Women with interstitial cystitis at risk for irritable bowel syndrome and depression

Compared to women without bladder problems, women with 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 this population.

Dr. Joseph M. Novi, of the University of Pennsylvania, Philadelphia, and colleagues conducted a case-control study comparing 46 women with newly diagnosed interstitial cystitis and 46 similar but unaffected women presenting for annual gynecologic examination. Standardized, validated questionnaires were used to collect data. Among the women with interstitial cystitis, 20 (43%) were diagnosed with irritable bowel syndrome, the team reports in the September issue of the Journal of Urology. Five of the control women (11%) were diagnosed with irritable bowel syndrome. The odds ratio for irritable bowel syndrome associated with interstitial cystitis was11 (p < 0.001). 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%) and five controls (11%) had symptoms of major depression, for an odds ratio of 4 (p = 0.01). The association with depression was significantly higher among women with severe interstitial cystitis than among those with mild interstitial cystitis (OR 10.1).The investigators found that in the interstitial cystitis group, women with depression were significantly more likely to complain of bladder pain, nocturia, abdominal pain, and other bowel symptoms than those without depression. "A common pathogenesis, that is the interaction of mast cells with nerve cells to produce neurogenic inflammation and pain, has been proposed for interstitial cystitis and irritable bowel syndrome," Dr. 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 appropriate pain management techniques may improve depression symptoms. (Source: J Urol 2005;174:937-940: Reuters Health: Oncolink: September 2005.)