• Interstitial Cystitis

    Interstitial Cystitis

Interstitial Cystitis

Interstitial cystitis also referred to as, IC, is a painful bladder condition caused by inflamed tissues of the bladder wall. Most IC patients have recurring pelvic pain, pressure, or discomfort in the bladder and pelvic region. They also experience urinary frequency (needing to go often) and urgency (feeling a strong need to go). I.C. can have a long lasting adverse effect on your quality of life.

IC may also be referred to as painful bladder syndrome (PBS), bladder pain syndrome (BPS), and chronic pelvic pain. Symptoms may be mild or severe and may vary in intensity even in the same individual over time. There is no cure for PBS/IC, and treatments are directed at reducing the severity of symptoms.
Currently there are two recognized types of I.C.: non-ulcerative and ulcerative.

Non-ulcerative: The majority of IC patients have the non-ulcerative form of IC. Non-ulcerative IC presents with pinpoint hemorrhages, also known as glomerulations, in the bladder wall. However, these are not specific for IC and any inflammation of the bladder can give that appearance.

Ulcerative: A small portion of IC patients have the ulcerative form of IC. These patients usually have Hunner's ulcers or patches, which are red, bleeding areas on the bladder wall.

How is this Diagnosed?

Diagnosis is made by ruling out other causes. Tests include:

  • Bladder biopsy
  • Cystoscopy (endoscopy of bladder)
  • Urine analysis
  • Urine culture
  • Urine cytology
  • Urodynamics (shows how much urine must be in the bladder before you feel the need to urinate)

To learn about the possible treatment options for IC, click on any of the tabs below.

Behavioral Modifications

Diet
Diet modification is one of the most effective ways to help control symptoms associated with IC. It is important to avoid foods and beverages that cause bladder irritation such as caffeine, alcohol, and acidic foods. Each patient reacts to certain foods differently so it is important to test each food and eliminate accordingly.

Smoking
Smoking can worsen the symptoms for patients with chronic pain conditions such as I.C. Not only does cigarette smoke irritate the bladder, smoking is also the major known cause of bladder cancer.

Exercise
Many PBS/IC patients feel that exercising regularly helps relieve symptoms because stretching can help release pelvic floor and other muscle tension that can add to pain. Good blood flow to the pelvic area and strong muscles around your bladder can help to maintain a healthy bladder. A physical therapist that is knowledgeable about treating pelvic pain can also help you choose exercises that target your specific needs.

The next step is to gradually increase the interval of time between your trips to the restroom. Your goal is to continue lengthening this interval until you reach intervals of two to four hours. Please be patient as it may take some time to reach these goals.

Physical Therapy

Physical therapy and biofeedback may help relieve pelvic floor muscle spasms in patients with I.C. Bladder training can also help with managing I.C. symptoms such as frequency. By using relaxation techniques patients can train the bladder to go only at specific times.

Medical Therapy

Treatment results vary from person to person. As long as the cause is unknown, treatment is based on trial and error. Elmiron is the only medication taken by mouth that is specifically approved for treating IC. This medicine coats the bladder and protects it from irritation. Oral medications that may improve the signs and symptoms of interstitial cystitis include ibuprofen (Advil, Motrin, others) and other nonsteroidal pain medications to relieve discomfort. Tricyclic antidepressants, such as amitriptyline or imipramine (Tofranil), may help relax your bladder and block pain. Antihistamines may provide symptom relief for some people.

Bladder installations are performed by using a thin catheter to instill medicines directly into the bladder. Medicines such as dimethyl sulfoxide (DMS), heparin, Clorpactin, lidocaine, doxorubicin, or bacillus Calmette-Guerin (BCG) vaccine are administered this way usually on a weekly basis for 6-8 weeks.

Surgery

Bladder hydrodistention consists of over-filling the bladder with water while under general anesthesia in order to stretch the bladder. Some patients find relief in their symptoms using this method while others do not.

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