Chronic Pelvic Pain and Cross-sensitization
Conditions like irritable bowel syndrome (IBS) and overactive bladder, both of which causes chronic pain in the pelvic region, are often found to occur together. A new study has revealed some of the facts that may explain why this happens. Chronic pain results when the pain is ongoing, whether continuously or periodically, for more than six months.
Results of a study presented at the annual meeting of the American Urogynecologic Society in Long Beach, California, showed that nerves in the painful organ may leak the information to a nearby organ so that the brain is not able to process where the message is originated from. “Earlier it was hard to explain the reason for this," says Tirsit Asfaw, MD, a fellow in the department of obstetrics and gynecology at the University of Pennsylvania. This finding is quite significant for the patient, as it is common for patients to be told there is nothing structurally wrong with their organs.
“The symptoms of chronic pelvic pain arise from a number of organs in the body including the bladder and the bowel," says Asfaw. A person diagnosed with IBS may also have symptoms of overactive bladder resulting in sudden urgency to relieve the bladder.
In this study, Asfaw and colleagues performed studies in animals to observe the changes that happen in the adjacent organs when the colon becomes inflamed and painful. Earlier studies had shown that when the colon is inflamed, it affects the bladder muscle and leads to overactive bladder condition. Animal studies clearly showed that colonic inflammation is associated with bladder spasms which are often similar to that of an overactive bladder. Animals with inflamed colons had five times more bladder contractions when compared to animals that do not have colon inflammation.
According to Asfaw, the nerves from the inflamed colon pass on the information to the adjacent bladder resulting in a leakage of information. When this message reaches the brain, the organ finds it difficult to pinpoint where the inflammation is. This leakage of information between the adjacent organs causes cross-sensitization and the brain perceives the pain in both the organs. This finding supports the view that inflammation in one of the pelvic organ may lead to symptoms in other organs through cross-sensitization.
Rebecca Rogers, MD, professor of obstetrics and gynecology at the University of New Mexico Health Sciences Center, Albuquerque, agrees that there is a lot of overlap among the different conditions resulting in pelvic pain. According to Rogers, the finding is the first step to define the origin of overlapping problems.
