4: GI Causes of Pelvic Pain Flashcards
A trial of local estrogen therapy is suggested, though if there is no improvement after 2 months, urethral dilation is a consideration.
Urethral syndrome
Its cause is believed to involve dysregulation in interactions between the central nervous system and the enteric nervous system. This brain–gut dysfunction my ultimately disrupt the GI mucosal immune response, intestinal motility and permeability, and visceral sensitivity.
IBS
Its etiology is uncertain but is thought to involve noninfectious, stenotic, or fibrous changes in the urethra, often associated with multiparity, delivery without episiotomy, and general pelvic relaxation.
Urethral syndrome
Women who have had a _____ for chronic pelvic pain are twice as likely to have IBS.
Women who have had a hysterectomy for chronic pelvic pain are twice as likely to have IBS.
- Characterized by a recurrent abdominal pain or discomfort at least 3 days a month for the past 3 months, and is usually accompanied by constipation or diarrhea.
- Clinical features of IBS include shifting abdominal pain accompanied by constipation or diarrhea, or both. Bloating, nausea, and vomiting are also common symptoms.
IBS
Pain originating from trigger points in skeletal muscle
Myofascial syndrome
Management of interstitial cystitis?
- Management is empirical.
- Diet changes
- Stress reduction
- Behavior changes
- Pelvic floor exercises (bring relief of urge frequency)
Diagnosis is made by exclusion. For this reason, a clean-catch or catheterized urine specimen should be ordered to rule out urinary tract infection. Sometimes sterile pyuria is present; if it is, a course of doxycycline or erythromycin is helpful.
Urethral syndrome
The most common functional GI disorder. Accounts for as many as 60% of referrals to the GYN for CPP.
IBS
What are diet recommendations for IBS?
- Eliminate carbs
- Fructose
- Lactose
- Sorbitol
- Increase fiber (no evidence to support this recommendation)
Most individuals diagnosed with this condition are between 40 and 60 years of age. Cystoscopy findings of petechiae or decreased bladder capacity (less than 350 mL) are considered diagnostic.
Interstitial cystitis
Associated with incomplete emptying of the bladder and burning during urination, especially after intercourse.
Urethral syndrome
Most individuals diagnosed with this condition are between 40 and 60 years of age. Cystoscopy findings of petechiae or decreased bladder capacity (less than 350 mL) are considered diagnostic.
Interstitial cystitis
The _____ criteria are used to categorize the symptoms and make the diagnosis. These criteria constitute a system developed to classify functional gastrointestinal disorders (FGIDs)—that is, disorders of the digestive system in which symptoms cannot be explained by the presence of structural or tissue abnormality—based on clinical symptoms
The Rome criteria are used to categorize the symptoms and make the diagnosis. These criteria constitute a system developed to classify functional gastrointestinal disorders (FGIDs)—that is, disorders of the digestive system in which symptoms cannot be explained by the presence of structural or tissue abnormality—based on clinical symptoms
What helps with diagnosis and identifying triggers in myofascial syndrome?
Carnett’s sign
