Pain In The Butt – The Bladder, The Bowel, And Their Relationship

Every morning after we wake up, the first thing everybody needs to do is go to the toilet. We get rid of the digested food we ate yesterday and empty our bladder. Can you imagine what’s going on inside our body?

In order to have a normal happy life, we require a very good relationship between ‘the Bowel’ and ‘the Bladder’, because when we pee, we can’t defecate at the same time and vice versa. This relationship is wisely controlled by the nervous system. However, the Bowel is very sensitive, especially in the condition of ‘Irritable bowel syndrome’. The Bowel is easily irritated after we have eaten some spicy curry, coffee, or are under stress, and it becomes more sensitive to any stimulus. In 2014, this condition was reported the most common digestive complaint affecting almost a fifth of the UK’s population with more women affected than men. People with irritable bowel syndrome have abdominal pain, discomfort and defecation symptoms (constipation, diarrhea, or both).

Similarly, the Bladder gets inflamed easily. The condition is especially common in women. 400,000 people in the UK have ‘Interstitial cystitis’ or chronic inflammation in the bladder wall, which is also diagnosed as painful bladder syndrome. Patients with interstitial cystitis urinate very frequently and have unpleasant urgency and pain during urination or sex. Unfortunately, the causes of these diseases are still unclear.

Our body requires electrical messages from the brain to allow the Bowel and the Bladder to work accurately. The brain sends messages through the network of nerves, which are specific to pelvic organs including the Bowel and the Bladder. ‘Command nerves’ carry messages from the brain to the organs and ‘sensory nerves’ send messages from the organs to the brain. When the Bowel and the Bladder are filled with stool or urine, the sensory nerves detect the fullness. Then, they directly communicate it to the brain and the brain sends the command signal back to allow the sphincters – gatekeepers of the Bowel and the Bladder – to relax when we are ready to release stool or urine. We need a good coordination between ‘command nerves’ and ‘sensory nerves’ to control contraction or relaxation of muscles in these organs. This coordination ensures that the sphincters remain closed when we are not ready to go to the toilet.

The sensory nerves play a key role in controlling not only fullness of these hollow organs, but also their pain sensation. When one organ is sick or affected by a disease, pain or discomfort is detected in the other. About 3 in 5 of irritable bowel syndrome patients also have painful bladder symptoms and vice versa. Therefore, we still need to find more clues to understand and control unnecessary pain sharing between those two organs.

One of the key signs the Bowel and the Bladder are sick is high activity of their sensory nerves. When sensory nerves become hyperactive to any stimulus, they send more warning signals to the spinal cord and the brain and make patients very sensitive to pain.

My main focus is how these two organs communicate and share information with each other. Understanding it could lead to the development of potential drugs that would help relieve pain in the butt for everyone.

About the Author

Nipaporn Konthapakdee - Getty ScienceMy name is Nipaporn Konthapakdee. I am currently doing PhD in Biomedical Science at the University of Sheffield, United Kingdom. I finished a Master degree in Physiology from Mahidol University, Thailand. I am interested in sensory process and physiology of the urinary bladder. My research is currently focused on cross-talk between the bowel and the bladder. After finishing the degree, I will go back to Thailand, do research, and expand knowledge in bladder physiology. I hope my research help people who suffer from bladder diseases.

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