Interstitial Cystitis
Interstitial cystitis (IC), also known as painful bladder syndrome, is a chronic condition that leads to sensations of bladder pressure, bladder pain, and sometimes pelvic discomfort.
The severity of pain can vary from mild discomfort to intense agony. This condition is part of a group of diseases that falls under a broader category called painful bladder syndrome.
How Does IC Affect the Bladder?
The bladder, a hollow, muscular organ responsible for storing urine, typically expands until it's full and then communicates with your brain through pelvic nerves to signal the need for urination. The result is the urge to urinate.
However, in interstitial cystitis, these signaling processes become disrupted. This can cause you to feel the need to urinate more frequently and produce smaller amounts of urine than what's typical.
What Causes IC?
The exact cause of IC is not fully understood. It appears to be a complex condition with multiple potential factors contributing to its development. Some factors that researchers believe may play a role in the development of IC include:
- A defect or damage to the protective lining of the bladder.
- An autoimmune response, is where the immune system mistakenly attacks the bladder tissues, causing inflammation and discomfort.
- Dysfunction in the nerves that control bladder function.
- A genetic predisposition to developing IC.
- Infections or chronic inflammation in the urinary tract that may trigger or exacerbate IC.
In addition, some individuals with IC report sensitivities to certain foods, beverages, or environmental factors. This suggests that allergies or sensitivities could be involved in their symptoms and an interstitial cystitis diet may be beneficial. Some of these sensitivities include:
- Coffee
- Chocolate
- Citrus fruits
- Tomatoes
- Spicy foods
- Alcoholic beverages
- Caffeinated beverages
- Foods high in potassium
- Carbonated beverages
What Are the Symptoms of IC?
The symptoms of interstitial cystitis can vary from person to person. If you have this condition, your symptoms might change over time, occasionally getting worse due to common triggers like stress, physical activity, or sexual activity. Some people may experience symptom-free periods.
Typical signs and symptoms of interstitial cystitis include:
- Pelvic pain in women is often felt between the vagina and anus.
- In men, discomfort between the scrotum and anus (perineum).
- Ongoing pelvic pain.
- An urgent need to urinate that doesn't go away.
- Frequent urination, even in small amounts, throughout the day and night.
- Discomfort or pain as your bladder fills, with relief after urinating.
- Pain during sexual intercourse.
It's important to note that while interstitial cystitis symptoms can resemble those of a chronic urinary tract infection, there's usually no actual infection involved. However, if someone with interstitial cystitis gets a urinary tract infection, it can worsen their symptoms.
How is IC Diagnosed?
Diagnosing IC isn't straightforward because it shares symptoms with other urinary issues. To pinpoint IC, your doctor may include a combination of tests to arrive at an accurate diagnosis. These include:
- Medical history and physical examination.
- Lab testing of your urine.
- Cystoscopy. This involves inserting a thin, flexible tube with a viewing device through the urethra to inspect the bladder and urinary tract for structural changes or blockages.
- Bladder wall biopsy. Tissue samples are examined under a microscope to check for the presence of abnormal cells.
- Prostate secretions test (in men). A lab examination of prostate secretions may be conducted to identify inflammation or infection in the prostate.
IC Treatment
Treating IC can be challenging since there's no cure, but the goal is to alleviate symptoms. Some approaches include:
- Bladder enlargement - This procedure, also known as bladder augmentation, is a surgery that makes the bladder larger. Some people with IC have a bladder that isn’t big enough or the muscles are no longer able to stretch properly.
- Bladder wash - During a bladder wash or bladder instillation, various medications are placed directly into the bladder. The medications help to provide pain relief and decrease inflammation.
- Medications - NSAIDs, non-narcotic pain medications (like Uribel), or even opioid medications may be prescribed to help manage pain in patients with IC.
- Neuromodulation - Treatments like Urgent PC use electrical stimulation of nerves, such as the tibial nerve or the sacral nerve, to help reset nerves that are causing urinary urgency or frequency.
- Bladder training - During bladder training, urination is scheduled for specific times with an increasing interval. This can help decrease urinary frequency.
- Surgery - In severe cases where other treatments don't work, surgery may be considered. Surgery is typically a last resort and usually involves removing some or all of the bladder.
Interstitial Cystitis Diet
While no single food universally causes IC, many individuals experience symptom triggers related to their diet.
Discovering which foods can worsen your IC symptoms might require some trial and error. A helpful approach is maintaining a food diary to record when you experience bladder discomfort. For instance, your diary might reveal that your symptoms tend to flare up after consuming foods like tomatoes or oranges. If you identify specific foods that exacerbate your symptoms, your doctor and dietitian can collaborate with you to create a customized eating plan.
Another useful strategy involves temporarily removing certain foods and drinks from your diet and then reintroducing them one by one to see if they affect your symptoms.
Interstitial Cystitis Self Care
During an IC flare-up, you can take steps to care for yourself effectively:
- Stay well-hydrated by drinking extra water to dilute your urine.
- Apply an ice pack or warm heating pad to your abdominal area or the perineum for relief.
- Soothe your body with a warm sitz bath.
- Adopt relaxation techniques.
- Prioritize loose, comfortable clothing choices.
If sexual activity tends to trigger flare-ups, consider taking pain-relieving medications before intercourse and using lubricants during sex to minimize discomfort.
Frequently Asked Questions
Does interstitial cystitis cause blood in urine?
IC can sometimes lead to blood in the urine, a condition known as hematuria. However, not everyone with IC experiences this symptom, and its presence can vary in severity.
Is interstitial cystitis hereditary?
While evidence suggests a genetic component in IC, it's not solely hereditary. Lifestyle factors, environmental influences, and other unknown factors also play a role in its development.
Can interstitial cystitis go away?
IC is considered a chronic condition, and there is currently no known cure. However, the course of IC varies from person to person. Some individuals may experience periods of symptom improvement or even remission, where symptoms lessen or disappear for a while. Others may have persistent symptoms. The goal of treatment is typically to manage and alleviate symptoms rather than to cure the condition.
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