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Interstitial Cystitis: What It Is All About

Put simply, it is a bladder infection — or, interstitial cystitis [IC], in medical parlance. The presenting symptom of the condition is often a feeling, or an intense urge, to urinate frequently.

The passing of urine is often accompanied by pain, though you cannot, like most infections, fix the blame for IC on bacteria.
So, when you take antibiotics, which kill bacteria and knock out a bladder infection, they have no effect on IC. This done, the symptoms come to stay.

Doctors say that hundreds and thousands of people have IC — 90 per cent of them women. Blame it on the numbers-game, IC most often remains under-diagnosed in most instances.

While a cure for the condition is still a far cry, it is ironical that doctors are not sure as to what causes the problem in the first place.
This explains why IC has prompted a good deal of research interest in the medical fraternity. This has also resulted in a host of treatment protocols available to break the symptoms and get on with normal activity and/or our day-to-day life

Identifying IC

Acknowledged to be one of the chronic pelvic pain disorders, mainly because many of the signs related to pelvic affections come together in IC, symptoms of the disorder differ from one person to the other. This applies even when it involves the same individual, at different times.
Common symptoms of the problem are —

  • Mild discomfort.
  • Pressure.
  • Sensitivity, or tenderness or intense pain on touch, in your bladder, or the surrounding areas.

Besides, you may feel the urge to urinate 10-12 times a day, or up to 40, or more, times daily.

Another indication is that the pain may change in intensity as your bladder fills with urine and/or as you void it.

Periods, diet and sexual activity may aggravate some of your symptoms. While most women are able to understand the symptoms themselves, because the idea of the painful bladder syndrome is a commonplace topic of discussion with many of their friends and acquaintances, doctors often depend on the symptoms ascribed and related to by women as the key to diagnosing the problem.

Reason? There's no classic test to spot IC. However, it is imperative for your doctor to classify other conditions that mimic IC — especially those with similar symptoms, such as bladder infection, bladder cancer, sexually transmitted diseases [STD], kidney disorders, and certain vaginal infections.

It is also possible for your doctor to advice for a cystoscopic examination. This exam is done with the view to look inside your bladder for abnormalities. A special instrument called the cystoscope, a narrow hollow tube fitted with lenses and a light, is used in the procedure. The procedure is often painful. Hence, it's done under local or general anaesthesia.

During cystoscopy, your doctor will look for minute [petechial] haemorrhages. These, in medical terminology, are called glomerulations. Approximately, 80 per cent of individuals with IC have glomerulations on the walls of their bladders.

What if they are not detected? It doesn't essentially mean that you don't have IC. As a matter of fact, most doctors don't recommend a cystoscopic examination to confirm the diagnosis. They would rather prefer to listen attentively to what their patient is describing to them. This often helps them to distinguish IC from other diseases with urinalysis and culture for bacteria, and help them arrive at a diagnosis without cystoscopy.

Treatment Goals

The best way to deal with IC is an approach that suits the individual best. The reason being that IC is so conflicting, that, it's very tricky to pin-point any therapeutic option of choice. It would be, therefore, viable for one to try a host of options, with the founded reason that something is going to work. Not that you should try to beat the disorder with hit-or-miss therapeutic options. Far from it. There is reason to believe that most patients with IC spontaneously respond just as quickly.

Recommended Medications

  • Pentosan polysulphate sodium [Elmiron], is a drug that the Food and Drug Administration, US, approved in 1996 as the first medication exclusively meant for IC. In clinical trials, Elmiron improved symptoms in 38 per cent of people treated. Doctors, however, are of the opinion that you may not feel any relief from IC pain for the first two-four months. You need to stay on it for at least six months to figure out its curative effects.
  • Aspirin and Ibuprofen. These over-the-counter [OTC] pain relievers would be helpful if your symptoms are mild.
  • Anti-depressants such as amitriptyline and imipramine — Elavil and Tofranil-PM —respectively, can help reduce pain and also deal with the emotional stress associated with chronic pain.
  • Anti-spasmodics and muscle relaxants can likewise help relax the bladder muscle, and relieve your symptoms.
  • Dimethyl sulphoxide [DMSO], which is laid directly into the bladder, is suggested to work by reducing inflammation and “jamming” the pain. The medication can be mixed with steroids, anti-coagulants such as heparin and/or local anaesthetics, to help relieve pain.
  • Bladder distension. Your bladder is filled with water under general anaesthesia. The water is held in the bladder for 10 to 15 minutes before being emptied. This may raise bladder capacity and obstruct pain signals which are transmitted by nerves in the bladder.

Most important. Although there’s no cure for IC, it is not uncommon for most people to feel quite all right in the long-run. However, thanks to growing awareness juxtaposed by research studies, there is now a better understanding of what the condition is all about, and what best one could do to manage and also, perhaps, prevent the disease from getting the upper hand.

Things To Do

It is not just medications or management of pain alone that would bring you relief from IC. It would help you greatly if you augmented your treatment plan with the following specific self-help tips —

  • What you eat may often be the trigger. The best thing to do is to eat the right type of food and follow a diet regimen that is balanced. Simple reason — it has been found that certain foods can contribute to bladder irritation and inflammation. Examples — alcohol, tomatoes, spices, chocolate, coffee, caffeinated and citrus beverages and high-acid foods. Keep away from them, and you will be able to bring down your symptoms significantly. Other foods you’d do well to skip are — canned cheese, yogurt, onion, monosodium glutamate [MSG], aspartame [artificial sweeteners], nuts and smoked foods.
  • Maintain a bladder diary on a daily basis. Record urination times, symptoms, response to food, exercise, medications etc., A daily record will help you keep a register of what helps your symptoms, and what doesn’t.
  • Eat 4 small meals during the course of the day. Avoid large meals.
  • Do rebounding exercises on a mini-trampoline, or low-impact aerobics, walking, yoga, and t’ai chi.
  • If your symptoms are not intense, you may do swimming, jogging, weight training, and cycling.
  • Try to reduce stress through basic relaxation techniques, biofeedback, meditation, self-hypnosis and/or listening to soft, soulful music
  • Get a soothing massage. Or, use a heating pad or a cold pack on your bottom. Or, take a warm sitz bath. Find out what suits you well over a period of time, and use it with good effect.
  • Cotton underwear is ideal clothing. Also, opt for loose-fitting clothes such as baggy pants, shorts, or skirts.
  • Avoid the use of belts and other types of clothing that put pressure on your waist and below.

At A Glance

You probably have IC if you have any, or some, of the symptoms outlined below:

  • When you have a pressing urge to urinate day and night.
  • When you urinate frequently.
  • Have pain when you empty your bladder.
  • When the pain changes in intensity as your bladder fills with urine.
  • Have pain and pressure in your lower abdomen.
  • When urine cultures don’t show any signs of bacteria.
  • When symptoms get worse during menstruation.
  • When you experience pain during intercourse.
  • When your symptoms get bad after you light a cigarette.
  • When some foods make your symptoms worse.
  • When your symptoms intensify and also decline.
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