Thursday, October 6, 2016

Pelvic PT Distance Journal Club October 5, 2016

Discussion about ICS CPP terms and mucosal sensitivity versus PFM pain in vulvodynia.  Outlines on the blog


Next meeting November 9, 2016

Mucosal versus muscle pain sensitivity in provoked vestibulodynia Witzeman K, Nguyen R, Eanes A, Sawsan S, Zolnoun, D. Journal of Pain Research 2015:8 549-555

Elizabeth Lewis, PT, OCS, WCS, 10/5/16

Pelvic PT distance journal club

Aim: To understand and compare the relative contribution of mucosal versus muscle pain sensitivity with intercourse as reported from women with  provoked vestibulodynia (PVD).


 Estimated that 8.3%-16% of women experience vulvovaginal discomfort in their lifetime and for many, it’s provoked on contact, commonly referred to as  provoked vestibulodynia (PVD).

Little is known about the etiologies: PFM dysfunction and mucosal components, Or how abnormalities in muscle form or function may impact pain during intercourse. 

And, more information is needed on the relationship of mucosal sensitivity to PFM contracture/hypertonicity and potential pain and vice versa.

A Standard terminology in chronic pelvic pain syndromes: a report from the chronic pelvic pain working group of the international continence society. Doggweiler R, et al. Neurourol and Urodynam 2016 DOI 10.1002/nau.23072.

Pelvic PT Distance Journal Club Oct 5, 2016

Beth Shelly

The following text in black is the exact text in the document.  Red comments added for discussion.  This is only a portion of the entire document. The recording starts with a discussion of the taxonomy at the beginning of the document and the question of what nociceptive, inflammatory and neuropathic types of pain are only listed under visceral pain and not also listed under somatic pain.  The group also discussed the confusion of the terms "centrally generated pain", "hypersensitivity", and "central sensitization". 

Friday, September 16, 2016

September Pelvic PT Distance Journal Club

This month we discussed three articles about bowel dysfunction.   One on diet in IBS and two on hands on treatments in patient with IBS and constipation. 

 Meeting recording

 Next month's meeting is October 5th.

The Science, Evidence, and Practice of Dietary Interventions in Irritable Bowel Syndrome. Brian Lacey Clinical Gastroenterology and Hepatology 2015;13:1899-1906

Pelvic PT Distance Journal Club
September 7, 2016
Jane O’Brien Franczak, PT, MSPT

Summary: This article is a review of pathophysiologic mechanisms that may explain IBS food related symptoms (sx) and evaluates clinical trials of specialized diets used to treat IBS sx.

Premise: Food can cause GI distress due to stimulation of mechanoreceptors and chemoreceptors (ie capsaicin) or alterations in GI transit, intestinal osmolarity and secretion. IBS patients report more food related issues than healthy controls

What causes food symptoms? :

Food Allergies

1. IgE mediated = Rapid onset, ie nuts, wheat, shellfish, strawberries.

Sx of nausea, dysphagia, abdominal pain, vomiting, diarrhea (urticaria)

2. Non IgE -mediated : cell mediated response (T helper 2 cells), delayed onset, IgG antibodies are more prevalent with IBS pts. Sx= GI only.

Food Intolerances

Non- immunologic events, (non-celiac gluten sensitivity, presence of chemicals in foods, histamine, enzyme defects, short chain carbohydrates.)

70% of IBS patients report symptoms representative of food intolerances.