Dietary therapy: a new strategy for management of chronic pelvic pain.
Chronic pelvic pain (CPP) can be identified as a chronic nociceptive, inflammatory and neuropathic pain characterised by spontaneous pain and an exaggerated response to painful and/or innocuous stimuli. This pain condition is extremely debilitating and usually difficult to treat. Currently, the main approaches to treatment include counselling supported by reassuring ultrasound scanning or psychotherapy, attempting to provide reassurance using laparoscopy to exclude serious pelvic pathology, hormonal therapy and neuroablative treatment to interrupt nerve pathways. Dietary supplementation has been suggested as a means to treat chronic medical illnesses that are poorly responsive to prescription drugs or in which therapeutic options are limited, costly or carry a high side-effect profile. A comprehensive search of the PubMed database was performed using the search terms 'chronic pelvic pain', 'oxidative stress', 'antioxidants' and 'dietary therapy'. The systematic review focuses on both randomised and non-randomised controlled trials from 2005 onwards, in which CPP was the end point. Given the complexity and not well-understood aetiology of CPP, its treatment is often unsatisfactory and limited to partial symptom relief. Dietary therapy with antioxidants improves function of the immune system and in fighting free radical damage. Agents with antioxidant activity are able to improve CPP without undesired effects and any important metabolic changes associated with hormonal suppression therapy. In conclusion, dietary therapy with antioxidants could be considered as a new effective strategy in the long term for CPP, and may be better accepted by patients. Further randomised trials with larger series and long-term follow-up to confirm these observations are needed.
Endometriosis Center, Section of Gynecology and Obstetrics, Department of Surgical Sciences, Tor Vergata University Hospital, Rome, Italy.
Francesco
F
Sesti
Endometriosis Center, Section of Gynecology and Obstetrics, Department of Surgical Sciences, Tor Vergata University Hospital, Rome, Italy.
Talia
T
Capozzolo
Endometriosis Center, Section of Gynecology and Obstetrics, Department of Surgical Sciences, Tor Vergata University Hospital, Rome, Italy.
Adalgisa
A
Pietropolli
Endometriosis Center, Section of Gynecology and Obstetrics, Department of Surgical Sciences, Tor Vergata University Hospital, Rome, Italy.
Marco
M
Collalti
Section of Clinical Nutrition, Department of Internal Medicine, Tor Vergata, University Hospital, Rome, Italy.
Maria Rosa
MR
Bollea
Endometriosis Center, Section of Gynecology and Obstetrics, Department of Surgical Sciences, Tor Vergata University Hospital, Rome, Italy.
Emilio
E
Piccione
D000975:Antioxidants / Q000627:therapeutic use*; D002908:Chronic Disease; D006801:Humans; D017699:Pelvic Pain / Q000178:diet therapy*
D000975:Antioxidants