Pelvic Floor Dysfunction and Gut-Brain Axis: Implications for Multidisciplinary Diagnosis and Treatment in Gynecology, Gastroenterology, and General Surgery

Pelvic floor dysfunction is a prevalent multifactorial condition that significantly impairs quality of life. Traditionally managed from a compartmentalized perspective, recent evidence highlights the connection between the pelvic floor and the gut-brain axis. This review analyzes the pathophysiological association between both and proposes an integrated diagnostic and therapeutic approach involving gynecology, gastroenterology, and general surgery. A narrative review of the literature was conducted. Bidirectional communication between the central nervous system, enteric nervous system, and gut microbiota influences pelvic tone, visceral sensitivity, and symptom perception. Chronic constipation, intestinal dysbiosis, and psychological stress can exacerbate or trigger pelvic floor dysfunction, which in turn alters bowel habits and contributes to anxiety and depression. An interdisciplinary model enables comprehensive management including dietary interventions, pelvic floor physical therapy, psychological support, and coordinated surgery, thereby improving diagnostic accuracy and expanding therapeutic options.