Interstitial Cystitis: A Commonly Misdiagnosed Disorder

Interstitial cystitis or IC, is a chronic inflammation of the bladder wall that causes frequent, urgent and painful urination with or without pelvic pain. The bladder has a natural coating of enzymes that protects it from the toxins in urine. Interstitial cystitis is also known as painful bladder syndrome.

People with interstitial cystitis have a defective coating and this allows the toxins in the urine to penetrate into the interstitial layers of the bladder wall. When this happens, the nerve endings are depolarized and this causes severe irritation when voiding and bladder pain.

Interstitial cystitis, unlike a urinary tract infection, is not infectious and not curable. Interstitial cystitis is treatable with medications and lifestyle changes. The pain from this condition can come and go. Symptoms may leave and then return again for no specific reason and may vary.

Most people with interstitial cystitis are women, about 90%, and about 700,000 people in the U.S. are affected with this problem. More and more men are being diagnosed with interstitial cystitis after having been previously misdiagnosed as having chronic prostatitis. The average age of onset is about 40 years; however 25% of cases are people under 30. Interstitial cystitis is usually misdiagnosed, and it could take years and trips to many doctors to be diagnosed properly.

Many people with interstitial cystitis complain of pain in the lower abdomen that occurs as the bladder fills. They also may have more frequent day or night time urges to empty their bladder without having a urinary tract infection or other infection. Feelings of pressure, pain and tenderness around the bladder and pelvis is also common. Sexual intercourse can also be very painful. In men, pain in the penis and scrotum is also a symptom.

The cause of interstitial cystitis is unknown. It is believed that ICS is a wide range of disorders rather than one single disorder as the symptoms of it are so wide and varied.

Diagnosing ICS is an involved process. Usually a urinalysis and urine culture will be done to identify the most common bacteria in the urine. In men, they will take a sample of prostatic fluid and check it for signs of infection. Another test that might be done is a potassium sensitivity test. This tests checks the leakiness of the lining of the bladder, people with ICS have abnormal readings. Another test uses a cystoscope under anesthesia with bladder distension to look into the bladder and urethra. This can detect inflammation, thick or stiff bladder wall and Hunner's ulcers. Lastly, a biopsy may be performed. This is done to rule out bladder cancer and to possibly confirm the presence of mast cells or inflammation of the bladder wall.

Interstitial cystitis is treated with a modified diet and oral medications. The drug Elmiron is used to treat ICS as it is chemically similar to the substance that lines the bladder. It is believed to help restore and repair the lining of the bladder. While these treatments greatly help those with ICS, they are not a cure and people may still continue to have symptoms for quite some time. It will usually take a year or two, depending on severity, to determine if the medicine and diet changes are working fully.

Diet changes include cutting out foods such as: alcohol, spices, chocolate and caffeinated and citrus beverages. These foods are believed to be possible irritants of the bladder. Any acidic foods are discouraged. Foods such as cheese, nuts, yogurt, bananas, sour cream, avocados, beer and while are also discouraged as they contain the natural chemical tyramine which can increase symptoms. Smoking is also discouraged while exercising is encouraged.

While interstitial cystitis is a very uncomfortable incurable disorder, it is treatable with changes in diet and the addition of medication. Many people find relief and are able to live normal lives without worry of pain and discomfort everywhere they go. Interstitial cystitis is being recognized more often and people are finding they are getting diagnosed faster.

Interstitial Cystitis - Mayo Clinic

Interstitial Cytitis Association