IRRITABLE BOWEL SYNDROME (IBS)
IBS and Chronic Prostatitis or Chronic Pelvic Pain Syndrome
Overlapping Conditions for Men

Male executive running to toilet
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By Barbara Bolen, PhD - Reviewed by a board-certified physician.
Updated April 12, 2017

Some men may experience chronic prostatitis, also known as chronic pelvic pain syndrome, (CP/CPPS), alongside irritable bowel syndrome (IBS). They are two different conditions but they do have some common features. The overlap is a good reason to discuss
all of your symptoms with your doctor. Here is a brief overview of CP/CPPS, with some information as to how it might relate to IBS.

What Is Prostatitis?
Prostatitis refers to health conditions related to the prostate, a gland that is part of the male reproductive system.


The prostate is responsible for secreting fluid that contributes to semen, as well as helping to squeeze semen out during the ejaculation process.

CP/CPPS is one of four types of prostatitis:

Acute bacterial prostatitis
Chronic bacterial prostatitis
Chronic pelvic pain syndrome (CP/CPPS), inflammatory and non-inflammatory types Asymptomatic prostatitis (inflammation is noted, but patient reports no symptoms)
What Is CP/CPPS?
CP/CPPS is a chronic type of prostatitis, it develops and persists over a longer period of time rather than occurring suddenly. You might be diagnosed with it when your physician's comprehensive diagnostic assessment has ruled out a bacterial infection
and/or the presence of other health disorders. The symptoms must be present for at least three of the last six months in order to receive a CP/CPPS diagnosis.

Symptoms of CP/CPPS
Symptoms of CP/CPPS can wax and wane over time and may include:

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Chronic pain and/or discomfort in the pelvis, testicles, anus, rectum and groin Pain and/or discomfort when urinating or ejaculating
Urinary urgency
Urinary incontinence
Sexual dysfunction
Treatment of CP/CPPS
As little is known as to why men develop CP/CPPS, there is no one-size-fits-all treatment. You must work closely with your doctors to develop a personalized plan for addressing your symptoms.


Medications may be prescribed, including:

alpha blockers
muscle relaxants
nonsteroidal anti-inflammatory drugs (NSAIDs)
Overlap Between CP/CPPS and IBS
Research studies have found that a large number of men experience IBS alongside CP/CPPS. Although IBS and CP/CPPS are two separate disorders, they do share some similar features:

Both are classified as functional disorders
Prevalence rates are similar
Higher than expected rates of comorbid mental health diagnoses
Higher than expected rates of past physical and sexual abuse
Both have a negative impact on quality of life
What Do I Do if You Have Both IBS and CP/CPPS?
Due to the high overlap rate between IBS and CP/CPPS, be sure to be open with your doctor about all of your symptoms, whether they be bowel, bladder or sexual in nature. Even though talking about these particular parts of your body may feel uncomfortable.

Both disorders appear to benefit from an excellent working relationship with a physician (see Is Your Doctor Right for You?). Your doctor is in the best position to identify treatment options that take into account all of your symptoms.

Although as of now there is no known system-wide dysfunction that may be contributing to symptoms of both disorders, it never hurts to incorporate strategies that benefit your overall health into your life.

Pain sensations can be enhanced by stress and anxiety, so it may be helpful to look into mind/body activities that ease stress and tension, such as meditation, relaxation exercises, and yoga.

Sources:

Nickel, J. "The Multidisciplinary Approach to Defining the Urologic Chronic Pelvic Pain Syndromes" Reviews in Urolology 2008 10:157-159.

"Prostatitis: Disorders of the Prostate" National Kidney and Urological Diseases Information Clearinghouse (NKUDIC) Accessed June 12, 2011.

Rodriguez, M., Afari, N. & Buchwald, D. "Evidence for Overlap Between Urological and Nonurological Unexplained Clinical Conditions" The Journal of Urology 2009 182:2123-2131.

Vicaril, E., et.al. "High Frequency of Chronic Bacterial and Non-Inflammatory Prostatitis in Infertile Patients with Prostatitis Syndrome Plus Irritable Bowel Syndrome" PLoSone 2011 6:e18647.

Wagenlehner, F., et.al. "Prostatitis and Male Pelvic Pain Syndrome: Diagnosis and Treatment" Deutsches Aerzteblatt International 2009 106:175-183.

IRRITABLE BOWEL SYNDROME (IBS)
IBS and Bladder Problems
What to Do When They Happen at the Same Time
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Photo: Robert Lang Photography/Moment Open/Getty Images
By Barbara Bolen, PhD - Reviewed by a board-certified physician.
Updated February 13, 2017
Are dealing with double trouble? Bowel and bladder problems at the same time? Frequent urination alongside your irritable bowel syndrome (IBS)? You may find some small comfort in learning that you are not alone - many people experience bladder problems
and IBS at the same time. Let's take a look at the overlap between the two and what might be the underlying reasons behind your double distress.

Bladder Symptoms and IBS
There is a surprising overlap between bowel and bladder problems.


Some researchers have estimated that urinary symptoms may be experienced as many as 50 percent of people who have IBS. These symptoms include:

Frequent urination
Incomplete emptying of the bladder
Nocturia (need to get out of bed to urinate)
Urinary urgency
There is also some evidence that women who suffer from IBS also may be more likely to experience urinary incontinence than women who do not have IBS.

Why the Overlap?

Researchers do not know for sure why people who have IBS are at higher risk for urinary problems and vice versa. Their work into underlying factors may eventually lead to a better understanding of all of the factors at play. Certainly, the proximity of
the organs responsible for elimination suggests that there is interaction among the various nerves and muscles of each system. Other possible reasons for the overlap between bowel and bladder symptoms include shared inflammation and/or shared central
nervous system dysfunction.

Having a better understanding of the underlying causes can lead to more effective treatments, offering well-needed symptom relief.

It may be heartening to know that researchers have found some evidence that improving the functioning of one of the two systems can lead to an improvement in the functioning of the other.

Urinary Conditions that May Co-Exist with IBS
The following health conditions each may affect the functioning of the bladder and/or the bowel:

Interstitial Cystitis:
Otherwise known as painful bladder syndrome, interstitial cystitis (IC) is a condition in which a person experiences frequent urination, and chronic pain and discomfort associated with the bladder. Both IC and IBS have been associated with visceral
hypersensitivity. In terms of identifying causes to explain an overlap between IC and IBS, researchers have been looking at the role of inflammation, a "cross-sensitization" among the nerves of the gut and bladder, and other possible centralized
dysfunction. If you have IC alongside IBS, work with your doctor on a treatment plan that addresses both conditions. This may include medication, diet changes, and treatments such as physical therapy or biofeedback.
Pelvic Floor Dysfunction:
Pelvic floor dysfunction (PFD) is another condition that could result in both IBS and frequent urination. In PFD, the muscles found within the pelvis that are responsible for coordinating urination and defecation do not work as they should. Having such a
dysfunction might well explain why a person would suffer bowel and bladder symptoms simultaneously. If you are diagnosed with pelvic floor dysfunction, speak with your doctor about treatment options, as a wide variety of options are available depending
on the severity of your symptoms.
Chronic Prostatitis/Chronic Pelvic Pain Syndrome:
Some men may find themselves with the misfortune of suffering from this chronic form of prostatitis alongside IBS. Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) results in a variety of symptoms, including urinary pain, urinary urgency and
incontinence. There are medications available for easing the symptoms of CP/CPPS, so be sure to work with your doctor on a treatment plan.
Urge Incontinence:
This urinary disorder results in symptoms of urinary urgency and involuntary urine passage. Unfortunately, there is not a lot of research regarding this overlap. Urge incontinence requires a complete medical workup, as a variety of different health
conditions may be at the root of symptoms.
What to Do If You Have Both
The most important thing to do if you are experiencing both bowel and bladder symptoms is to make sure to bring both to the attention of your doctor. Because of old-school stigma regarding "bathroom symptoms" many people are too shy to discuss their
issues with their doctors. Don't be embarrassed - elimination is a normal part of being human, as your doctor well knows. Your doctor will help to come up with a diagnosis and provide you with a plan to address each problem.

Your doctor will tailor your treatment plan according to which bladder problem you are experiencing. If your double problem appears to be related to pelvic floor dysfunction, your doctor may recommend physical therapy or biofeedback. If your symptoms
appear to be more related to visceral hypersensitivity, they may recommend a medication that targets the nervous system (in particular the neurotransmitter serotonin). Another option is the use of a medication that has anticholinergic effects. As you can
there are a variety of different things that can be tried to bring you symptom relief, so be sure to tell your doctor what you are dealing with in terms of your "bathroom issues."

Sources:

Ya-Jun Guo Y, Ho C, Chen S, Yang S, Chiu H, Huang K "Lower urinary tract symptoms in women with irritable bowel syndrome" International Journal of Urology 2010 17:175-181.

Malykhina AP, Wyndaele J, Andersson K, De Wachter S, Dmochowski RR. "Do the urinary bladder and large bowel interact, in sickness or in health?" Neurourology Urodynamics 2012 31:352-358.

Persson R, Wensaas K-A, Hanevik K, Eide GE, Langeland N, Rortveit G. The relationship between irritable bowel syndrome, functional dyspepsia, chronic fatigue and overactive bladder syndrome: a controlled study 6 years after acute gastrointestinal
infection. BMC Gastroenterology. 2015;15:66.

Wang J, Varma MG, Creasman JM, Subak LL, Brown JS, Thom DH, Van Den Eeden, SK. "Pelvic floor disorders and quality of life in women with self-reported irritable bowel syndrome" Alimentary Pharmacology & Therapeutics 2010 31:424-431.


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