Mind & Body • 27 Jul 2020
Functional Disorders: The Relationship Between Chronic Prostatitis and IBS
Functional Disorders: The Relationship between Chronic Prostatitis and IBS
By Michael Palladino, ND – SSIHI Integrative and Preventative Medicine and Jacob Hwang, ND – SSIHI Resident, PGY2
Susan Samueli Integrative Health Institute
UCI Susan and Henry Samueli College of Health Sciences
Functional disorders are chronic conditions that have impaired bodily processes, which cannot be explained by a structural abnormality. In medicine, functional disorders have an overlap between various body systems as symptoms tend to be general and nonspecific. Examples of functional disorders in males are chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and irritable bowel syndrome (IBS).
Chronic prostatitis/chronic pelvic pain syndrome is a male disorder with four subtypes including acute and chronic bacterial infections, and inflammatory and non-inflammatory causes with clinical features of pain in the pelvic region, irritation with urination, pain with ejaculation, sexual dysfunction, depression and/or psychosocial dysfunction. Chronic pelvic pain is a primary component of the condition and is present for at least three of the preceding 6 months. The most common type of CP is chronic non-bacterial prostatitis, which makes up roughly 90-95% of prostatitis cases. This leaves most CP cases without a clear cause, making it difficult to devise treatment approaches.
Like CP, IBS is the most common functional gastrointestinal disorder with symptoms including altered bowel movements, increased sensitivity to pain, and inflammation. Both functional disorders have worldwide prevalence and diagnosed mainly by clinical presentation rather than a diagnostic test. One population study examined the relationship between CP and IBS and found CP cases to be highly associated with a prior IBS diagnosis meaning potential overlap among functional disorders. Moreover, research suggests a relationship between body systems referred to as the bladder-gut-brain axis. Therefore, thoroughly understanding the relationship between CP and IBS, integrative medical treatment focuses on a multisystem support including the brain/nervous system, gastrointestinal system, and genitourinary system.
Biofeedback, has been shown to be effective with CP/CPPS based on the principle that maximum muscle contraction prompts maximum muscle relaxation. This mechanism addresses the chronic pain aspect of CP/CPPS and focuses on muscular reeducation, which may ultimately provide symptom relief. Integrative gastrointestinal support centers on improving gut barrier integrity, and decreasing inflammatory processes. Often times, a food elimination diet followed by food reintroduction are also recommended to isolate common food sensitivities that contribute to CP/CPPS and IBS. Phytonutrients such as quercetin, play a positive role by modulating immune function to prevent and treat diseases, including those with potential microbial etiology. Phytonutrients belong to a group of polyphenolic substances commonly found in the plant kingdom in the rinds and barks of certain foods such as onions, grapes and green tea.
Even though these are common treatment strategies to treat CP/CPPS and IBS, integrative medicine acknowledges that each individual is unique and will often include additional treatment strategies to improve functional disorders. As this brief article outlines, there is a strong interconnectedness between the functional disorders of chronic prostatitis and irritable bowel syndrome in which integrative assessment and treatment strategies can offer significant improvement for males with these conditions.
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