Nickel, J Curtis, Tripp, Dean A, Pontari, Michel et al. · The Journal of urology · 2010 · DOI
This study looked at how often bladder pain syndrome occurs alongside other conditions like irritable bowel syndrome, fibromyalgia, and ME/CFS. Researchers found that people with bladder pain syndrome were much more likely to have these other conditions compared to healthy controls. Importantly, people who had multiple overlapping conditions experienced worse pain, sleep problems, depression, and lower quality of life than those with just one condition.
This study is highly relevant to ME/CFS patients because it demonstrates that ME/CFS frequently co-occurs with other pain and functional disorders, and that having multiple overlapping conditions significantly worsens patient outcomes. Understanding these co-occurrence patterns helps explain why many ME/CFS patients experience multi-system symptoms and informs the need for integrated, multi-system approaches to care.
This study does not establish causation or the direction of causality between conditions—it only shows they occur together more frequently. It does not determine whether one condition causes another, whether they share a common underlying mechanism, or whether the progression from localized to systemic symptoms actually occurs over time, since the design is cross-sectional and based on symptom duration recall. The findings are limited to female patients and may not generalize to male patients with these conditions.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Nickel, J Curtis, Tripp, Dean A, Pontari, Michel, Moldwin, Robert, Mayer, Robert, Carr, Lesley K, et al. (2010). Interstitial cystitis/painful bladder syndrome and associated medical conditions with an emphasis on irritable bowel syndrome, fibromyalgia and chronic fatigue syndrome.. The Journal of urology. https://doi.org/10.1016/j.juro.2010.06.005
BibTeX
@article{mecfsatlas-nickel-2010-interstitial-cystitis,
author = {Nickel, J Curtis and Tripp, Dean A and Pontari, Michel and Moldwin, Robert and Mayer, Robert and Carr, Lesley K and Doggweiler, Ragi and Yang, Claire C and Mishra, Nagendra and Nordling, Jorgen},
title = {Interstitial cystitis/painful bladder syndrome and associated medical conditions with an emphasis on irritable bowel syndrome, fibromyalgia and chronic fatigue syndrome.},
journal = {The Journal of urology},
year = {2010},
doi = {10.1016/j.juro.2010.06.005},
note = {PubMed: 20719340},
url = {https://www.mecfsatlas.com/evidence/nickel-2010-interstitial-cystitis},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/nickel-2010-interstitial-cystitis
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