Interstitial cystitis or painful bladder syndrome is a chronic condition that causes pain in the pelvis and urinary problems. Although it is present in both genders mostly affects females, affecting their quality of life as there is no permanent cure or treatment that may provide relief from the condition.
- Risk factors
- Associated conditions
- Lifestyle modifications and home remedies
- When to consult a doctor?
Symptoms of interstitial cystitis
Signs and symptoms experienced by a patient with interstitial cystitis are:
- Pain in the pelvis, lower abdomen, lower back, and sometimes in the urethra
- Increasing pressure and pain with the filling of the bladder
- Urgency to urinate
- Increased frequency of urination
- Burning micturition
- In males: There is pain in the scrotum, testicles, and penis. Other than this, painful orgasms and pain after intercourse are also reported
- In females: There is a pain in the vulva, vagina, and area behind the vagina along with dyspareunia
- The intensity of pain ranges from a dull ache to severe piercing pain
Causes of interstitial cystitis
There is no known cause of interstitial cystitis but several studies suggest chronic inflammation of the lining of bladder and muscle layers which may lead to this disorder, this inflammation is mostly due to damage to these layers caused by:
- Trauma to the lining during surgical procedures
- Recurrent bacterial infections
- Autoimmune disorders that affect bladder
- Increased pressure in the bladder from holding the urine for longer periods of time
- Hypersensitivity of pelvic nerves
- Inflamed pelvic nerves
- Trauma to the spinal cord
- Weak pelvic floor muscles
- Toxic urine contents
- Allergic reaction
Triggers of interstitial cystitis
Interstitial cystitis can be triggered due to consumption of certain food items, some of these are:
- Caffeinated beverages like sodas and coffee
- Artificial sweeteners
- Spicy foods
- Carbonated drinks
Some people are more likely to develop interstitial cystitis than others, some of these risk factors are:
- Female gender, 90% of the patients are females
- People in their late 30s or early 40s
- People with fair complexion and red hair
- With chronic pain conditions like fibromyalgia
Conditions associated with interstitial cystitis
Interstitial cystitis can also exist as a symptom of another widespread problem such as:
- Lupus erythematous
- Irritable bowel syndrome (IBS)
- Chronic fatigue syndrome (CFS)
Complications of interstitial cystitis
Since, interstitial cystitis is a syndrome it can affect different parts of the system and may cause several complications, including:
- Low quality of life due to chronic nature of the disorder
- Reduced capacity of the bladder as the elasticity decreases due to scarring of walls
- Depression and panic disorders
- Lack of sleep
- Loss of confidence
- Barriers in sexual relationships
Stages of interstitial cystitis
This is divided into three stages in the sequence of its intensity.
- Mild: The symptoms are vague and intermittent often resulting in a misdiagnosis. The onset is slow and some flare-ups may be experienced during sexual intercourse.
- Moderate: In this stage, the urinary symptoms appear increasing urgency and frequency of urination. The flare-ups are longer in duration lasting from 3 days to 14 days, only relieved after medical assistance.
- Severe: There are frequent flare-ups lasting for months. Sexual intercourse becomes almost impossible, exacerbated symptoms during the premenstrual phase. The pain is debilitating during this stage.
As there is no known cause of IC, thus, there is no specific test to confirm its diagnosis. A series of tests an examination was conducted to rule out any other cause.
- Pelvic examination
- Blood picture to rule out any signs of inflammation
- Urine analysis and culture to find out any signs of urinary tract infection
- Ultrasound is conducted to measure the amount of post-void urine volume
- Cystoscopy to visualize the bladder and urethra from inside, in case of hematuria
- Cystoscopic bladder stretching
- Bladder and urethral biopsy to rule out any carcinoma
- Urine cytology to rule out cancer
- In females, endometriosis is ruled out by proper pelvic examination and ultrasound
- Prostate fluid culture is done to look for an inflamed prostate in males
- The potassium sensitivity test comes positive in patients with interstitial cystitis.
Management of interstitial cystitis
Various treatments or combinations of treatments are experimented with to find a suitable approach for every individual. Every patient responds differently to every treatment and thus is treated differently. Some of the options that may help relieve the symptoms are as under:
- Nonsteroidal anti-inflammatory drugs for pain relief
- Anti-histamines means to reduce urgency and frequency of urine
- Pentosan polysulfate sodium is the only FDA approved drug for IC
- Tricyclic antidepressants block the nerves and give some relief from pain
- Amitriptyline to control the bladder spasms
- Dimethyl sulfoxide is placed inside the bladder to reduce the inflammation
- Cyclosporines are given as the last option to decrease the immunity of the body
- Steroids are injected into the ulcers in patients with Hunner’s lesions
- Hunner’s lesions are also burnt called fulguration and surgically excised (resected)
- Botulinum toxin injections are paralyzed to relieve the pain from bladder muscles
- Neurostimulation devices like TENS, deliver electric shocks to the nerves.
- Slow stretching of bladder walls to relieve the symptoms for at least a duration of 6 months
- Bladder augmentation is done by placing a part of the intestine on the bladder to increase its capacity
- If everything else fails, a complex surgical procedure called a cystectomy is carried out to divert the urine away from the bladder and remove the bladder completely
Lifestyle changes and home remedies
- Avoid certain foods and drinks that trigger your condition
- Abstain from alcohol use and smoking
- Limit your caffeine and carbonated drinks intake
- Interstitial cystitis is often triggered by dietary factors and patients should get a diet plan made
- Keep a diary to regulate your toilet breaks thereby stopping your bladder from becoming too full
- Refrain from wearing tight clothes or belts that may exert pressure on your bladder
- Acupuncture is a great option for pain relief
- Avoid stress and anxiety
When to consult a doctor?
In case of persistent pelvic pain auto change in the usual pattern of urination is an alarming situation and can be a symptom of several causes. Your doctor will do a pelvic examination followed by cystoscopy followed by other examination procedures to find out the cause.
Where do you feel pain due to interstitial cystitis?
Pain is experienced in the pelvis, lower abdomen, lower back, and during urination.
What is the best medication for interstitial cystitis?
Nonsteroidal anti-inflammatory drugs like Naproxen sodium and Advil are good for pain relief.
What is the life expectancy of interstitial cystitis?
Interstitial cystitis is not a life-threatening condition it does not affect life expectancy but surely affects the quality of life.
What drinks are good for interstitial cystitis?
Herbal teas like chamomile and mint help in pain relief.