Interstitial cystitis (IC) which is also known as Bladder pain syndrome is a type of chronic pain that affects the bladder.
Women are five times more prone to have this condition than men.
SIGNS & SYMPTOMS OF INTERSTITIAL CYSTITIS
- Suprapubic pain
- Urgent need to urinate
- Increased frequency of urination
- Painful sexual intercourse
- Waking up from sleep to urinate
- Painful urination
- Burning sensation in the urethra
- Pelvic pain
- Urinary retention
- Difficulty & discomfort during driving, walking or traveling.
- Pelvic floor dysfunction
- Hunner’s ulcer
- Chronic fatigue syndrome
- Sjogren Syndrome
- Chronic bacterial prostatitis
- Low quality of life
CAUSES OF INTERSTITIAL CYSTITIS
No specific causes are known that lead to interstitial cystitis, some theories are based on:
- Damaged urothelium/bladder lining;
- Due to infection of the bladder, excess consumption of soda or coffee & trauma.
- Due to a deficiency in the glycosaminoglycan (GAG) layer, which leads to impaired protection & allows the irritating substances in urine to breakdown the bladder lining.
- Interstitial cystitis is also linked with stress, anxiety & panic.
- Another theory proposes it as an autoimmune disorder, as mast cells present on the bladder lining produce chemicals which attack the bladder lining and damage it.
- Genetic factors: An antiproliferative agent is secreted by bladders of people with IC which inhibits bladder cell proliferation.
Some disease/disorders that are found along with IC are:
- Irritable bowel syndrome
- Gluten sensitivity
- Overactive bladder
- The diagnosis of IC done primarily by the exclusion of other conditions/diseases that show similar symptoms.
- All the physical symptoms, medical history, diet & lifestyle factors of the patients are noted.
- Urine analysis for detection of foreign antigens, infectious agents, abnormal chemicals, etc.
- Serum Prostate specific antigen test in men.
- Cytoscopy: The endoscopy of the bladder seen by inserting of a scope through the urethra under local anesthesia.
TREATMENT OF INTERSTITIAL CYSTITIS
- Antihistamine drugs, cimetidine, hydroxyzine
- Antidepressant drugs, amitryptyline, duloxetine
- Immunosuppressant drug, cyclosporin A
- Oral pentosan polysulfate has shown to repair the lining of the bladder
- Bladder instillation with heparin & lidocaine
- Treatment of Hunner’s ulcer by triamcinolone injection
- Botulinum toxin (Botox)
- Bladder distension while under general anesthesia, also known as hydrodistention (a procedure which stretches the bladder capacity), provides pain relief & reduces urinary frequency.
- Bladder instillation in people with Interstitial cystitis with medications like dimethyl sulfoxide (DMSO), heparin, hyaluronic acid, chondroitin sulfate, etc which are efficient in management of symptoms.
- Bladder augmentation, the surgical alteration of the bladder
- Urinary diversion, rerouting of the urine flow
- Transurethral fulguration
- Resection of ulcer
- Cystectomy, surgical removal of the urinary bladder
- Neuromodulation of the affected region by electrical stimulation through TENS, PTNS, percutaneous sacral nerve stimulation.
PREVENTION & MANAGEMENT
- Pelvic floor exercises by physiotherapy & kegel exercise to strengthen the pelvic muscles.
- Elimination of potential trigger foods like;
- Citrus fruits
- Hot pepper
- Artificial sweetners
- Stopping smoking
- Lifestyle changes by reducing stress & anxiety management.