i made improvements in my mid back & back neck muscles have gotten stonger , so now my PT focus is front core. the
    that translated to more hip flexor progress , posture improvement, but sitting long will hurt right in my soaz!! & is not worth the time it takes me to reverse/ revert
    pain. hopefully no more epidural this year.
    do u have any advice for me?

    I really appreciate your article. I’m glad I searched & found someone who cares. your information resonates so much with my struggle. thank you

    1. Wow! Such great information and insight! Thank you so much. I fractured my pelvis 25 years ago on my mission in Taiwan, but they didn’t realize that it was broken until months later…so it healed broken. I have struggled with pain and being out since then. I have struggled with IBS for the last 13 years and now sibo .
      I have some new things to try. Thank you so much. Please continue to share your insight and what you have learned, heartfelt thanks

      1. What a relief to find this blog tonight…..just as I was becoming desperately concerned about myself and all the varying aches and pains which appear constantly these days within my body….and now my pelvic area which is not only becoming embarrassing and worrying should I not get to the toilet in time….or when I get there nothing happens. Do I need to see the doctor? Do I need to talk to the surgery nurse? the continence physiotherapist ?
        There is much more happening to me within my body. I sense this. Something seriously wrong. How can I begin to explain. Everything too tight. Unforgiving. I’m unhappy. I’m lost really and so troubled.
        THEN I FOUND this blog this evening….and I feel that I’ve found the perfect written word… all these replies….which have given me some hope.
        Thank you so much. I am a ‘supersensitive’ mother….brought up my six children mostly on my own. Divorced 30years ago. They have now grown up and have their own families. But it has been so difficult to switch off…and yes I carry the scars. I understand even more through reading your blog….so maybe I can start re thinking. Will read again your very interesting article but will sleep well tonight. Thank you so much.

        1. Hi there, this article was helpful for me too. Saw your comment & wanted to let you know that I’ve had successful treatment for the pelvic problems you describe. Please look for a “pelvic floor specialist” or “pelvic floor physical therapist.” If you ask your gynecologist to refer you, it may be covered by insurance.

          My pelvic muscles were very tight & elevated, pressing on my bladder (urgent urination, not able to empty my bladder fully or at all). My pt helped me relax these muscles release them back to their normal resting position at the bottom of the pelvis. She used massage, taught me exercises, and used “biofeedback” which puts your muscle contractions on a screen you can see to help you find & recognize what it feels like to put those muscles back at rest.

  69. I came across this blog post some time last year in the search of figuring out my digestive problems. I book marked it so I can look back to it as a good refresher/reminder of the relation between ibs, sibo, and hsp. This is the first and only article that I have found regarding this connection – mainly focusing on highly sensitive people. I recently begun seeing a naturopathic doctor and have confirmed that I do have SIBO. I am just starting the protocol with herbal supplements and randomly decided to go through my old tabs/bookmarks. Re-reading this article has given me a sense of hope and reassure and came at the perfect time now knowing that the further steps in healing my body. I want to say thank you so much for this post and blog.

  70. Amazing knowledge. I had my second session with a wonderful massage therapist and had been very open with my SIBO diagnosis, which is really the end and beginning of an incredible long (since childhood) journey of struggling with digestion. This article is everything. I googled psoas/SIBO because the lady included work on the psoas thus week and mentioned how hot my right one was and how tight. She said it was hard to even get in to feel it through how hard my intestines were. Within minutes my intestines began to churn and the next day I saw a complete reduction of inflammation and about 2.5 less on the scale. I’ve had tests random come up for mixed connective tissue disease only to go away on second round and I think I now understand why!!! You’re so amazing for sharing this knowledge. Thank you! Thank you! Let the healing continue (about to finish rifaximin, then a round of that other stuff for clearing it out). Maintained fodmap for 2months and starting to feel human again. Yey for being HSP! 🙂 wouldn’t have it any other way though.

  71. Interesting article! I found it by Googling “psoas and poop”! And a m already familiar with being HSP. I became curious after spending a day working through hip/flexor stretches prepping for a yoga class and noticed my digestive output had immediately improved. I’m looking forward to researching more. Thanks.

  72. Thank you so much for this informative & interesting article. Your knowledge has opened my eyes to so many of my issues & it has helped me to understand how better to deal with my IBS & lower back pain pain.

  73. This is very interesting! I am HSP, have had IBS for 24 yrs,recently diagnosed SIBO, got scoliosis, always had lower back/lumbar/weak core. Currently on herbs and doing pilates reformer work to help strengthen and balance my body, as well

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