Below the belt: approach to chronic pelvic pain.

Risa Bordman, Bethany Jackson
Canadian family physician Medecin de famille canadien · 2006 · vol. 52(12) , pp. 1556–62 · PMID:17279236 · W2105865298
article OA: green CC0 ⤵ 19 in-corpus citations
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Abstract

OBJECTIVE: To present a practical approach to the symptom complex called chronic pelvic pain (CPP). Chronic pelvic pain is defined as nonmenstrual pain lasting 6 months or more that is severe enough to cause functional disability or require medical or surgical treatment. SOURCES OF INFORMATION: MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews were searched from January 1996 to December 2004. MAIN MESSAGE: While the source of pain in CPP can be gynecologic, urologic, gastrointestinal, musculoskeletal, or psychoneurologic, 4 conditions account for most CPP: endometriosis, adhesions, interstitial cystitis, and irritable bowel syndrome. More than one source of pain can be found in the same patient. Management involves treating the underlying condition, the pain itself, or both. Nonnarcotic analgesics are first-line therapy for pain relief; hormonal therapies are beneficial if the pain has a cyclical component. A multidisciplinary approach addressing environmental factors and incorporating medical management with physiotherapy, psychotherapy, and dietary modifications works best. CONCLUSION: Although caring for patients with CPP can be challenging and frustrating, family physicians are in an ideal position to manage and coordinate their care.

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Condition tags

mesh:D004715mesh:D017699endometriosischronic_pelvic_paininterstitial_cystitisirritable_bowel_syndrome

MeSH descriptors

Pelvic Pain Pelvic Pain Abdominal Pain Abdominal Pain Adult Chronic Disease Cystitis, Interstitial Cystitis, Interstitial Cystitis, Interstitial Cystitis, Interstitial Endometriosis Endometriosis Endometriosis Endometriosis Female Humans Irritable Bowel Syndrome Irritable Bowel Syndrome Irritable Bowel Syndrome Irritable Bowel Syndrome

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