Interstitial cystitis (IC) is a long-term inflammation of the bladder wall, also called painful bladder syndrome. Its symptoms are very similar to a urinary tract infection, such as urinary urgency and/or pelvic pain, but lack an identifiable cause such as bacterial infection. In the past, IC was believed to be a relatively uncommon problem, but now it is thought to affect up to 12 percent of women. Recent data have transformed both the definition of IC and the understanding of its prevalence.
The cause of IC is unknown, but many feel that it may be the result of a breakdown in the normal protective lining of the bladder. When this surface lining is damaged, urinary chemicals can leak into the surrounding tissues causing pain, inflammation and urinary frequency. IC is frequently misdiagnosed as a urinary tract infection. For this reason, there is on average a four-year delay between the time the first symptoms occur and the diagnosis is made.
The condition does generally occur between the ages of 30 and 40, although it has been reported in younger people. Also, women are 10 times more likely to have IC than men.
IC symptoms vary not only from patient to patient but also from one day to the next in a single individual. Some common symptoms include:
- Pain during intercourse
- Pelvic pain, which worsens with bladder filling or certain foods
- Urinary discomfort
- Urinary frequency (up to 60 times a day in severe cases)
- Urinary urgency
The diagnosis of IC is based on the presence of the characteristic pattern of symptoms of urgency, frequency, and/or pelvic pain in any combination. The diagnosis is made by ruling out other causes. Tests include:
- Urinalysis: An examination of the composition of the patient’s urine.
- Urodynamics: A special technique that measures pressure in the bladder and urine flow.
- Urine cytology: A test to determine abnormal cells in the urine.
- Cystoscopy: A thin tube with a tiny camera is inserted into the urethra to view any abnormalities in the urethra or bladder.
- Potassium sensitivity testing: Potassium chloride is injected into the bladder to measure levels of discomfort that might occur.
The key principle in treating IC is to use multiple therapies to control whatever is causing the symptoms. Patients with mild IC may not need much therapy and sometimes diet modification can help. Those with a severe condition may require more therapies to control their symptoms. Therapies include:
- Medication: Painkillers, tricyclic antidepressants and antihistamines can reduce pain and urination frequency. The oral medication pentosan polysulfate is believed to provide a protective coating to the bladder, allowing it to heal.
- Bladder hydrodistention: In this procedure the physician overfills the bladder while the patient is under general anesthesia.
- Bladder training: The patient uses relaxation techniques to train the bladder to release only at specific times.
- Instilled medications: With this treatment, medication is placed directly into the bladder. Medicines that are given this way include heparinoid compounds (heparin) and DMSO (dimethyl sulfoxide), which relieves pain and inflammation.
- Physical therapy and biofeedback (may help relieve pelvic floor muscle spasms).
For more information on Interstitial Cystitis, visit WebMD's Incontinence & Overactive Bladder Health Center.
Following a healthy diet is important to avoiding future episodes of interstitial cystitis. Click here for a healthy diet suggestion.
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