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Interstitial Cystitis

Interstitial cystitis, also known as bladder pain syndrome, is a chronic inflammation and painful condition of the bladder that causes frequent, urgent and painful urination and pelvic discomfort.

SYMPTOMS: 

The symptoms of interstitial cystitis are frequency, urgency, chronic pelvic pain, chronic vulvar pain, chronic urethral pain and/or abdominal discomfort during urination and sex. It can feel like a bladder infection.

RISK FACTORS: 

There are no specific risk factors. It may be influenced by a persons genes, so having a blood relative with interstitial cystitis may increase your chances of developing it. Interstitial cystitis is caused by the natural lining of bladder, a protective layer of the bladder, has broken down, allowing toxins to irritate the bladder wall. Consuming bladder irritants such as citrus fruits, tomatoes, chocolate, coffee, spicy foods and alcoholic beverages may increase chances of interstitial cystitis.

EVALUATION & DIAGNOSIS:

While there is no definite work up, our medical practitioners start with a history, physical exam and urine tests initially to rule out other causes of bladder pain. Some practitioners may feel IC is present if symptoms are present and there are no other causes for the symptoms. Some clinicians try:

  • Cystoscopy: Some people feel it is necessary to look at the lining of the bladder and rule out other problems such as cancer. It may show areas of bleeding or ulcers which would then get biopsied to rule out bladder cancers.
  • Urodynamics: This test uses a small catheter to fill the bladder and measures bladder pressures as the bladder fills and then empties. Usually people with IC are found to have a small bladder capacity and pain with filling.
  • Potassium Sensitivity Test: Potassium solution and water are placed into the bladder one at a time. Pain and urgency scores are then evaluated. People with IC feel more pain and urgency with the potassium solution than with water. People with normal bladders don't really feel the difference. This test is not diagnostic for IC and can be painful. It is not part of the routine evaluation for IC.

TREATMENT:

There is not a cure for interstitial cystitis. The goal is to relieve the symptoms. Other than dietary and lifestyle changes, there are 2 FDA approved treatments: Elimiron (Pentosan Polysulfate) orally and DMSO infusions into the bladder through a catheter once a week for 6 weeks. Maintenance infusions may be needed afterwards at longer intervals. Some practitioners may have other methods to treat it in their office. Please feel free to discuss other options with your practitioner.