About Interstitial Cystitis

Interstitial cystitis is a chronic condition of the bladder that causes discomfort and pain in varying degrees, affecting women most often. Although it is not a life threatening disease, it can adversely affect an individual's quality of life, sometimes severely.

Exact causes of interstitial cystitis have yet to be proven. However, it is thought many persons suffering from it have a defect in the wall of the bladder which enables toxic substances to leak through and irritate the organ.

Other possible factors are allergies, repeated infections, or autoimmune or hereditary factors.

Symptoms

Symptoms of interstitial cystitis include pelvic pain and pressure with a frequent urge to urinate. The individual feels the necessity to urinate often, but the volume will be much less. Often patients experience pain during sexual intercourse.

Sometimes the symptoms of individuals suffering from interstitial cystitis will worsen upon experiencing various triggers. These can be stress, allergies, menstruation, or other factors.

Diagnosis

Although interstitial cystitis can occur at a young age, it is not normally diagnosed until the patient's thirties or forties. The symptoms may appear to be those of a urinary tract infection, however when tests are run there is no bacteria in the urine.

Interstitial cystitis is also sometimes diagnosed in those with other disorders such as fibromyalgia or other syndromes affecting the nervous system. This may be because it affects the signals between the brain and pelvic nerves.

Besides reporting of symptoms and medical history, tests will be run to support a diagnosis of interstitial cystitis and rule out other conditions. These normally include a urinalysis, pelvic exam, and sometimes biopsy and cystoscopy. There may be a potassium sensitivity test, in which water and then potassium chloride are introduced into the patient's bladder one at a time. When an individual has interstitial cystitis, they will experience an increased urge to urinate when the potassium chloride is placed in the bladder.

Treatment
There is no actual cure for interstitial cystitis. There are some medications which may reduce symptoms. These include antihistamines to relieve urinary urgency, nonsteroidal anti-inflammatory medications such as ibuprofen to relieve pain, and antidepressants, which can help block pain and relax the bladder.

A drug called pentosan has been approved by the FDA to treat interstitial cystitis. This drug may help restore the surface of the inner bladder to protect it from irritants. However, this drug must build up for a few months before becoming effective, and does carry side effects such as possible hair loss and gastrointestinal problems.

Besides oral medications, there are other treatments that may be considered in cases of interstitial cystitis. These include pelvic exercises, bladder retraining and dietary adjustments such as excluding caffeine and other possible irritants.

There are nerve stimulation techniques which have been successful in relieving symptoms of interstitial cystitis in some patients.

Rarely, the doctor may recommend inserting a medication, DMSO, sometimes with an anesthetic, into the bladder. This procedure carries risks to the liver, can be painful and in some persons can worsen symptoms. A newer instillation solution that combines lidocaine, heparin and sodium bicarbonate, has shown some success in clinical trials and may become more commonplace.

Surgical procedures for interstitial cystitis are also rarely recommended, since they carry a risk of exacerbating symptoms rather than relieving them. Surgical procedures include bladder resection, or removal of damaged parts of the bladder and replacement with a section of colon. If ulcers are present in the bladder, they may be burned off, using instruments introduced through the urethra.

Research into causes and better treatments for interstitial cystitis is ongoing, and it is hoped that a definitive test and cure for this debilitating disorder will soon be found.

Sources:

National Institute of Health

Signet/Mosby Medical Encyclopedia

Mayo Clinic