Daily stress and symptom exacerbation in interstitial cystitis patients

Abstract

Stress-related exacerbation of interstitial cystitis (IC) symptoms has been frequently reported. Previous research has found stress-related IC symptom exacerbation in an experimental model. However, this relation has not been objectively examined with daily life stressors. We used a prospective daily symptom diary methodology to investigate relations between stress and bladder symptoms in IC patients and age-matched healthy controls. A total of 45 previously diagnosed female IC patients completed a bladder symptom and stress diary nightly for 1 month; 31 female age-matched healthy controls completed a similar diary for 7 days. Symptom questions were modified from the Interstitial Cystitis Database study. Patients reported greater mean daily stress, bladder pain, urgency, daytime and nocturnal frequency than controls (all P-values ,0.001). Among all patients, a significant relationship between stress and urgency was observed. In addition, a significant relation between stress and pain was observed among patients with moderate and severe disease. As disease severity increased, more pronounced relations between stress and the symptoms of urgency and pain were evidenced. Greater stress was associated with greater nocturnal frequency among patients with more severe disease. These stress-symptom relations were not observed among controls. Higher levels of stress were related to greater pain and urgency in IC patients but not in controls. In addition, the relation of stress and these IC symptoms was stronger among patients with more severe symptomatology. This study indicates that life stress is associated with greater IC symptoms, particularly among patients whose disease is not well controlled.