Neural Crosstalk, IBS and CPPS

Many patients with interstitial cystitis (IC) and chronic pelvic pain syndrome (CPPS) find that particular foods exacerbate disease symptoms. Several studies have linked both IC and CP/CPPS to irritable bowel syndrome (IBS).  So how is IBS connected to urological pain syndromes?

nerve-crosstalkScientists hypothesize that integration of neural signals from pelvic organs mediates the effects of diet on symptoms of IC. In animal models, pelvic inflammation is subject to crosstalk, so an inflammatory stimulus in one pelvic organ evokes a response in an independent organ. Recent data show that the colon can modulate bladder-associated pelvic pain in mice. As pelvic organs are innervated through shared circuitry, perceived pelvic pain might occur when spatial summation of individual pelvic inputs exceeds a threshold. Through this mechanism, a noxious dietary stimulus, which otherwise does not exceed the pain threshold in a normal individual, may substantially exacerbate pain in a patient with bladder symptoms, for instance. Repeated painful stimuli over time further contribute to symptoms by a process of temporal summation, resulting in enhanced responsiveness through central sensitization.

This means that the pain and distress caused by IBS can sensitize and inflame other pelvic organs, such as the bladder, prostate, urethra and other structures.

The good news is that new research has found that a FODMAP-free diet controls IBS, and this diet should help CPPS and IC patients too. Gluten is avoided in a FODMAP-free diet, and we have a page on gluten and prostatitis.

Note that noxious and irritating electrical activity in the nerves of the pelvis as a result of IBS can inflame other pelvic organs, and likewise constant tensing of the pelvic muscles, because of anxiety or stress, acts via the same crosstalk pathways on the genitourinary organs of the pelvis.

Further reading
Cross-Talk and Sensitization of Bladder Afferent Nerves
Summation model of pelvic pain in interstitial cystitis