{"id":1549,"date":"2013-11-17T12:17:47","date_gmt":"2013-11-17T17:17:47","guid":{"rendered":"https:\/\/pelvicguru.com\/?p=1549"},"modified":"2022-10-17T07:56:28","modified_gmt":"2022-10-17T11:56:28","slug":"bladder-pain-and-bowel-issues-oy-ipps-conference-highlight-series-part-1","status":"publish","type":"post","link":"https:\/\/thebetashow.com\/pelvicglobal_new\/bladder-pain-and-bowel-issues-oy-ipps-conference-highlight-series-part-1\/","title":{"rendered":"Bladder Pain and Bowel Issues &#8211; Oy! IPPS Conference Highlights"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"1549\" class=\"elementor elementor-1549\" data-elementor-post-type=\"post\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-19116a79 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"19116a79\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-314c4bc0\" data-id=\"314c4bc0\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-743469df elementor-widget elementor-widget-text-editor\" data-id=\"743469df\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h1 style=\"text-align: center;\">Bladder Pain and Bowel Issues &#8211; Oy!<\/h1>\r\n<h3>Highlights on these topics from the International Pelvic Pain Society Conference in Orlando, FL, October 17-20, 2013.<\/h3>\r\n<h5><em>The 2013 International Pelvic Pain Society (IPPS) Conference was highly anticipated and with great reason! We were impressed by the excellent clinical information for first-time and return attendees to the conference. It is exciting to see how far we have come in pelvic pain diagnosis and treatment and the direction we are heading in applying current research to clinical practice. A broad variety of diagnoses and treatment strategies were presented, and it\u2019s hard to choose just a few to showcase. \u00a0This is the latest and greatest info! The Twitter hashtag was #IPPS13<strong>\u00a0<\/strong><\/em><\/h5>\r\n<img decoding=\"async\" class=\"aligncenter wp-image-1611 size-full\" src=\"https:\/\/pelvicguru.com\/wp-content\/uploads\/2013\/11\/screen-shot-2013-11-17-at-6-58-42-am.png\" alt=\"Screen Shot 2013-11-17 at 6.58.42 AM\" width=\"477\" height=\"88\" srcset=\"https:\/\/thebetashow.com\/pelvicglobal_new\/wp-content\/uploads\/2013\/11\/screen-shot-2013-11-17-at-6-58-42-am.png 477w, https:\/\/thebetashow.com\/pelvicglobal_new\/wp-content\/uploads\/2013\/11\/screen-shot-2013-11-17-at-6-58-42-am-300x55.png 300w, https:\/\/thebetashow.com\/pelvicglobal_new\/wp-content\/uploads\/2013\/11\/screen-shot-2013-11-17-at-6-58-42-am-200x37.png 200w, https:\/\/thebetashow.com\/pelvicglobal_new\/wp-content\/uploads\/2013\/11\/screen-shot-2013-11-17-at-6-58-42-am-400x74.png 400w\" sizes=\"(max-width: 477px) 100vw, 477px\" \/>\r\n<h5><em><strong><span style=\"line-height: 1.5;\">We chose to share highlights over a series of posts, as to not overwhelm you with too much incredible information at once! You will see\u00a0<\/span>that<span style=\"line-height: 1.5;\">\u00a0this info is cutting-edge.\u00a0<\/span><\/strong><\/em><\/h5>\r\n<h2><span style=\"line-height: 1.5;\">Bladder pain and bowel issues &#8211; Most people don&#8217;t enjoy discussing this topic,<\/span><span style=\"line-height: 1.5;\">\u00a0but let&#8217;s face it: when you have bowel and\/or bladder problems (and they tend to co-exist quite a bit), they will have a huge effect on daily function AND your mood. Right!?\u00a0<\/span><\/h2>\r\n[fusion_builder_container hundred_percent=&#8221;yes&#8221; overflow=&#8221;visible&#8221;][fusion_builder_row][fusion_builder_column type=&#8221;1_1&#8243; background_position=&#8221;left top&#8221; background_color=&#8221;&#8221; border_size=&#8221;&#8221; border_color=&#8221;&#8221; border_style=&#8221;solid&#8221; spacing=&#8221;yes&#8221; background_image=&#8221;&#8221; background_repeat=&#8221;no-repeat&#8221; padding=&#8221;&#8221; margin_top=&#8221;0px&#8221; margin_bottom=&#8221;0px&#8221; class=&#8221;&#8221; id=&#8221;&#8221; animation_type=&#8221;&#8221; animation_speed=&#8221;0.3&#8243; animation_direction=&#8221;left&#8221; hide_on_mobile=&#8221;no&#8221; center_content=&#8221;no&#8221; min_height=&#8221;none&#8221;]\r\n<h2>Urinary Highlights:<\/h2>\r\n<h3><strong>Diagnosis and Treatment of Urological Causes of CPP &#8211; Amanda Yunker, DO, MSCR (Vanderbilt Medical Center, Dept. of OB\/GYN)<\/strong><\/h3>\r\nGreat review of female-associated pain: UTI, Urethritis\/ Urtheral Diverticulum, Bladder-related &#8211; stones, tumors, bladder pain\/IC , post-mesh pain.\r\n<ul>\r\n \t<li>One diagnosis that can be missed &#8211; <a title=\"Urethral Diverticulum emedicine\" href=\"http:\/\/emedicine.medscape.com\/article\/269493-overview\" target=\"_blank\" rel=\"noopener noreferrer\">Urethral Diverticulum<\/a> &#8211; localized outpouching of urethral mucosa. The best way to detect this is with an <a title=\"NIH article on MRI for UD\" href=\"http:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2441842\/\" target=\"_blank\" rel=\"noopener noreferrer\">MRI <\/a>\u00a0(best test) specifically looking at this area (<em>sometimes can be seen visually and correlated with symptoms but not always<\/em>). Some of the symptoms and signs a patient may have are recurrent\/chronic UTIs, painful intercourse, stone formations, urinary incontinence; and sometimes this can lead to urethral malignancy.<\/li>\r\n \t<li><a title=\"UTI\" href=\"http:\/\/www.mayoclinic.com\/health\/urinary-tract-infection\/DS00286\" target=\"_blank\" rel=\"noopener noreferrer\">Urinary Tract Infection<\/a>:\u00a0Some antibiotics have an anti-inflammatory effect. This explains what happens with those patients that are assumed to have a bladder infection, the pain is resolved while on the antibiotic, the pain returns as soon as the antibiotic is done, and the urine is negative for any infection.<\/li>\r\n \t<li>Bladder Pain Syndrom (PBS) \/ IC<span style=\"line-height: 1.5;\"> : Prevalence is 4-5%. Some symptoms &#8211; painful urination, frequency, urgency, incomplete emptying, nighttime voiding, and pelvic pain.<\/span><\/li>\r\n \t<li>There is a 3-13% risk of dyspareunia after vaginal mesh placement for pelvic organ prolapse, as well as risk for <a title=\"chronic pelvic pain\" href=\"http:\/\/www.uptodate.com\/contents\/chronic-pelvic-pain-in-women-beyond-the-basics\" target=\"_blank\" rel=\"noopener noreferrer\">Chronic Pelvic Pain (CPP)<\/a>. Potential risk factors include too much tension on the graft and proximity to the nerve (also discussed by Dr. Hibner). Early detection is critical for ease of removal if suspected to be the source of pain.<\/li>\r\n \t<li>CPP\/<a title=\"prostatitis\" href=\"http:\/\/www.mayoclinic.com\/health\/prostatitis\/DS00341\" target=\"_blank\" rel=\"noopener noreferrer\"> Prostatitis<\/a> prevalence is 2-10% of adult men with a peak in 40\u2019s<\/li>\r\n \t<li>Ever heard of\u00a0<a title=\"Retroperitoneal Fibrosis\" href=\"http:\/\/www.nlm.nih.gov\/medlineplus\/ency\/article\/000463.htm\" target=\"_blank\" rel=\"noopener noreferrer\">Retroperitoneal Fibrosis<\/a>\u00a0(<em>you aren&#8217;t the only one<\/em>). This is rare, but may be a cause of pelvic pain in males more than females (2:1).<\/li>\r\n \t<li><span style=\"line-height: 1.5;\">Prevalence of post-vasectomy pain is 1-15%-so much for a simple procedure and an ice pack. Pain is suspected to be due to backflow of sperm and testicular fluid into the epididymis, causing swelling and chronic congestive epididymitis and is asymptomatic in most men.\u00a0 Pain may be worse during ejaculation and may also be related to nerve entrapment or adverse tension.\u00a0 Treatment may range from NSAIDS to nerve blocks to surgery.<\/span><\/li>\r\n<\/ul>\r\n<blockquote><strong>&#8220;A warm bath is used to treat EVERYTHING. We should tell Congress to take a warm bath&#8221; &#8211; Dr. Yunker<\/strong><\/blockquote>\r\n<h3><strong>Contemporary Management of Pelvic Pain &#8211; (focus on the bladder), Robert Evans, MD, FACS (Associate Professor of Urology, Wake Forest School of Medicine)<\/strong><\/h3>\r\n<blockquote><strong>&#8220;IC may be a common and major cause of chronic pelvic pain in women&#8221;<\/strong><\/blockquote>\r\n<span style=\"line-height: 1.5;\">Dr. Bob Evans <strong>rocked a mean bowtie<\/strong> and shared some of the current treatments available for patients with Interstitial Cystitis (IC)\/ BPS.\u00a0<\/span>\r\n\r\n[\/fusion_builder_column][fusion_builder_column type=&#8221;1_1&#8243; background_position=&#8221;left top&#8221; background_color=&#8221;&#8221; border_size=&#8221;&#8221; border_color=&#8221;&#8221; border_style=&#8221;solid&#8221; spacing=&#8221;yes&#8221; background_image=&#8221;&#8221; background_repeat=&#8221;no-repeat&#8221; padding=&#8221;&#8221; margin_top=&#8221;0px&#8221; margin_bottom=&#8221;0px&#8221; class=&#8221;&#8221; id=&#8221;&#8221; animation_type=&#8221;&#8221; animation_speed=&#8221;0.3&#8243; animation_direction=&#8221;left&#8221; hide_on_mobile=&#8221;no&#8221; center_content=&#8221;no&#8221; min_height=&#8221;none&#8221;]\r\n<ul>\r\n \t<li>79% of women with persistent pelvic pain were diagnosed with bladder dysfunction consistent with IC\/ BPS<\/li>\r\n \t<li>Prevalence of CPPS is 9%- similar to heart disease and diabetes and 90-95% of CPPS patients have a negative urine culture.<\/li>\r\n \t<li>Among IC\/ BPS patients, the most common previous diagnosis was UTI<\/li>\r\n \t<li>IC\/ BPS and <a title=\"vulvodynia\" href=\"http:\/\/www.mayoclinic.com\/health\/vulvodynia\/DS00159\" target=\"_blank\" rel=\"noopener noreferrer\">vulvodynia<\/a> may have overlapping symptoms due to similar etiologies<\/li>\r\n \t<li>Treatments: Include Elmiron or less expensive OTC herbal options like Cysta Q and Prosta Q if there are financial limitations.\r\n<ul>\r\n \t<li>Medications like Singulair and antihistamines like Hydroxyzine, Cetirizine, and Cimetidine may help IC\/ BPS symptoms. Those containing pseudoephedrine (labeled \u2013D) may cause retention and are not recommended. \u00a0(<em>Isn&#8217;t this interesting that we are now seeing Singulair and Cymbalta used for bladder or pelvic pain!?)<\/em><\/li>\r\n \t<li>Vaginal valium suppositories may also be helpful but more expensive.\u00a0 An alternative is placing a valium tablet vaginally. (<em>as an aside- this is a bit controversial because some medical experts state that this does not work vaginally &#8211; <\/em>)<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<blockquote>&#8220;Beware- this may result in a \u2018Smurf vagina\u2019 due to the blue coating on the tablet. It\u2019s harmless but good to know&#8221; Dr. Evans<\/blockquote>\r\n<ul>\r\n \t<li>Learning self-instillations for home pain management gives patients some control over pain management for general activities as well as intimacy.<\/li>\r\n \t<li>Dr. Evans advocates for conservative measures, including physical therapy. Here was the quote of the weekend.\u00a0We know it\u2019s not all about manual therapy, but it got everyone\u2019s attention!<\/li>\r\n<\/ul>\r\n<blockquote>&#8220;If your therapist doesn\u2019t have a finger in your vagina by the second visit, find another therapist.&#8221;<\/blockquote>\r\n<h3>Mechanisms Underlying Urogenital Pain Syndromes in Women, Ursula Wesselmann, MD, PhD (Professor of Anesthesiology and Neurology, University of Alabama School of Medicine)<\/h3>\r\nDr. Wesselmann rocks! That is all. Actually, we will post more about her research in the future. Here are just a few highlights:\r\n<ul>\r\n \t<li>We know that there is a huge overlap between gynecological, urological, and gastrointestinal pain in the same patient (IC, Vulvodynia, Dysmenorrhea, IBS, Endometriosis).<\/li>\r\n \t<li><strong>We must keep a global picture in mind [\/fusion_builder_column][fusion_builder_column type=&#8221;1_1&#8243; background_position=&#8221;left top&#8221; background_color=&#8221;&#8221; border_size=&#8221;&#8221; border_color=&#8221;&#8221; border_style=&#8221;solid&#8221; spacing=&#8221;yes&#8221; background_image=&#8221;&#8221; background_repeat=&#8221;no-repeat&#8221; padding=&#8221;&#8221; margin_top=&#8221;0px&#8221; margin_bottom=&#8221;0px&#8221; class=&#8221;&#8221; id=&#8221;&#8221; animation_type=&#8221;&#8221; animation_speed=&#8221;0.3&#8243; animation_direction=&#8221;left&#8221; hide_on_mobile=&#8221;no&#8221; center_content=&#8221;no&#8221; min_height=&#8221;none&#8221;][and consider the cross-talk between visceral organs, the pelvic floor muscles, and the neural system] &#8211; rather than chasing a single symptom!\u00a0<\/strong><\/li>\r\n \t<li>There are differences between different urogenital pain syndromes, indicating that different pathophysiological mechanisms might be involved.<\/li>\r\n<\/ul>\r\n<blockquote>&#8220;There is a more than 4-fold higher risk of panic disorder\u00a0(PD) in patients with IC compared to controls. First degree\u00a0relatives of patients with IC are significantly more likely to\u00a0have PD and urologic problems, suggesting that there might\u00a0be a familial, possibly pleiotropic syndrome that may\u00a0include IC and PD.&#8221;<\/blockquote>\r\n<ul>\r\n \t<li>She highly recommends CONSERVATIVE management first or only (not immediate surgery); and supports an individualized approach that may include: pelvic physical therapy, psychological therapy, pharmacology approach (that does not include long-term antibiotics, BCG or RTX instillations, acupuncture) and more &#8211; refer to slide presentation.<\/li>\r\n \t<li><em>If you have a chance to read her research, it&#8217;s quite fascinating!\u00a0<\/em><\/li>\r\n<\/ul>\r\n<h2>Bowel Highlights:<\/h2>\r\n<b style=\"font-size: 14px; line-height: 1.5;\">Functional Bowel Disorders:<\/b><span style=\"font-size: 14px; line-height: 1.5;\"> Patients often presents with a history of irritable bowel syndrome (IBS) or constipation even when bowel symptoms are not their primary complaint. We are gaining a better understanding and classification of functional bowel disorders in order to treat these patients more effectively and were fortunate enough to have 2 separate presentations on IBS and constipation at this year\u2019s conference.<\/span>\r\n<h3>Irritable Bowel Syndrome &#8211; Maryam Kashi, M.D. (Central Florida Hepatology and Gastroenterology, Orlando, FL) &#8211;<\/h3>\r\n<b style=\"line-height: 1.5;\"><\/b><span style=\"line-height: 1.5;\">Dr. Maryam Kashi broke down the essential elements of classification, diagnosis and treatment of IBS.\u00a0 It is the most commonly diagnosed GI condition and affects over 13 million people, females more than males at a ratio of 2:1. \u00a0<\/span>\r\n\r\n<span style=\"line-height: 1.5;\">Many of our patients may report IBS in their medical history, but it is important to clarify that this is an actual diagnosis rather than a self-diagnosis. \u00a0\u00a0If their symptoms include weight loss, nighttime symptoms, worsening symptoms, rectal bleeding or abnormal blood work, it is not IBS and should be further evaluated.<\/span>\r\n\r\n<a style=\"line-height: 1.5;\" href=\"http:\/\/www.romecriteria.org\/assets\/pdf\/19_RomeIII_apA_885-898.pdf\">Rome III Criteria<\/a><span style=\"line-height: 1.5;\"> definition of IBS:<\/span>\r\n\r\nRecurrent abdominal pain or discomfort at least 3 days\/ month in the last 3 months with at least 2 of the following:\r\n<ol>\r\n \t<li>Relief after bowel movements<\/li>\r\n \t<li>Onset associated with change of <i>frequency <\/i>of stool, \u00a0or<\/li>\r\n \t<li>Onset associated with change in <i>form <\/i>of stool.<\/li>\r\n<\/ol>\r\n<ul>\r\n \t<li>May have subcategories of diarrhea, constipation or mixed.\u00a0 Be aware that some patients experiencing diarrhea are actually constipated and are experiencing overflow around the blockage.<\/li>\r\n \t<li>Dietary changes are essential for determining triggers and managing IBS symptoms (same goes for constipation).\u00a0 It is not enough for patients to \u2018try to eat better for a couple of days.\u2019 Dr. Kashi recommends:\r\n<ul>\r\n \t<li><b>Two (<em>yes 2!)<\/em> weeks<\/b> of dairy avoidance (no cheating).<\/li>\r\n \t<li>Elimination of gas-producing foods- this includes usual suspects like beans, onions, and celery but also more surprising foods like bananas, raisins, carrots, apricots, prunes, wheat germ, pretzels, and bagels.\u00a0 Yes- pretzels and bagels are on this list.\u00a0 There goes my college diet.<\/li>\r\n \t<li>Consider gluten sensitivity if celiac tests are negative.<\/li>\r\n \t<li>And if you are still reading this list with intention to try these changes, there is also a <strong>FODMAPS<\/strong> diet\u00a0to assist those with carbohydrate malabsorption. <em><strong>This is EXCELLENT information because we see patients trying to do all sorts of diets for IBS or going completely gluten-free, when they may actually respond to this specific type of plan!\u00a0<\/strong><\/em><\/li>\r\n \t<li>Fiber (we will talk more about this when we review constipation)<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h3><strong>Evaluation of the Patient with Constipation, Sergio Larach, M.D. \u00a0(Center for Colon and Rectal Surgery, Orlando, FL)<\/strong><\/h3>\r\n<div id=\"attachment_1628\" style=\"width: 402px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/pelvicguru.files.wordpress.com\/2013\/11\/photo-4.jpg\"><img fetchpriority=\"high\" decoding=\"async\" aria-describedby=\"caption-attachment-1628\" class=\" wp-image-1628 \" src=\"http:\/\/pelvicguru.files.wordpress.com\/2013\/11\/photo-4.jpg\" alt=\"Dr. Larach at the head of the table with Drs. Feranec, Colimon, and Hoover (and 2 fellows). Colorectal and GYN surgeons.\" width=\"392\" height=\"294\" \/><\/a><p id=\"caption-attachment-1628\" class=\"wp-caption-text\">Dr. Larach at the head of the table with Drs. Feranec, Colimon, and Hoover (and 2 fellows). Colorectal and GYN surgeons.<\/p><\/div>\r\n\r\nA few <a title=\"Constipation\" href=\"http:\/\/www.webmd.com\/digestive-disorders\/digestive-diseases-constipation\" target=\"_blank\" rel=\"noopener noreferrer\">constipation<\/a> facts:\r\n<ul>\r\n \t<li>Most common digestive complaint<\/li>\r\n \t<li>Affects 4 million people with female: male ratio of 3:1.<\/li>\r\n \t<li>Incidence increases greatly after age 65.<\/li>\r\n \t<li>The evaluation includes assessment of intestinal transit, evaluation of pelvic floor via manometry, invasive or non-invasive EMG, Sitz marker testing, manual exam, and <a title=\"defecography\" href=\"http:\/\/www.ddc.musc.edu\/public\/tests\/diagnosticRadiology\/defecography.cfm\" target=\"_blank\" rel=\"noopener noreferrer\">defecography<\/a>.\u00a0 You may also see a patient who has had a pelvic floor dynamic MRI, but it\u2019s not as likely- it\u2019s not done as often as defecography (although the pictures are pretty amazing!).<\/li>\r\n \t<li><em>CHECK out this video of a Dynamic Pelvic Floor MRI of a <a title=\"rectocele\" href=\"http:\/\/www.mayoclinic.com\/health\/rectocele\/DS00704\" target=\"_blank\" rel=\"noopener noreferrer\">rectocele<\/a>!<\/em><span style=\"line-height: 1.5;\">[youtube=http:\/\/www.youtube.com\/watch?v=RvFr_KhSnFU&amp;w=420&amp;h=315]<\/span><\/li>\r\n \t<li><span style=\"line-height: 1.5;\">You may be more familiar with a diagnosis of rectocele and pelvic floor dyssynergia, but what about internal rectal prolapse, known as intussusception? Symptoms that may be reported are the sensation of incomplete emptying and the need standing and walk between evacuation attempts before emptying completely.<\/span><\/li>\r\n \t<li>Non-surgical treatment includes (<em>you guessed it<\/em>) dietary changes- 30 grams of fiber\/ day, plenty of liquids and exercise are all recommended aspects of care. Different laxatives may also be indicated to improve frequency, and biofeedback is indicated for short term response and may need to be repeated annually to continue positive effects.<\/li>\r\n \t<li><em>Just remember: There can be one or several factors contributing to constipation. It likely requires a multi-modal approach. Is it just a rectocele issue? Is it also a tightness\/spasm of the pelvic floor leading to difficulty emptying? Is it a dietary issue? Much to consider.<\/em><\/li>\r\n \t<li>Surgical interventions are dictated by the differential diagnosis and severity of symptoms.<\/li>\r\n \t<li><span style=\"line-height: 1.5;\">Future direction is looking at sacral plexus stimulation for patients with true colonic inertia. In this patient group, very few dietary changes are effective.<\/span><\/li>\r\n<\/ul>\r\n*<em>Here&#8217;s a bonus &#8211; <a title=\"constipation eval\" href=\"http:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2780146\/\" target=\"_blank\" rel=\"noopener noreferrer\">nice article describing medical evaluation of constipation<\/a>.<\/em>\r\n\r\n<em>* We are always open to receiving highlights and blog posts from other pelvic health conferences such as AUGS, Section on Women&#8217;s Health, SSSS, etc. If you&#8217;d like to share highlights in a blog post, please send an email to pelvicguru1@gmail.com<\/em>\r\n\r\n* Text in italics was information added to enhance the presenter&#8217;s content (but not directly expressed). Furthermore, the links are added for educational purposes, but not directly recommended by the presenters.\r\n\r\n<address><a href=\"http:\/\/pelvicguru.files.wordpress.com\/2013\/11\/dsc_1031-2.jpg\"><img decoding=\"async\" class=\" wp-image-1613 alignleft\" src=\"http:\/\/pelvicguru.files.wordpress.com\/2013\/11\/dsc_1031-2.jpg\" alt=\"Sarah Talley\" width=\"107\" height=\"161\" srcset=\"https:\/\/thebetashow.com\/pelvicglobal_new\/wp-content\/uploads\/2013\/11\/dsc_1031-2.jpg 298w, https:\/\/thebetashow.com\/pelvicglobal_new\/wp-content\/uploads\/2013\/11\/dsc_1031-2-200x301.jpg 200w\" sizes=\"(max-width: 107px) 100vw, 107px\" \/><\/a><strong>Primary Contributing Author,\u00a0<\/strong><span style=\"line-height: 1.5;\"><strong>Sarah Pinneo Talley, PT, DPT,<\/strong> has over 17 years of experience as a physical therapist and has devoted most of her practice to treating men and women with pelvic dysfunction.\u00a0 Sarah is co-owner of <\/span><a style=\"line-height: 1.5;\" title=\"Carolina Pelvic Health\" href=\"http:\/\/www.carolinapelvichealth.com\" target=\"_blank\" rel=\"noopener noreferrer\">Carolina Pelvic Health Center<\/a><span style=\"line-height: 1.5;\">, Inc. in Raleigh, North Carolina and has extensive training in the treatment of a range of pelvic symptoms, including bowel and bladder dysfunction, orthopedic back, hip and tailbone injuries, and complex pelvic pain syndromes.\u00a0 Sarah\u2019s passion is to help her patients surpass their expectations by empowering them to learn the tools necessary to build a better life through improved movement and decreased pain.\u00a0<\/span><\/address><address>Sarah earned her combined BS\/ MS of Physical Therapy from D\u2019Youville College and her transitional Doctorate of Physical Therapy from Northeastern University.\u00a0 She is a member of the Women\u2019s Health and Private Practice Sections of the APTA and the International Pelvic Pain Society. \u00a0<\/address><address>Sarah is currently a lab assistant at Elon University and has been a guest speaker at University of North Carolina at Chapel Hill, the 2010 Advances in Gynecology and Pelvic Pain Symposium and the 2011 International Pelvic Pain Society annual meeting.<\/address><address>\r\n\r\n<div id=\"attachment_1630\" style=\"width: 175px\" class=\"wp-caption alignleft\"><a href=\"http:\/\/pelvicguru.files.wordpress.com\/2013\/11\/loretta-and-tracy.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-1630\" class=\" wp-image-1630 \" src=\"http:\/\/pelvicguru.files.wordpress.com\/2013\/11\/loretta-and-tracy.jpg\" alt=\"Loretta and Tracy at IPPS\" width=\"165\" height=\"292\" \/><\/a><p id=\"caption-attachment-1630\" class=\"wp-caption-text\">Loretta and Tracy at IPPS<\/p><\/div>\r\n\r\n<\/address><address><strong>Editor-in-Chief (not my day job) and Contributing Author:\u00a0\u00a0<a title=\"About Tracy Sher\" href=\"http:\/\/www.sherpelvic.com\/about.html\" target=\"_blank\" rel=\"noopener noreferrer\">Tracy Sher, MPT, CSCS<\/a><\/strong>\u00a0\u00a0Passionate about treating pelvic pain and all pelvic floor disorders &#8211; bowel, bladder, sexual function. Secretly hoping to be a circus clown some day. \u00a0<a title=\"Pelvic Guru Facebook\" href=\"https:\/\/www.facebook.com\/pelvicguru\" target=\"_blank\" rel=\"noopener noreferrer\">Check out Pelvic Guru on Facebook <\/a>or <a title=\"Pelvic Guru Facebook\" href=\"https:\/\/twitter.com\/PelvicGuru1\" target=\"_blank\" rel=\"noopener noreferrer\">Twitter <\/a>@pelvicguru1<\/address><address><span style=\"line-height: 1.5;\">\u00a0<\/span><\/address><address>\u00a0<strong>Another fabulous contributor:\u00a0Loretta Robertson, PT,MS\u00a0\u00a0<\/strong>An awesome person and pelvic PT. More from Loretta in future posts.<\/address><address><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-1629\" title=\"Loretta, Sarah, and Victoria at IPPS\" src=\"http:\/\/pelvicguru.files.wordpress.com\/2013\/11\/photo-5.jpg\" alt=\"Loretta, Sarah, and Victoria\" width=\"263\" height=\"198\" \/><\/address>[\/fusion_builder_column][\/fusion_builder_row][\/fusion_builder_container]\r\n\r\n&nbsp;\r\n\r\n&nbsp;\r\n\r\n&nbsp;\r\n\r\n&nbsp;\r\n\r\nIf you are interested in more pelvic health education, please see our online platform,\u00a0<a href=\"http:\/\/www.pelvicguruacademy.com\/\">Pelvic Guru Academy<\/a> for some amazing courses, including <a href=\"https:\/\/www.pelvicguruacademy.com\/course\/bowel-clinton-recorded\">The Ultimate Bowel Course<\/a> with Susan Clinton.\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Bladder Pain and Bowel Issues \u2013 Oy! Highlights on these topics from the International Pelvic Pain Society Conference in Orlando, FL, October 17-20, 2013. The 2013 International Pelvic Pain Society\u2026<\/p>\n","protected":false},"author":3,"featured_media":68193,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2,3,5,6,8,9,18,19,25,27],"tags":[28,65,74,262,266,277,279,379,388,1489,1476,391,855,410,425,1384,506,563],"class_list":["post-1549","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-all","category-bladder-painic","category-colorectal-2","category-endometriosis-2","category-gastroenterology-gi","category-gynecology-2","category-pelvic-pain-2","category-pelvic-physical-therapy-2","category-sexual-pain","category-urology-2","tag-ipps13","tag-bladder","tag-bowel","tag-ibs","tag-ic","tag-interstitial-cystitis","tag-ipps","tag-pelvic-floor","tag-pelvic-floor-therapy","tag-pelvic-global","tag-pelvic-global-academy","tag-pelvic-guru","tag-pelvic-guru-academy","tag-pelvic-pain","tag-pelvic-physical-therapy","tag-pelvic-physiotherapy","tag-sarah-talley","tag-tracy-sher"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Bladder Pain and Bowel Issues - Oy! 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