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New Clues to Chronic Pelvic Pain

Nerve ‘Cross-Talk’ May Explain Coexisting Pelvic Pain Conditions, Researchers Say
WebMD Health News
Reviewed by Laura J. Martin, MD

Long Beach, Calif. (Oct. 1, 2010) -- Conditions that cause chronic pelvic pain -- such as irritable bowel syndrome and overactive bladder -- often occur together, and now new research may have uncovered more information on why.

Nerves in the painful organ may ''leak'' information to nerves in an adjacent organ, and as a result the brain isn't sure which organ the pain message originates from, says Tirsit Asfaw, MD, a fellow in the department of obstetrics and gynecology at the University of Pennsylvania. She presented her findings this week at the annual meeting of the American Urogynecologic Society in Long Beach, Calif.

''Before, we couldn't explain why these [conditions] were [often] occurring together," Asfaw tells WebMD. For patients, the finding may be reassuring, she says, as they are now sometimes told after examinations and testing that nothing is wrong functionally in the adjacent organ in which they feel pain.

Chronic pelvic pain conditions are those in which pain has been ongoing, either continuously or intermittently, for six months or longer.

Chronic Pelvic Pain: A Closer Look

Patients with chronic pelvic pain often have symptoms from multiple organs, such as bladder and bowel, Asfaw says. Patients diagnosed with irritable bowel syndrome or IBS, for instance, often also have symptoms of bladder urgency, or overactive bladder, in which they get a sudden urge to urinate and may ''leak."

Previously, laboratory studies have found that when the colon is inflamed, the bladder muscle known as the detrusor is affected, with inflammatory markers found. The detrusor helps you empty your bladder by contracting, but when it contracts too much, it can lead to overactive bladder problems.

Asfaw's study took the previous research a step further by looking at an animal model to find out what happens to surrounding organs when the colon becomes inflamed and painful. "We induced colonic inflammation with a chemical," she says, and then tested bladder function.

"We saw a lot of bladder spasms in the animals with colonic inflammation," she says. "The contractions are similar to those in overactive bladder."

Those with the inflamed colons had five times the number of bladder contractions as the control animals.

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