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Interstitial Cystitis - Symptoms, Causes, and Treatment

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Interstitial Cystitis -  Symptoms, Causes, and Treatment

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Interstitial cystitis is a chronic condition affecting the bladder. Read this article to know more about the symptoms, causes, and treatment.

Written by

Dr. Lochana .k

Medically reviewed by

Dr. Vaibhav Vishal

Published At August 12, 2020
Reviewed AtMarch 21, 2023

What Is Interstitial Cystitis?

Interstitial cystitis is also known as painful bladder syndrome. It is a tricky condition and is difficult to diagnose. Treatments can make life and health better, but the complete cure is questionable. If a person has urinary pain lasting for more than nine months, and if it is not caused by other conditions like kidney stones and other infections, they might have interstitial cystitis. The age of the patient should be more than 18 years to confirm the condition. Also, if the symptoms have not subsided after the administration of multiple antibiotics and anti-inflammatory treatments, then the doctor would choose to diagnose the condition as interstitial cystitis.

The disease can affect social life, sleeping patterns, and even the ability to work. Interstitial cystitis is associated with pain and urine urgency. Since it affects the bladder region, there are chances of sexual life getting affected. So, it can disrupt the personal relationships too. Interstitial cystitis commonly affects women. People first start having minor problems. The risk of getting interstitial cystitis goes up as the person ages.

What Are the Symptoms of Interstitial Cystitis?

The symptoms might vary from person to person. They can change every day or every week and are never periodic. They might even subside without any treatment.

The common symptoms are:

  • When the bladder is full, there will be an increase in bladder pressure and pain. The pain will also be felt in the lower abdomen, lower back region, pelvis, or in the urethra.

  • For women, there will be a pain in the vulva, vaginal region, or the anatomical region behind the vagina.

  • For men, there will be pain in the scrotum, testicles, and in the penis. There might also be pain behind the scrotum.

  • The urge to urinate often. It might exceed more than eight times a day.

  • Vaginismus. It is a pain occurring in women during intercourse.

  • Men might experience pain after ejaculation or immediately after sex.

The bladder pain that people feel with interstitial cystitis can range from dull to piercing pain. The urine might have a foul smell, or it can feel like burning. A small range of people with the condition might get an ulcer in their bladder.

What Are the Risk Factors?

  • Certain food and beverages.

  • Menstruation.

  • Mental stress. It affects the interpersonal relationship with the partner.

  • Physical stress. It can interrupt the general health patterns.

  • Having a family member with interstitial cystitis may increase an individual's risk of getting interstitial cystitis.

What Are the Causes?

The exact cause of interstitial cystitis is not known correctly. It is usually multifactorial. It may also be due to autoimmune reaction, genetics, infection, or allergic response.

  • People with interstitial cystitis may also have a defect in the protective lining of the bladder. Any leakage or damage in the epithelium may allow the toxic substances in urine to irritate the bladder. This defect in the bladder may allow the irritating substances in the urine to enter by penetrating the bladder directly.

  • A specific type of inflammatory cell known as a mast cell tends to release histamine and other chemicals. These chemicals can cause interstitial cystitis.

  • Alterations in the nerves that carry bladder sensations. These alterations might cause pain.

  • The body's immune system begins to attack the bladder. This might be similar to other autoimmune conditions.

How Is It Diagnosed?

There is no specific test for interstitial cystitis. The following tests can help rule out other conditions:

  • Urinalysis and Urine Culture: A urine sample will be collected and sent to a laboratory to check for infections.

  • Cystoscopy: A thin tube with a camera is inserted inside in the bladder and urethra, and then they are visualized.

  • Bladder Stretching: The bladder is filled with liquid or gas, and the patient will be asked to stretch it out. The patient will be put under anesthesia. This is used as a treatment and is done with the help of cystoscopy.

  • Bladder and Urethral Biopsy: A small piece of tissue is taken and tested in the laboratory.

  • Postvoid Residual Urine Volume: This test measures the amount of urine remaining in the bladder even after urination.

What Is the Treatment?

A particular treatment does not work for all people. Treatment must be chosen differently for each patient, depending on the symptoms. Patients usually try different treatments until proper relief occurs. Most treatments are aimed at controlling the symptom. Interstitial cystitis treatment is done in five distinct phases with constant monitoring of the pain and to check the quality of life. It is essential to talk to the healthcare provider about how the treatment is working so, that together the patient can also find the best treatment option for himself.

The following are the different phases of the treatment:

  • The first phase involves the necessary lifestyle changes. This will enable the person to come out of the comfort zone and achieve good health.

  • The second phase involves following prescription drugs properly.

  • The third phase comprises neuromodulation therapy, ulcer cauterization, and injections.

  • The fourth phase involves medications like Cyclosporine.

  • The fifth phase is the final stage. It involves surgery.

The interstitial cystitis symptoms can come back even if the disease has been in remission for an extended period of time. The exact cause of recurrence is not known. Also, there is no known method to prevent recurrences. Patients can try to avoid the symptoms by:

  • Staying on their medical treatments even after remission of the condition.

  • Avoiding certain foods that may irritate the bladder and cause infection.

  • Avoiding certain activities or stresses that might make interstitial cystitis worse.

The specific foods or activities that affect interstitial cystitis are different for various patients, and so each person has to discuss their individual plan with the doctors.

What Is the Differential Diagnosis of Interstitial Cystitis?

  1. Urinary tract infection.

  2. Sexually transmitted diseases.

  3. Kidney stones.

  4. Tumors in the bladder.

What Are the Complications?

Interstitial cystitis can lead to various complications and some of which include:

  • Reduced bladder capacity.
  • Lower quality of life.
  • Emotional troubles.
  • Sexual intimacy problems.

Conclusion:

Interstitial cystitis is a common condition affecting the frequency and urgency of using the restroom and causing discomfort in the bladder area. This can cause various complications in the patient’s life emotionally and sexually. This condition can be controlled by following an effective treatment plan.

Frequently Asked Questions

1.

Can Interstitial Cystitis Go Away?

Interstitial cystitis or bladder pain syndrome (BPS) is a chronic bladder issue with pain and pressure in the bladder area. It goes away on its own in most cases, and those who require treatment get their lives back to normal with great relief.

2.

What Is the Best Treatment for Interstitial Cystitis?

Medications that improve the signs and symptoms are,
- Nonsteroidal anti-inflammatory drugs - To relieve pain.
- Ibuprofen.
- Naproxen sodium.
- Tricyclic antidepressants -To relax bladder pain.
- Amitriptyline.
- Imipramine.
- Loratadine (Antihistamine) - To reduce urinary urgency and frequency.
- Pentosan polysulfate sodium (Elmiron) - Specifically helpful for treating interstitial cystitis.

3.

How Do You Test for Interstitial Cystitis?

Intestinal cystitis can be diagnosed by,
- Medical history.
- Bladder diary.
- Pelvic exam.
- Urine test.
- Cystoscopy.
- Biopsy.
- Urine cytology.
- Potassium sensitivity test.

4.

How Long Does Interstitial Cystitis Last?

The early stage of interstitial cystitis accompanies the symptoms, and these symptoms flare up over time with pain and appear for 2 weeks. Pain can be accompanied by urinary tract symptoms and can last for more than 6 weeks. When these symptoms last longer, they are referred to a specialist.

5.

What Triggers Interstitial Cystitis?

The common triggers of interstitial cystitis are coffee, chocolate, soda, hot and spicy foods, alcohol, tomatoes, citrus juices, high-acid foods, and caffeinated beverages.

6.

What Happens if Interstitial Cystitis Goes Untreated?

Intestinal cystitis (IC) mimics urinary tract infections, but when it is left untreated, it may stay over time and get worse with a long-lasting impact affecting the quality of life.

7.

What Is the Difference Between Uti and Interstitial Cystitis?

- Interstitial cystitis does not have bacteria, and on a urine culture test, the results will be negative, unlike urinary tract infections. So, interstitial cystitis is difficult to treat and diagnose when compared to urinary tract infections.
- Interstitial cystitis is a chronic inflammatory condition of the bladder lining and is not an infection.
- With interstitial cystitis, there will be pain and pressure around the bladder area and pelvic region, and women also experience pain during sexual intercourse where these are not commonly associated with urinary tract infections.

8.

How Do You Calm an Interstitial Cystitis Flare-Up?

The general self-help techniques to reduce the interstitial cystitis flare-ups are:
- Relaxation techniques.
- Meditation or visualization.
- Learn self-hypnosis.
- Massages.
- Increase coping skills and reduce stress.
- Relax often as possible.

9.

How Serious Is Interstitial Cystitis?

Interstitial cystitis can result in several complications, such as,
- Stiffening of the bladder wall causes reduced bladder capacity.
- Frequent urination and pain affect the quality of life.
- Affects sexual relationships.
- Emotional stress and depression.

10.

How Painful Is Interstitial Cystitis?

Interstitial cystitis causes bladder pressure, bladder pain, and also pelvic pain. The pain ranges from mild discomfort to severe pain, and the condition is also called bladder pain syndrome (BPS), which is a chronic bladder issue.

11.

What Is End-Stage Interstitial Cystitis?

End-stage interstitial cystitis is the severe form of interstitial cystitis, where about 5 % of interstitial cystitis cases have persistent symptoms for more than two years with very hard bladders and terrible pain. These patients are also associated with urinary urgency.

12.

What Is a Good Diet for Interstitial Cystitis?

A balanced diet with a wide variety of food groups is the best diet for interstitial cystitis (IC). Always take fruit as such without having juice. In the case of fruit juice, take 100% fruit juice. Take vitamin C-rich fruits often and select unsweetened fresh fruits.

13.

Can Dehydration Cause Interstitial Cystitis?

Dehydration can cause interstitial cystitis due to the concentration of urine irritating the lining of the bladder. But also, drinking plenty of water is not agreed by everyone with interstitial cystitis, and when they drink less, they have fewer painful trips to the bathroom.

14.

How Much Water Should You Drink With Interstitial Cystitis?

With interstitial cystitis, always remember that many foods already contain fluids, and try to drink at least 6 to 8 glasses of water per day. It is necessary to increase the intake of water if you are drinking less than 1.5 liters per day.

15.

Is It Normal to Bleed With Cystitis?

In the case of hemorrhagic cystitis, there will be bladder inflammation along with blood in the urine. There are four grades of hemorrhagic cystitis, depending on the amount of blood in the urine. They are,
- Grade 1 - Bleeding not visible.
- Grade 2 - Bleeding is visible.
- Grade 3 - Bleeding with small clots.
- Grade 4 - Bleeding with clots.
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Dr. Lochana .k
Dr. Lochana .k

Dentistry

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