Guest Author - Heather C. Guidone
Interstitial Cystitis
Interstitial Cystitis (IC) is an elusive chronic pain disorder affecting an estimated 700,000 Americans; 90% of which are female.(1) Symptoms of IC include feelings of pressure or tenderness around the bladder, mild to
intense pelvic pain, dysuria (pain or burning with urination), dyspareunia (painful intercourse), hematuria (blood in the urine), fatigue, and urinary frequency, urgency or retention. Women´s symptoms worsen during
menstruation, and some sufferers complain of Irritable Bowel Syndrome, allergies and migraines during symptom flares.
IC is a diagnosis of exclusion. Physicians must rule out other disorders like urinary tract or vaginal infections, cancer of the
bladder, cystitis, kidney stones, neurological disorders, bladder Endometriosis, sexually transmitted diseases, and chronic
bacterial and nonbacterial prostatitis in men. IC is often mistaken for an infection; however, there is a marked absence of
bacteria in cultures, and symptoms fail to respond to typical antibiotic therapy.(2) IC is currently incurable; treatment is aimed
primarily at symptom relief.
The most important test to confirm IC is the cystoscopy. Pinpoint hemorrhages on the bladder wall, discovered during the
cystoscopy, are hallmark indications of IC. Also called a cystourethroscopy, this short test involves the insertion of an intrument
(the cystoscope) is through urethra, into the bladder. The cystoscope may be either the "flexible" or the "rigid" model;
depending on the physician and the purpose of the exam. Once the scope is passed into the bladder, water is then inserted. As
the water fills the bladder, it stretches the wall, enabling your physician to obtain a view of your entire bladder wall. Tissue
samples can also be obtained appears through the scope to be sent for analysis. A cystoscopy is uncomfortable, but it does not
last long. The average cystoscopy takes only about 15-20 minutes. After the cystoscope is removed, your urethra may be sore
and you will likely feel a burning sensation during urination for a day or two thereafter. You should arrange to have someone
drive you home after the test is completed.
IC is currently incurable; however, there are many treatment options. Symptom relief can potentially be
obtained through such measures as bladder distention, bladder instillation (or "bladder wash"), medications like Elmiron
(pentosan polysulfate sodium), aspirin and ibuprofen for discomfort, antidepressants, antihistamines, narcotics like Tylenol with
Codeine, TENS units (Transcutaneous Electrical Nerve Stimulation), alternative therapies, and modifications in nutritional and
lifestyle habits, such as eliminating alcohol, high acid foods like tomatoes or spices, chocolate, caffeinated and citric beverages,
and those products with artificial sweeteners from the diet, quitting smoking, and performing gentle stretching exercises.
Surgery can also be considered when other treatments have failed. In severe, extreme cases, bladder removal
can be performed. However, even this drastic method of treatment is not absolute; some patients will still
continue to experience variable IC symptoms.
While there are several theories regarding the etiology of IC, definitive cause(s) remains unknown. One theory
being studied is that IC is an autoimmune response following a bladder infection. Other theories include the
belief that bacteria may be present in the bladder cells, but remains undetectable through routine cultures; that
certain substances in urine may be irritating to IC sufferers; and that the condition may be hereditary.(3)
Patients with IC speak of underdiagnosis and undertreatment. Sufferers of may feel ignored, experience
depression and suffer from chronic pain, seemingly with no end or relief in sight. Research is desperately
needed to discover what causes these diseases and more importantly, how to cure them.
Where to get help:
National Kidney & Urologic Diseases Information Clearinghouse
http://www.niddk.nih.gov/health/urolog/pubs/cystitis/cystitis.htm
Interstitial Cystitis Association
http://www.ichelp.org/
Intercyst.org
http://www.intercyst.org/
References:
(1), (6) & (7) The National Institute of Diabetes and Digestive and Kidney Diseases, NIH Publication No.
99-3220, August 1999/updated February 2000.
Copyright © by Heather C. Guidone. All rights reserved.
