Cross-organ sensitization between the colon and bladder: to pee or not to pee?

Abstract

Chronic abdominal and pelvic pain are common, debilitating clinical conditions experienced by millions of patients around the globe. The origin of such pain commonly arises from the intestine and bladder, which share common primary roles; the collection, storage and expulsion of waste. These visceral organs are located in close proximity to one another, and also share common innervation from spinal afferent pathways. Chronic abdominal pain, constipation or diarrhoea are primary symptoms for patients with Irritable Bowel Syndrome (IBS) or Inflammatory Bowel Disease (IBD). Chronic pelvic pain, urinary urgency and frequency are primary symptoms experienced by patients with lower urinary tract disorders such as interstitial cystitis/painful bladder syndrome (IC/PBS). It is becoming clear that these symptoms and clinical entities do not occur in isolation, with considerable overlap in symptom profiles across patient cohorts. Here we review recent clinical and experimental evidence documenting the existence of 'cross-organ sensitisation' between the colon and bladder. In such circumstances, colonic inflammation may result in profound changes to the sensory pathways innervating the bladder, resulting in severe bladder dysfunction.