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Interstitial Cystitis
Definition
A long-term (chronic) inflammation of the bladder of uncertain cause in the absence of any infection with bacteria
Causes and risk factors
- Interstitial cystitis (IC) is a painful condition due to inflammation of the tissues of the bladder wall.
- The cause is unknown.
- IC is often misdiagnosed as a urinary tract infection.
- Patients can go years without a correct diagnosis.
- On average, there is about a 4-year delay between the time the first symptoms occur and the diagnosis is made.
- The condition is most common around ages 30 to 40, although it has been reported in younger people.
- Women are 10 times more likely to have IC than men.
Warning signs / symptoms
- Pelvic pain
- Pain during intercourse
- Urinary discomfort
- Urinary frequency (up to 60 times a day in severe cases)
- Urinary urgency
- Depression because of the pain and changes to their lifestyle.
Diagnosis
Diagnosis is made by ruling out other causes.
Tests include:
- Urinalysis
- Urine culture
- Urine cytology
- Cystoscopy (telescopic examination of the bladder)
- Bladder biopsy
- Video urodynamics (to assess how much urine must be in the bladder before needing to urinate)
Treatment
There is no cure for IC, and there are no standard treatments that are known to be effective for most patients. Results vary from person to person. Treatment is based on trial and error until the patient finds relief. Treatment results vary. Some people respond well to simple treatments and dietary changes. Others may require extensive treatments or surgery.
- Elmiron is the only medication taken by mouth that is approved for treating IC. This medicine coats the bladder like Pepto-Bismol coats the stomach.
- Painkillers for severe pain
- Tricyclic antidepressants such as amitriptyline to relieve pain and urinary frequency
- Bladder hydrodistention- over-filling the bladder with fluid while under general anesthesia
- Bladder training (using relaxation techniques to train the bladder to go only at specific times)
- Medicines placed directly into the bladder, including dimethyl sulfoxide (DMS), heparin, Clorpactin, lidocaine, doxorubicin, or bacillus Calmette-Guerin (BCG) vaccine
- Physical therapy and biofeedback (may help relieve pelvic floor muscle spasms)
- Surgery, ranging from cystoscopic manipulation to bladder removal (cystectomy)
- Dietary changes can help some patients control symptoms. The idea is to avoid foods and beverages that can cause bladder irritation. Below are some of the foods that the Interstitial Cystitis Association says may cause bladder irritation.
- Aged cheeses
- Alcohol
- Artificial sweeteners
- Chocolate
- Citrus juices
- Coffee
- Cranberry juice
(Note: Although cranberry juice is often recommended for urinary tract infections, it can make IC symptoms worse.)
- Fava and lima beans
- Cured, processed, smoked, canned, aged, meats that contain nitrites
- Most fruits except blueberries, honeydew melon, and pears
- Nuts except almonds, cashews, and pine nuts
- Onions
- Rye bread
- Seasonings that contain MSG
- Sour cream
- Sourdough bread
- Soy
- Tea
- Tofu
- Tomatoes
- Yogurt
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