Interstitial Cystitis (Painful Bladder Syndrome)
When the bladder becomes filled with urine, the pelvic nerves will communicate to your brain that it is time to urinate. In those with Interstitial Cystitis (IC), these signals may fire too frequently or at the wrong moment, causing the urge to urinate even when there is only a small amount of urine in the bladder.
The complications from this issue can greatly impact the patient’s quality of life. Sufferers of IC can experience reduced bladder capacity, sexual intimacy issues, loss of sleep and even emotional troubles.
The symptoms of Interstitial Cystitis can vary for each patient, but listed below are the most common symptoms felt by IC sufferers:
- Pressure or pain in the bladder is the most frequently felt symptom. The pain tends to get worse as the bladder fills.
- Lower abdomen, lower back or pelvic pain can also be felt by some patients. The pain can range from intermittent to constant.
- Frequent urination is typically the first symptom that IC suffers notice. Frequent urination is classified as going more than 7 times per day and/or waking up to go in the middle of the night.
- The urgency to urinate may never go away for some patients, even after urinating.
Causes & Risk-Factors
The exact causes of Interstitial Cystitis are unknown, but there are several risk-factors that could make a person more likely to suffer from this issue.
- Gender is a major contributing factor. 90% of patients with Interstitial Cystitis are women. When men experience these symptoms, it’s typically linked to prostate gland inflammation.
- The age of patients who are diagnosed with IC tends to be 40 or older.
- A bladder defect in which the lining can allow an irritating substance to affect the bladder.
- Chronic pain disorders such as irritable bowel syndrome or fibromyalgia have been found to be associated with Interstitial Cystitis.
There is no test than can definitively determine whether Interstitial Cystitis is or is not present. A healthcare provider will determine whether the patient’s symptoms are consistent with IC and they well then run tests to ensure that other health issues are not causing these symptoms.
Next, a physical and neurological exam may be performed. The physical exam will consist of an examination of the abdomen and organs in the pelvic area. The mental exam will be performed to rule out any potential mental health or anxiety disorders that could be causing symptoms.
Treatment Options from Dr. Tapscott
Symptoms can take weeks or even months to improve and the issue may never be completely cured. The treatment of Interstitial Cystitis will begin with minimally invasive measures and escalate progressively if symptoms are not improving:
- First phase – home & lifestyle treatment: The physician may recommend some simple lifestyle changes including a change of diet, bladder retraining (holding urine for longer to regain muscle control,) low-impact exercises and wearing looser clothing.
- Second phase – prescription medication: If lifestyle changes don’t control symptoms, prescription medication may be ordered. The medication can be taken orally, or it could be placed into the bladder directly through a catheter.
- Third phase – injections: Injections of a small amount of Botox can help to paralyze the muscles that are causing pain and alleviate symptoms.
- Fourth phase – cyclosporine: The medication is infrequently used because of its immune system lowering effects. The doctor and patient should thoroughly discuss the risks of this option.
- Fifth phase – surgery: Surgery is reserved for patients who have tried the first four phases of treatment and have not gotten symptom relief.