Is there an appropriate strategy for treating co-morbid irritable bowel syndrome and bladder pain syndrome?

ABSTRACT

Introduction: Two of the most frequent components of chronic pelvic pain syndrome (CPPS) are irritable bowel syndrome (IBS) and bladder pain syndrome (BPS), characterized by considerable overlapping symptoms and pathophysiology. Currently, its management is challenging meaning there is high the demand for novel efficient therapeutics to aid patient care and to tackle the socioeconomic burden of IBS and BPS. As there are presently no sufficient treatment strategies, identifying the mechanisms that result in their main symptoms is the opportunity for developing appropriate therapies.

Areas covered: Herein, the authors explore the potential common treatment strategies for co-morbid IBS and BPS and highlight the absolute need for further research of these deliberating clinical entities.

Expert opinion: In the future, the authors summise that the discovery of predictive molecular biomarkers combined with clinical phenotypic categorization will likely allow for more definitive differentiation of patients and thus for better treatment options. Furthermore, it has been suggested that effective IBS treatment strategies would be of great value to co-morbid IBS and BPS therapy.

KEYWORDS:

• Bladder pain syndrome
• irritable bowel syndrome
• treatment strategy

Article highlights

• Both IBS and BPS are characterized by chronic visceral pain as a noticeable hallmark, with unknown precise pathophysiology.

• Besides challenges regarding the pathogenesis of IBS and BPS, dysfunction of the bladder–gut–brain–axis is suggested as the critical pathogenetic mechanism.

• It has been postulated that either the inflammatory conditions or the innate immune system dysfunction and respectively cytokine imbalance change the epithelial barrier function and increase visceral hypersensitivity.

• A multimodal approach is proposed for the management of co-morbid IBS and BPS focusing on specific inflammatory cytokines or receptors.

• IBS treatment strategies could improve co-morbid BPS.

This box summarizes key points contained in the article.

Authors’ contribution

All authors contributed the same in authoring the article.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This manuscript has not been funded.