What is interstitial cystitis?
Interstitial cystitis (IC) is a chronic inflammatory condition which leads to bladder pressure or pain. It also produces the following symptoms:
- pain and pressure in pelvic or abdominal region
- frequent urination
- urgency (feeling like you need to urinate, even just after urinating)
- incontinence (accidental leakage of urine)
Discomfort which can range from a mild burning sensation to severe pain. The level of discomfort can be constant or irregular. Some individuals have periods of remission.
According to the Interstitial Cystitis Association, Interstitial cystitis affects more than 12 million people in the United States. Women are at higher risk to develop IC, but children and adult men can also get it affected.
IC is also called as painful bladder syndrome (PBS), bladder pain syndrome (BPS), and chronic pelvic pain (CPP).
Symptoms of interstitial cystitis?
You may experience one or more of the given symptoms:
- chronic or irregular pain in the pelvis
- pressure or discomfort in pelvis
- urinary urgency (feeling that you need to urinate)
- leakage of urine
- frequent urination day and night
- pain during sexual intercourse
Your symptoms may differ from day to day, and you may have sometimes asymptomatic periods. Symptoms may intensity if you get a urinary tract infection.
What causes interstitial cystitis?
The exact cause of IC is not clear, but researchers suggest that several factors may damage the lining of the bladder and thus trigger the disorder. These include:
- injury to the lining of bladder (for example, from surgical procedures)
- over stretching of the bladder, often because of long periods of without bathroom usage
- weakened or dysfunctional pelvic floor muscles
- autoimmune disorders
- reccuring bacterial infections
- hypersensitivity or inflammation of pelvic nerves
- spinal cord trauma
Many individuals having intermittent cystitis also have irritable bowel syndrome (IBS) or fibromyalgia. Some researchers think that IC may be part of a generalized inflammatory disorder that affects multiple organ systems.
Researchers are also looking for the probability that people may inherit a genetic predisposition to IC. Although it’s not common, IC has been reported in blood relatives. Cases have been seen in mother and daughter as well as in two or more sisters.
Research is in progress to find out the cause of IC and to develop more effective treatments.
How is interstitial cystitis diagnosed?
There are no tests available for the confirmed diagnosis of IC, and there are several cases of IC go undiagnosed. Because IC shows many symptoms similar to of the other bladder disorders, your doctor needs first to eliminate these symptoms. These other disorders are the following:
- urinary tract infections
- bladder cancer
- chronic prostatitis (in men)
- chronic pelvic pain syndrome (in men)
- endometriosis (in women)
You’ll be diagnosed with IC when your doctor confirms that your symptoms aren’t because of any of these disorders.
Potential complications of interstitial cystitis
IC can lead to so many complications, which includes:
- decreased bladder capacity due to hardening of the bladder wall
- lower quality of life due to frequent urination and pain
- barriers to relationships and sexual intimacy
- issues with self-regard and social awkwardness
- sleep disruption
- anxiety and depression
How is interstitial cystitis treated?
There is no cure or specific treatment for IC. Most people use a combination of treatments, and you may have to try many ways before you sort out a suitable the therapy that gives the most relief. Following are some treatments for intermittent cystitis:
Your doctor may suggest one or more of the following drugs to help in relieving your symptoms:
- Pentosan polysulfate sodium (Elmiron) has been approved by the Food and Drug Administration as a treatment of IC. Doctors don’t know accurately how pentosan works, but it may help repair tears or defects in the walls of the bladder.
Pregnant women or who want to concieve should not suggested to take Pentosan.
- Nonsteroidal anti-inflammatory drugs(NSAIDs), including ibuprofen,aspirin, and others, are taken for relieving pain and inflammation.
- Tricyclic antidepressants (such as amitriptyline) help relax your bladder and also relieve pain.
- Antihistamines (such as Claritin) lowers urinary urgency and also lowers frequent urination.
Bladder distention is a process that stretches the bladder using water or gas. It can help improve symptoms in some people, probably by increasing the capacity of the bladder and by breaking pain signals transmitted by nerves in the bladder. Improvement can be seen after two to four weeks to see improvement in your symptoms.
Bladder instillation includes filling the bladder with a solution containing dimethyl sulfoxide (Rimso-50), also called as DMSO. The DMSO solution is kept in the bladder for 10 to 15 minutes before it’s emptied. One treatment cycle usually involves up to two treatments in a week for six to eight weeks, and the cycle can be repeated as required.
It’s thought that the DMSO solution may decrease inflammation of the bladder wall. It may also control muscle spasms that leads to pain, urinary urgency and frequent urination.
Electrical nerve stimulation
Transcutaneous electrical nerve stimulation (TENS) delivers mild electrical pulses through the skin to trigger the nerves to the bladder. TENS may help improve symptoms by raising blood flow to the bladder, strengthening pelvic muscles that help control the bladder, or triggering the release of substances that stop pain.
Many individuals with IC found that specific foods and drinks make their symptoms worse. Common foods that may make symptoms of IC more serious are following:
- caffeine containing drinks
- acidic foods such as citrus fruits and juices
Your doctor will help you to know if you are sensitive to any foods or drinks.
Although there is no approved association between smoking and IC, smoking is certainly related to bladder cancer. It’s possible that quitting smoking may help in lowering or relieving your symptoms.
Maintaining an exercise routine may help you control your symptoms. You may have to improve your daily life routine so that you avoid high-impact activity that causes outbursts.Follow some of these workouts:
- tai chi
- low-impact aerobics or Pilates
A physical therapist can help you learn some exercises to strengthen your bladder and pelvic muscles. Consult your doctor about meeting with a physical therapist.
Techniques planned to increase the time between urinating may help ease symptoms. Your doctor can tell about these techniques.
Learn to manage life’s stresses and the stress of having IC.It may help to relieve your symptoms. Meditation and biofeedback may also help.
There are so many surgical options to enlarge the size of the bladder and remove or treat ulcers in the bladder. Surgery is not used frequently and is considered only when symptoms are severe and other treatments have failed to relieving them. Your doctor will discuss these options with you if you a surgery is needed for you.
- Genetics of interstitial cystitis (MaGIC) [Call to participate in clinical trial]. (2010).
- Interstitial cystitis (painful bladder syndrome). (2017).
- Interstitial Cystitis Association. (2016).
- Mayo Clinic Staff. (2017). Interstitial cystitis.