Interstitial Cystitis

Interstitial Cystitis Q & A

Q1. What is interstitial cystitis?

Interstitial cystitis (IC) is a chronic condition of the urinary bladder that causes symptoms of pelvic pain, pressure or pain in the bladder and urinary urgency or frequency. The severity of the pain can range in between mild and severe. Interstitial cystitis is also called bladder pain syndrome, chronic pelvic pain, and painful bladder syndrome. According to estimates, it affects about four to 12 million individuals in the USA. Women are more prone to develop interstitial cystitis, though; it may affect any person regardless of gender, age, ethnicity or race.

Q2. What are the symptoms of interstitial cystitis?

The symptoms and signs of interstitial cystitis may vary in different individuals. They also vary in the same person over time, flaring periodically in response to triggers including menses, stress, exercise, sexual activity and sitting for a long duration.

The symptoms and signs of interstitial cystitis are:

• Chronic pain in the pelvis
• Pain in the urethra, perineum, lower back, and lower abdomen
• Pain the vagina or vulva
• Frequent urination; you may pass small amounts of urine at a time, all through the night and day (it may go up to 60 times in a day)
• Pain in the bladder when it fills with relief after passing urine
• An urgent and persistent need to pass urine
• Pain while having sex

The severity of symptoms is distinct for every individual and you may experience periods that are free from symptoms.

Although, interstitial cystitis symptoms can resemble chronic urinary tract infection symptoms, usually no infection is present. But, symptoms of interstitial cystitis can worsen if you get a urinary tract infection along with it.

Q3. What are the causes of interstitial cystitis?

While what exactly causes interstitial cystitis is unknown, but there are many factors that may trigger the condition. Some of these are:

• A defect in the bladder epithelium (lining that protects the bladder). A leak in this lining can allow toxic substances from the urine to cause irritation of the bladder wall.
• Overstretching of the bladder wall or trauma to it
• Pelvic floor muscle dysfunction
• Autoimmune disorders
• Trauma to the spinal cord
• Primary neurogenic inflammation
• Allergy
• Genetics
• An infection
• Physical, sexual or childhood abuse

Q4. What are the risk factors of interstitial cystitis?

The following factors make you more prone to develop interstitial cystitis:

• Your sex: Females are more prone to develop interstitial cystitis than males.
• Your hair and skin color: Having red hair and fair skin makes you more prone to develop interstitial cystitis.
• Your age: If you are in your 30s or older then you are more prone to develop the condition.
• Suffering from another chronic pain disorder: Having a chronic pain disorder including fibromyalgia or irritable bowel syndrome makes you more prone to develop interstitial cystitis.

Q5. What are the complications of interstitial cystitis?

The following are the complications of interstitial cystitis:

• Reduced capacity of the urinary bladder: Due to interstitial cystitis the walls of your urinary bladder may become stiff; thereby, allowing it to store less urine.
• Problems with sexual intimacy: Pain and frequent urination can produce tension in your personal relationships due to which your sexual intimacy may also suffer.
• Reduced life quality: Pain and frequent urination can interfere with your work and social and daily activities.
• Emotional problems: Interstitial cystitis is associated with interrupted sleep due to frequent urination and chronic pain and this may result in emotional distress and cause symptoms of depression.

Q6. How does your doctor diagnose interstitial cystitis?

• Your physician will ask details about your medical history. They may also ask you to maintain a bladder diary in which you have to record the volume of intake and output (in the form of urine) of fluids.
• Your physician may perform a pelvic exam to examine the external genitals, cervix and vagina, rectum and anus.
• Your urine sample may be tested to check whether a urinary tract infection is present or not.
• Your physician may do other diagnostic tests to diagnose interstitial cystitis. These include the potassium sensitivity test, urodynamics, cystoscopy, and biopsy.

Q7. What is the treatment of interstitial cystitis?

Interstitial cystitis is a chronic condition and it can’t be completely cured. You can only manage its symptoms. The treatment is complex and involves multiple approaches. Some of the potential treatments are:

• Bladder distention
• Physical therapy
• Alternative therapies including guided imagery, energy therapy, acupuncture or massage therapy.
• Bladder instillations using mixtures such as sodium hyaluronate, heparin, DMSO, and others.
• Injections into the bladder wall such as Botox.
• Neuromodulation by using electrical nerve stimulators.

Several oral and topical medicines are available to treat chronic pain. These include:

• Non-narcotic and narcotic medicines
• Topical medicines such as rectal or vaginal diazepam, topical amitriptyline, and lidocaine patches
• Tricyclic antidepressants including imipramine or oral amitriptyline
• Antihistamines including loratadine
• Pentosan
• Immunosuppressant including cyclosporine, mycophenolate mofetil, and mycophenolate
• Alpha-blockers
• Amphetamines
• Histamine blockers
• Antiseizure medicines
• Leukotriene inhibitors
• Urinary antacids, tricitrates, and sodium or potassium citrate
• Prostaglandins such as ibuprofen, NSAIDs
• Urinary tract antispasmodics such as Detrol, VESIcare or Toviaz

Q8. What are the home and lifestyle remedies to treat interstitial cystitis?

The following are the various home and lifestyle remedies that you can follow to relieve interstitial cystitis:

• Dietary changes: Reduce or eliminate those foods from your diet, which irritate the urinary bladder. Examples of such foods are carbonated beverages, citrus foods, and products that are rich in vitamin C and caffeine-containing foods (including chocolate). Also avoid foods such as tomatoes, alcohol, spices, and pickles and artificial sweeteners as they may worsen symptoms of interstitial cystitis.
• Bladder training: It involves going to pass urine according to the clock instead of waiting for the time when the need arises.
• Manage your stress levels
• Quit smoking if you are a smoker
• Avoid wearing tight clothing
• Exercise: Doing certain easy stretches can help in reducing the symptoms of interstitial cystitis.