Open AccessSystematic review of the relationship between bladder and bowel function: implications for patient management
Author(s) -
Kaplan S. A.,
Dmochowski R.,
Cash B. D.,
Kopp Z. S.,
Berriman S. J.,
Khullar V.
Publication year - 2013
Publication title -
international journal of clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.756
H-Index - 98
eISSN - 1742-1241
pISSN - 1368-5031
DOI - 10.1111/ijcp.12028
Subject(s) - medicine , constipation , overactive bladder , interstitial cystitis , urinary system , irritable bowel syndrome , urinary urgency , fecal incontinence , defecation , urology , urinary incontinence , urinary bladder , functional constipation , lower urinary tract symptoms , gastroenterology , pathology , prostate , alternative medicine , cancer
Summary Background: The complex relationship between bladder and bowel function has implications for treating pelvic disorders. In this systematic review, we discuss the relationship between bladder and bowel function and its implications for managing coexisting constipation and overactive bladder (OAB) symptoms. Methods: Multiple PubMed searches of articles published in English from January 1990 through March 2011 were conducted using combinations of terms including bladder, bowel, crosstalk, lower urinary tract symptoms, OAB, incontinence, constipation, hypermotility, pathophysiology, prevalence, management and quality of life. Articles were selected for inclusion in the review based on their relevance to the topic. Results: Animal studies and clinical data support bladder‐bowel cross‐sensitization, or crosstalk. In the rat, convergent neurons in the bladder and bowel as well as some superficial and deeper lumbosacral spinal neurons receive afferent signals from both bladder and bowel. On a functional level, in animals and humans, bowel distention affects bladder activity and vice versa . Clinically, the bladder‐bowel relationship is evident through the presence of urinary symptoms in patients with irritable bowel syndrome and bowel symptoms in patients with acute cystitis. Functional gastrointestinal disorders, such as constipation, can contribute to the development of lower urinary tract symptoms, including OAB symptoms, and treatment of OAB with antimuscarinics can worsen constipation, a common antimuscarinic adverse effect. The initial approach to treating coexisting constipation and OAB should be to relieve constipation, which may resolve urinary symptoms. Conclusions: The relationship between bladder and bowel function should be considered when treating patients with urinary symptoms, bowel symptoms, or both.