Chelimsky Gisela, Heller Elizabeth, Buffington C A Tony, Rackley Raymond, Zhang Di, Chelimsky Thomas
Department of Pediatric Gastroenterology, Medical College of Wisconsin Milwaukee, WI, USA.
Front Neurosci. 2012 Aug 10;6:114. doi: 10.3389/fnins.2012.00114. eCollection 2012.
This study aimed to estimate the proportion of patients with interstitial cystitis/painful bladder syndrome (IC/BPS) with systemic dysfunction associated co-morbidities such as irritable bowel syndrome (IBS) and fibromyalgia (FM).
Two groups of subjects with IC/BPS were included: (1) physician diagnosed patients with IC/BPS and (2) subjects meeting NIDDK IC/PBS criteria based on a questionnaire (ODYSA). These groups were compared to healthy controls matched for age and socio-economic status. NIDDK criteria required: pain with bladder filling that improves with emptying, urinary urgency due to discomfort or pain, polyuria >11 times/24 h, and nocturia >2 times/night. The ODYSA instrument evaluates symptoms pertaining to a range of disorders including chronic fatigue, orthostatic intolerance, syncope, IBS, dyspepsia, cyclic vomiting syndrome, headaches and migraines, sleep, Raynaud's syndrome, and chronic aches and pains.
IC/BPS was diagnosed in 26 subjects (mean age 47 ± 16 years, 92% females), 58 had symptoms of IC/BPS by NIDDK criteria (mean age 40 ± 17 years, 79% females) and 48 were healthy controls (mean age 31 ± 14 years, mean age 77%). Co-morbid complaints in the IC/BPS groups included gastrointestinal symptoms suggestive of IBS and dyspepsia, sleep abnormalities with delayed onset of sleep, feeling poorly refreshed in the morning, waking up before needed, snoring, severe chronic fatigue and chronic generalized pain, migraines, and syncope.
Patients with IC/BPS had co-morbid central and autonomic nervous system disorders. Our findings mirror those of others in regard to IBS, symptoms suggestive of FM, chronic pain, and migraine. High rates of syncope and functional dyspepsia found in the IC/BPS groups merit further study to determine if IC/BPS is part of a diffuse disorder of central, autonomic, and sensory processing affecting multiple organs outside the bladder.
本研究旨在评估间质性膀胱炎/膀胱疼痛综合征（IC/BPS）患者中伴有诸如肠易激综合征（IBS）和纤维肌痛（FM）等全身功能障碍相关合并症的患者比例。
纳入两组IC/BPS受试者：（1）经医生诊断的IC/BPS患者；（2）基于问卷（ODYSA）符合美国国立糖尿病、消化和肾脏疾病研究所（NIDDK）IC/PBS标准的受试者。将这些组与年龄和社会经济地位相匹配的健康对照进行比较。NIDDK标准要求：膀胱充盈时疼痛，排空后改善；因不适或疼痛导致尿急；多尿>11次/24小时；夜尿>2次/夜。ODYSA工具评估一系列疾病相关症状，包括慢性疲劳、直立性不耐受、晕厥、IBS、消化不良、周期性呕吐综合征、头痛和偏头痛、睡眠、雷诺综合征以及慢性疼痛。
26名受试者被诊断为IC/BPS（平均年龄47±16岁，92%为女性），58名根据NIDDK标准有IC/BPS症状（平均年龄40±17岁，79%为女性），48名是健康对照（平均年龄31±14岁，77%为女性）。IC/BPS组的合并症主诉包括提示IBS和消化不良的胃肠道症状、睡眠异常（入睡延迟）、早晨感觉恢复不佳、在需要之前醒来、打鼾、严重慢性疲劳和慢性全身性疼痛、偏头痛以及晕厥。
IC/BPS患者伴有中枢和自主神经系统合并症。我们在IBS、提示FM的症状、慢性疼痛和偏头痛方面的发现与其他人的发现一致。IC/BPS组中高比例的晕厥和功能性消化不良值得进一步研究，以确定IC/BPS是否是影响膀胱外多个器官的中枢、自主和感觉处理的弥漫性疾病的一部分。
