Two doctors talk about what ovarian cancer pelvic pain and that from irritable bowel syndrome are like.
Pelvic pain can be caused by ovarian cancer. It can also be caused by IBS. Do they feel alike? What are the differences?
Let’s first start with the pelvic pain from ovarian cancer. For this topic is Teresa P. Diaz-Montes, MD, of the Gynecologic Oncology Center at Mercy Medical Center, Baltimore, MD.
Dr. Diaz-Montes first notes that the pelvic pain is usually local to the pelvis: the lower abdominal area, beneath the belly button.
“The pain could be more localized to one side (right or left) of the pelvis depending on the size and location of the ovarian mass,” she says.
“The pain is usually constant and not aggravated by movement. It can be associated with a sensation of pressure in the pelvis.
“A women may complain of a new onset of constipation (difficulty with moving her bowels) or urinary frequency (going to the bathroom to urinate more frequently).
“This is due to the compression of the pelvic mass on the adjacent organs.
“If the mass is too big, it may be able to be palpated on examination. This can also cause abdominal distention and the sensation of bloating.
“The intensity of the pain depends of the size of the mass. When the ovarian mass is small, the pain is dull and described as a discomfort.
“When the mass is larger, the pain could be very intense and sharp, requiring the use of pain medications.”
For pelvic pain associated with irritable bowel syndrome, the physician is Nnenna C. Okpara, MD, gastroenterologist and director of endoscopy at the Center for Women’s Gastrointestinal Health, Women & Infants Hospital in Providence, RI.
“Many IBS patients report chronic pelvic pain,” says Dr. Okpara. “The pain is usually localized to the lower abdominal area, above the pelvic bone, or in the perineal area.
“It is usually referred to as a cramping sensation, which is sometimes worsened by movement of pelvic organs including during intercourse, urination or defecation.
“It is also sometimes exacerbated by menses, supporting a possible role for hormonal factors in the mechanism.
“Such complaints should usually trigger an evaluation of the pelvic organs including ovary, tubes and uterus to exclude structural abnormalities including cancer.
“Pelvic pain, though seen in IBS, has been illustrated in studies mostly as an association, meaning that neither proven to be the ‘cause’ of the other, but merely that a certain group of patients are likely to have both.
“This may point to common underlying factors common to both including depression, somatization and physical abuse.
“Another factor is that many IBS patients have undergone multiple abdominal surgeries over the years, which can lead to development of scar tissue (adhesions) within the abdomen and pelvic cavity, that predisposes to chronic pain.”
Irritable bowel syndrome is a diagnosis of exclusion. Make sure you get cleared of all possible causes of pelvic pain or aching before you get diagnosed with IBS.
That means see a gynecologist first to rule out any problems with the ovaries or other reproductive organs.
is associate director of The Lya Segall Ovarian Cancer Institute at Mercy Medical Center. Board certified in gynecologic oncology, she has conducted various clinical trials to advance the care of gynecologic cancer. 
Dr. Okpara’s
