You may have a condition called Interstitial Cystitis (IC), also known as Painful Bladder Syndrome (PBS), Bladder Pain Syndrome (BPS) or chronic pelvic pain...
Interstitial Cystitis, often referred to as IC, is a chronic condition that is associated with recurring pelvic pain, pressure or discomfort in the bladder and pelvic area. Most people with IC also have urinary frequency (needing to go often) and urgency (feeling a strong need to go).
IC affects 4 to 12 million people in USA. It is 4 times more common in women and more frequently diagnosed in those over age 30, but can also affect men and children. Having fair skin and red hair, or being diagnosed with another chronic pain disorder (like irritable bowel syndrome or fibromyalgia) have been associated with a greater risk of developing IC.
Although symptoms often feel like a bladder infection, no infection is present. The cause in unknown, but is thought to be associated with the nervous or immune systems – possibly an autoimmune reaction, heredity, previous infection or allergy.
IC is associated with a defect in the lining of the bladder that allows irritating substances in urine to leak into the bladder wall, but it is not known whether this is a cause or an effect of IC.
No cure is available, but there are several treatments that can give relief. Some treatments work better than others in different individuals, and some believe this is due to the existence of different subtypes of IC. 90% have non-ulcerative IC, with pinpoint hemorrhages in the endometrium, or lining of the bladder, known as “glomerulations” (also present in any inflammation of the bladder), and 5 to 10% have ulcerative IC with red, bleeding areas on the bladder wall known as “Hunner’s Ulcers”.
TREATMENTS
Physical therapy may help relieve pain or muscle abnormalities of the pelvic floor muscles that support the bladder.
Non-steroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen (Advil, Motrin) or naproxen sodium (Aleve) can relieve pain.
Tricyclic antidepressants, such as amitriptyline (Elavil) or imipramine (Tofranil), can help relax the bladder and block pain.
Antihistamines, such as loratadine (Claritin) or cetirizine (Reactine), may reduce urgency and frequency, and other symptoms.
Pentosan polysulfate sodium (Elmiron) is a prescription drug approved specifically for treating IC. Exactly how it works is unknown, but it may restore the inner surface of the bladder, protecting the bladder wall from irritating substances in urine. It can take 2 to 4 months for pain relief and up to 6 months to reduce urinary frequency.
TENS (transcutaneous electrical nerve stimulation) is a small portable device that delivers mild electrical pulses. It can relieve pain, strengthen muscles that support and control the bladder, and may increase blood flow to the bladder. In some cases, it can reduce urinary frequency.
Sacral nerve stimulation is achieved by placing a thin wire near the sacral nerves between the spinal cord and the bladder to deliver mild electrical impulses. The sacral nerves control the bladder and stimulating them will sometimes reduce urgency associated with IC. If successful, a permanent device can be implanted.
Bladder distension – Stretching the bladder by inserting a catheter (a thin flexible tube) into the bladder through the urethra (the opening through which urination occurs) and filling the bladder with water can give some people temporary improvement in symptoms. This procedure is called a bladder instillation, and can be repeated, as necessary.
Other solutions can also be instilled, such as DMSO (dimethyl sulfoxide or brand name Rimso-50), or a sterile solution containing lidocaine (an anesthetic), sodium bicarbonate (baking soda) and pentosan or heparin.
ALTERNATIVE MEDICINE
Two alternative therapies have shown promise in treating IC:
Guided imagery – uses visualization and direct suggestions using imagery to help imagine healing, encouraging the mind to help direct the immune system.
Acupuncture – several thin needles are placed in the skin at specific points to relieve pain. Chinese medicine describes acupuncture as rebalancing the flow of life energy, while western medical practitioners believe it boosts release and activity of endorphins, the body’s natural painkillers.
If you are experiencing symptoms that suggest you may have IC, see your doctor for an assessment. Keep a bladder diary for a few days before your appointment to record:
your symptoms
how often you urinate
what kinds of fluid you drink
any medications or supplements you take
Interstitial cystitis is a debilitating condition that can negatively affect a person’s quality of life. Although no cure has yet been found, there are several different treatments that can reduce your symptoms and make this condition more manageable.
References: www.mayoclinic.org ; www.ichelp.org
