| Interstitial
Cystitis
What is interstitial
cystitis (IC)?
Interstitial cystitis (IC) is
complex, chronic disorder characterized by an inflamed or irritated
bladder wall. It can lead to scarring and stiffening of the bladder,
decreased bladder capacity, and glomerulations (pinpoint bleeding). IC may
also be known as:
- painful bladder syndrome
- frequency-urgency-dysuria
syndrome
An estimated 700,000 people have
IC, and about 90 percent of them are women. People of any age can be
affected with IC, although it is rare in children.
What causes IC?
The cause of IC is still unknown and
patients do not respond to antibiotic medication. Researchers are
investigating many theories to understand the causes of IC and to
determine appropriate treatments.
What are the symptoms of
IC?
The following are the most common symptoms of IC. However, each
individual may experience symptoms differently. Symptoms may include:
- feelings of pressure, pain,
and tenderness around the bladder, pelvis, and perineum (the area
between the anus and vagina or anus and scrotum)
- painful sexual intercourse
- in men, discomfort or pain in
the penis and scrotum
- in most women, symptoms may
worsen around the menstrual cycle
Stress may also intensify
symptoms, but stress does not cause symptoms to occur.
The symptoms of IC may resemble other conditions or medical
problems. Always consult your physician for a diagnosis.
How is interstitial
cystitis diagnosed?
Because there is no definitive test
to diagnose IC, and because symptoms of IC are similar to other urinary
disorders, a variety of diagnostic tests and procedures may be necessary.
In addition to a complete medical history and physical examination,
diagnostic procedures for IC may include the following:
- urinalysis - laboratory examination of urine for
various cells and chemicals, such as red blood cells, white blood
cells, infection, or excessive protein.
- urine culture and cytology
- cystoscopy (Also called cystourethroscopy.) - an
examination in which a scope, a flexible tube and viewing device, is
inserted through the urethra to examine the bladder and urinary tract
for structural abnormalities or obstructions, such as tumors or stones
- (bladder wall)
biopsy - a procedure in which tissue samples are removed
(with a needle or during surgery) from the body for examination under
a microscope; to determine if cancer or other abnormal cells are
present.
- laboratory examination
of prostate secretions (in men)
Treatment for IC:
Specific treatment for IC will be determined by your physician based
on:
- your age, overall health, and medical history
- extent of the disease
- your tolerance for specific medications, procedures, or therapies
- expectations for the course of the disease
- your opinion or preference
Currently, there is no specific
way to diagnose IC, and no cure for IC, making it difficult to treat.
Thus, treatments are primarily focused on relieving symptoms, and may
include:
- bladder distension-
a procedure aimed at increasing bladder capacity and interfering with
pain signals that are being transmitted by the nerve cells in the
bladder.
- bladder instillation
(Also called a bladder wash or bath.) - the bladder is filled
with a solution that is held for varying periods of time, from a few
seconds to 15 minutes, before being drained through a catheter.
- transcutaneous
electrical nerve stimulation (TENS) - mild,
electric pulses enter the body for minutes to hours two or more times
a day either through wires placed on the lower back, or through
special devices inserted into the vagina in women or into the rectum
in men.
- bladder training
- patient voids at designated times and uses relaxation techniques and
distractions to help keep to the schedule. Gradually, the patient
tries to lengthen the time between the scheduled voids.
- surgery
Management of IC may also
include:
- diet modification
No scientific evidence links diet to IC, but some physicians
and patients believe that alcohol, tomatoes, spices, chocolate,
caffeinated and citrus beverages, and high-acid foods may contribute
to bladder inflammation. Thus, eliminating these substances from the
diet may help to eliminate some symptoms.
- smoking
Smoking is a major known cause of bladder cancer.
- exercise
Exercise may help relieve symptoms or hasten remission.
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