Interstitial Cystitis

An inflammation of the bladder wall. Interstitial cystitis has symptoms similar to cystitis (bacterial infections of the bladder), but urine cultures are negative for bacteria and antibiotics usually do not help. The average age of onset is 40, but is affects women of all ages, symptoms range from mild to severe.

FREQUENT SIGNS AND SYMPTOMS

  • Pelvic pain and pressure.
  • Urgent need to urinate (sometimes 60 to 80 times a day).
  • Sensation of incomplete emptying of the bladder.
  • Pain during sexual intercourse.
  • Burning when urinating.
  • Vaginal and rectal pain (sometimes).

CAUSES

Exact cause is unknown. Studies suggest that’s it is a syndrome of bladder inflammation possibly initiated by bacterial infection, Autoimmune process (misdirected immune response in which the body’s defenses become self destructive) or contract irritants. It is probably not an infectious disease.

RISK INCREASES WITH

  • A history of sensitivities or allergies to medications, food, or other substances; hay fever or asthma.
  • Rheumatoid arthritis.
  • Previous hysterectomy.

PREVENTIVE MEASURES

None known.

EXPECTED OUTCOME

  • Treatments are available that may control or minimize the symptoms, but do not cure the disorder. Medical studies are ongoing to help determine the cause, more beneficial treatments and a possible cure.
  • Women with the disorder may have flare-ups and remissions; also, different women respond to different treatment. In some women, a treatment may work and then lose its effectiveness.

POSSIBLE COMPLICATIONS

Unrelieved symptoms that come and go and may vary in intensity from mild to severe.

TREATMENT
GENERAL MEASURES

  • Initial diagnostic tests will include urine studies (which are usually normal) and a pelvic examination. Conditions that have similar symptoms (bladder infection, kidney problems, vaginal infections, endometriosis, and sexually transmitted disease) will need to be excluded.
  • If other tests are negative, a cystoscopy (use of a small lighted telescope to view the inside of the bladder) is often recommended. A biopsy is taken at this time to rule out a malignancy. As an added benefit, cystoscopy often helps relieve symptoms. It involves distention of the by filing it with water, thereby stretching the bladder and increasing its capacity.
  • There is no consistently effective treatment for the disorder. Options include various oral medications, medication instilled into the bladder, special routines for stretching the bladder, diet changes, bladder retraining, relaxation training, and transcutaneous electrical nerve stimulation (TENS).
  • Counseling, biofeedback or self-hypnosis or self-relaxation therapy is recommend to help manage the stress, anger, anxiety and, sometime, depression that accompanies disorders of chronic pain.
  • Surgical measures are rarely used (only as a last resort when other methods of treatment have failed and quality of life warrants drastic steps.
  • Additional information available from The Interstitial Cystitis Association (ICA), P.O. Box 1553, Madison Square Station, New York, NY 10159, (800) 422 – 1626.

ACTIVITY

No restrictions other than those caused by the symptoms.

DIET

  • Elimination of caffeine-containing beverages, alcohol, artificial sweeteners, spicy foods, citrus fruits and tomatoes in the diet may help relieve symptoms.
  • A bland diets helps some patients.