Interstitial Cystitis & Painful Bladder Syndrome

Interstitial Cystitis (IC) is a condition that causes sufferers the need to frequently pass urine whilst also having to deal with bladder pain and/or discomfort. IC is most commonly diagnosed in women, with only one in ten people with IC being male. It can be caused by an inflamed bladder wall, and in severe cases the bladder wall can scar and grow stiff, preventing the bladder from expanding when urine enters. Many women may find that they can get fissure of the bladder lining, ulcers or pinpoint bleeding, which can be painful and leads to the need to urine frequently and urgently.

The condition is also known as painful bladder syndrome (PBS) when there is no abnormality in the bladder. Bladder Pain Syndrome is often used to encompass both IC and PBS.

Causes of Interstitial Cystitis

The cause of IC are unknown at this moment in time. Infections with bacteria or viruses have been ruled out as a cause, and it is thought that it may be down to a defect lining in the bladder. In a normal bladder, the lining should protect the bladder wall from the toxic nature of the urine passing through it. It has been discovered the about 70% of people with IC have a leaky protective lining in their bladder which may allow the urine to aggravate the bladder wall.

There is also a noticeable increase of histamine which is produced by the body due to the inflammation process and an increased amount of nerve cells in the bladder wall.  An autoimmune response may also cause IC to develop in some people. This is when antibodies are made that fight against another part of the body, such as rheumatoid arthritis.

Treatments of Interstitial Cystitis

As the causes of IC are not yet known, all treatments are currently aimed at relieving its symptoms. One, or a few, of the treatments help a majority of sufferers for varying periods. The more that is discovered about IC, the more the potential treatments will evolve so that patients will be able to discuss the type of treatments they prefer with their doctor. The majority of sufferers are likely to feel better after trying one or more of the following treatments:

Diet

Alcohol, tomatoes, spices, chocolate, caffeine, citrus drinks, artificial sweeteners, acidic foods and tobacco can aggravate your bladder. Try removing these types’ foods from your daily diet for a couple of weeks to a month. Then it is worth eating one food at a time to see if it makes your symptoms worse.

Bladder distension

Around 33% of people claim that their bladder feels better after they have received bladder distension. A doctor will fill up your bladder with fluid, whilst you are under anaesthesia, and will stretch the wall of your bladder. Although it is a common treatment for IC, doctors are unsure why this helps symptoms. It could be interfering with pain signals sent by nerves in the bladder. This, of course, is not a full proof treatment and some people even claim that their pain is worse after the procedure.

 Medication

  • When it comes to using medication as a form of treatment for IC, your doctor may prescribe an oral medication called pentosane polysulfate. This will help protect the lining of your bladder from the toxicity of your urine. Around 40% of patients claim to have a positive improvement in their IC symptoms after taking this medication. Although, due to its high price, it may not be available in every country.
  • Amitryptiline is another type of medication that you may be prescribed. This medication is used to block pain and reduce bladder spasms. Amitryptiline can make you drowsy so it is usually taken before the sufferer goes to bed.
  • Oral antihistamines or H2 antagonists have also aided many patients with their bladder symptoms, these treatments normally work better if the cause of inflammation is allergy based.

Bladder instillation

Bladder instillations can be given every week or two one or two months. The doctor will insert a catheter in to your bladder and then fill it up with liquid medicine that is meant to help the bladder wall. You are then expected to hold the liquid in your bladder for a few seconds to 15 minutes and then it is drained. The treatment will be repeated as needed.

Further treatments of Interstitial Cystitis

As much as the above treatments work for many sufferers of IC, there are also a large number of people who do not react positively to them. There are currently some treatments being assessed for these people, such as a botulinum toxin bladder injection and sacral nerve stimulation. Many people need strong pain medication or referral to a multidisciplinary pain clinic. A small amount of sufferers do not respond to any treatment at all and have to undergo surgery in order to get some relief. Surgery should only ever be considered as an option if all available treatments have failed and the pain is disabling.