Compared with women without bladder problems, women who have interstitial cystitis are more likely to have irritable bowel syndrome and depression, researchers report. They hypothesize that bladder and bowel pain may cause depression in these women.
Interstitial cystitis, a troubling problem that involves severe pain when the bladder is full and a frequent and urgent need to urinate. The condition is often chronic, progressive and difficult to treat.
Dr. Joseph M. Novi, of the University of Pennsylvania, Philadelphia, and colleagues conducted a study comparing 46 women with newly diagnosed interstitial cystitis and 46 similar but unaffected women (the “control” group) who were seen at an annual gynecologic examination. Standardized questionnaires were used to collect patient data.
Among the women with interstitial cystitis, 20 (43 percent) were diagnosed with irritable bowel syndrome, the team reports in the Journal of Urology. Five of the control women (11 percent) were diagnosed with irritable bowel syndrome.
Women with interstitial cystitis were 11-times more likely to also have irritable bowel syndrome. No significant difference in the frequency of irritable bowel syndrome was observed between women with severe interstitial cystitis and those with mild interstitial cystitis.
A total of 19 cases (41 percent) and five controls (11 percent) had symptoms of major depression, a four-fold increased risk. The association with depression was significantly higher among women with severe interstitial cystitis than among those with mild interstitial cystitis, a 10-fold increased risk.
The investigators found that in the interstitial cystitis group, women with depression were significantly more likely to complain of bladder pain, waking up at night to urinate, abdominal pain, and other bowel symptoms than those without depression.
A common underlying source for the inflammation and pain has been proposed for interstitial cystitis and irritable bowel syndrome, Novi and colleagues comment.
“We hypothesize that pain associated with irritable bowel syndrome and interstitial cystitis is a causal factor in depression in these women,” they write. They suggest that pain management techniques may improve depression symptoms.
