Abstract

Bladder Pain Sensitivity Is a Potential Risk Factor for Irritable Bowel Syndrome

Dig Dis Sci. 2023 Mar 7. doi: 10.1007/s10620-023-07868-7. Online ahead of print.

 

Arielle E Shlobin 1Frank F Tu 1 2Cody R Sain 2Matthew J Kmiecik 1 2Diana Kantarovich 3Lavisha Singh 4Chi E Wang 4Kevin M Hellman 5 6 7

 
     

Author information

1Department of Obstetrics & Gynecology, Northshore University HealthSystem, Evanston, IL, 60201, USA.

2Department of Obstetrics & Gynecology, The University of Chicago Pritzker School of Medicine, Chicago, IL, 60637, USA.

3Rosalind Franklin University of Medicine and Science, North Chicago, IL, 60064, USA.

4Department of Biostatistics, Northshore University Health System, Evanston, IL, 60201, USA.

5Department of Obstetrics & Gynecology, Northshore University HealthSystem, Evanston, IL, 60201, USA. khellman@uchicago.edu.

6Department of Obstetrics & Gynecology, The University of Chicago Pritzker School of Medicine, Chicago, IL, 60637, USA. khellman@uchicago.edu.

7Department of Obstetrics & Gynecology, Evanston Hospital, Walgreen's Bldg 1507, 2650 Ridge Ave, Evanston, IL, 60201, USA. khellman@uchicago.edu.

Abstract

Background: Although dysmenorrhea is a highly prevalent risk factor for irritable bowel syndrome (IBS), the factors underlying this risk are not fully understood. Prior studies support a hypothesis that repeated distressing menstrual pain promotes cross-organ pelvic sensitization with heightened visceral sensitivity.

Aims: To further explore cross-organ pelvic sensitization we examined the association of dysmenorrhea, provoked bladder pain, and other putative factors with self-reported IBS-domain pain frequency and new onset after 1-year follow up.

Methods: We measured visceral pain sensitivity with a noninvasive provoked bladder pain test in a cohort of reproductive-aged women, enriched for those reporting moderate-to-severe menstrual pain intensity but without any prior IBS diagnosis (n = 190). We analyzed the relationship between menstrual pain, provoked bladder pain, pain catastrophizing, anxiety, and depression with primary outcomes: (1) frequency of self-reported IBS-domain pain and (2) new onset of IBS-domain pain after 1-year follow up.

Results: All hypothesized factors correlated with the frequency of IBS-domain pain (p's ≤ 0.038). In a cross-sectional model, only menstrual pain (standardized adjusted odds ratio 2.07), provoked bladder pain (1.49), and anxiety (1.90) were independently associated with IBS-domain pain ≥ 2 days/month (C statistic = 0.79). One year later, provoked bladder pain (3.12) was the only significant predictor of new onset IBS-domain pain (C statistic = 0.87).

Conclusion: Increased visceral sensitivity among women with dysmenorrhea could lead to IBS. Because provoked bladder pain predicted subsequent IBS, prospective studies should be performed to see if the early treatment of visceral hypersensitivity mitigates IBS.

 

 

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