AUA 2009: IC/PBS + IBS + CFS + FM

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(Note: this is an abstract from a conference, not a published study.)

Phenotypic Associations Between Interstitial Cystitis/Painful Bladder Syndrome (IC/PBS) And Irritable Bowel Syndrome (IBS), Fibromyalgia (FM), Chronic Fatique Syndrome (CFS): A Case Control Study

Authors: J Curtis Nickel*, Dean A Tripp, Kingston, ONCanada; Michel A Pontari, Philadelphia, PA; Robert M Moldwin, New York, NY; Robert Mayer, Rochester, NY; Lesley K Carr, Toronto, ONCanada; Raggi Doggweiler, Knoxville, TN; Claire C Yang, Seattle, OR; David Whitcomb, Pittsburgh, PA; Nagendra Mishra, India, India; Jorgen Nordling, Herlev, Denmark; The Interstitial Cystitis Deep Phenotyping Research Group

Introduction and Objective: Characterize and compare the impact of clinical phenotypic associations between Interstitial Cystitis/Painful Bladder Syndrome (IC/PBS) and controls in relation to 3 potentially related conditions: Irritable Bowel Syndrome (IBS), Fibromyalgia (FM) and Chronic Fatigue Syndrome (CFS). Methods: Female patients with IC/PBS and controls with no IC/PBS completed a biopsychosocial phenotyping questionnaire battery which included demographics/history form (including history of associated conditions), Medical Symptom Inventory (MSI) to be validated for identification of symptoms of associated conditions and 20 validated questionnaires focused on symptoms, suffering/coping and behavioral/social factors. Results: Questionnaires were completed by 208 IC/PBS patients and 180 controls. Prevalence of self-reported associated condition diagnosis in IC/PBS patients vs controls: IBS 38.7% vs 5.6%; FM 17.6% vs 1.7%; CFS 9.4% vs 1.1% (all p= .000). Significantly more patients in the IC/PBS vs Controls were identified with MSI symptoms associated with a diagnosis of IBS (49 vs 11%), FM (59 vs 32%) and CFS (45 vs 7%). Compared with control participants, patients with IC/PBS diagnoses had significantly more pain, poorer quality of life (mental & physical), sleep disturbance, stress and anxiety, more depression and increased thoughts of hurting themselves, lower perceived social support, poorer sexual functioning, and greater catastrophizing (all Anova’s p=.000). In the IC/PBS cohort, 52.4% reported no other associated condition, 23.6% had IC/PBS+IBS only, 2.4% had IC/PBS+FM only, 1.4% IC/PBS+CFS only, while 20.2% had multiple associated conditions. As the number of associated conditions increased (i.e., localized, regional, to systemic), pain, stress, depression, and sleep disturbance increased while social support, sexual functioning and quality of life deteriorated. Anxiety and catastrophizing remained elevated in all groups. Symptom duration was associated with phenotypic progression. Conclusions: IC/PBS patients have significant biopsychosocial impairment compared to controls. IBS, FM and CFS are more prevalent in IC/PBS patients and result in significant impact. There is progression over time from an organ centric to regional and finally systemic pain syndrome with progression of symptom severity and deterioration of cognitive and psychosocial parameters associated with IC/PBS.