Date Presented 4/21/2018
A study of 579 women with chronic pelvic pain identified factors that increased symptoms. Significant associations were found with consumption of bladder-irritating food and drinks, increased stress, poor sleep, pressure or vibration to the pelvic area, and decreased general health.
Primary Author and Speaker: Cindy Hayden
PURPOSE: The purpose of this study was to examine specific daily activities and their effect on increasing symptoms in women with chronic pelvic pain. Approximately one in seven women in the United States suffer from chronic pelvic pain. An estimated 8–12 million have painful bladder syndrome (PBS), also known as interstitial cystitis (IC; Berry et al., 2011). IC/PBS flares increase pelvic pain and urological symptoms, which disrupt daily life and result in greater use of health care (Martin et al., 2015). Although certain diet and sleep factors affect bladder symptoms (Bassaly et al., 2011), there is a need to examine everyday life activities and their impact on increasing IC/PBS symptoms. The research question was, What daily occupational tasks increase urinary urgency, frequency, and pain in women with IC/PBS?
METHOD: A mixed method design was used to gather information about women who self-identified as having IC/PBS. A Survey Monkey link was posted on the Interstitial Cystitis Association website (http://www.ichelp.org), which advocates for pelvic pain research and provides information for health care providers and patients. From January to March 2016, 579 women responded to the survey.
Participants completed a 14-question survey rating how everyday occupations affected their urinary frequency, urgency, and pain. Survey questions asked about specific foods, drinks, allergies, pressure- or vibration-causing activities, clothing, and hormone use. Questions about overall level of exercise, sleep, stress, current symptoms, and general health were also included. Two open-ended questions encouraged participants to elaborate on the daily activities or occupations that increased their pelvic pain. IBM SPSS Statistics (IBM Corp., Armonk, NY) was used to analyze the quantitative research data and NVivo (QSR International, Melbourne, Australia) for qualitative data analysis.
RESULTS: The majority of participants with bladder pain changed their diet by avoiding drinking caffeinated or soft drinks and eating foods that contain tomatoes, vinegar, or spices. Up to 60% noted that vibration- or pressure-causing activities, such as driving, riding in a bus or airplane, or sitting in a hard chair, adversely affected their pelvic pain. 70% of participants either did not wear restrictive clothing or experienced an increase in flares when doing so. 74% experienced an increase in symptoms with sexual relations. Allergies increased urinary symptoms in 20% of participants.
Activities that increased urinary frequency, urgency, and pain associated with IC/PBS were often multifactorial and varied with each individual. Significant associations were found between an increase in symptoms or flares and consumption of bladder-irritating food and drinks, increased stress, poor sleep, pressure or vibration to the pelvic area, and decreased general health. Qualitative themes were health, diet, physical activity, pressure and vibration, and irritants.
CONCLUSION: The decisions women with IC/PBS make regarding everyday activities can increase urinary urgency, frequency, and pain, making it difficult to continue engaging in daily activities. Women with IC/PBS can improve health and occupational participation by working with health professionals to identify and avoid factors causing flares. Educating pelvic pain clients in health behaviors such as dietary changes, activity adaptations, and stress reduction techniques can decrease flares and assist clients with reengagement in daily occupations.
References
Bassaly, R., Downes, K., & Hart, S. (2011) Dietary consumption triggers in interstitial cystitis/bladder pain syndrome patients. Female Pelvic Medicine and Reconstructive Surgery, 17, 36–39. https://doi.org/10.1007/s00192-015-2652-6
Berry, S. H., Elliott, M. N., Suttorp, M., Bogart, L. M., Stoto, M. A., Eggers, P., . . . Clemens, J. Q. (2011). Prevalence of symptoms of bladder pain syndrome/interstitial cystitis among adult females in the United States. Journal of Urology, 186, 540–544. https://doi.org/10.1016/j.juro.2011.03.132
Martin, E., Sheaves, C., & Childers, K. (2015). Underlying mechanisms and optimal treatment for interstitial cystitis: A brief overview. Urologic Nursing, 35, 111–116. https://doi.org/10.7257/1053-816X.2015.35.3.111
