Interstitial Cystitis: Symptoms and Treatment

Interstitial Cystitis (IC) is a disorder that affects the urinary system of the body. In this condition, the person experiences pain in the bladder and the pelvis. 'Cystitis', which means swelling of the bladder, causes discomfort that intensifies over time. A recent study suggests that more than 1 million people have been affected by this painful bladder syndrome. Although, the disorder can occur in both sexes, women are more affected. About 10 percent of IC patients also have ulcers in their bladder.

Symptoms of Interstitial Cystitis

People with interstitial cystitis often have painful urinary symptoms. The pain varies from mild to severe and differs from patient to patient. Severe symptoms of IC may force the person to urinate almost 50-60 times a day. Stress may worsen IC symptoms. The condition of women suffering from interstitial cystitis may aggravate during their periods. Symptoms may include:

• Inflammation of the interior bladder wall.
• Mild to intense discomfort in the bladder and pelvic area: in men, there is discomfort in the scrotum and penis; in women, pain is experienced between the anus and vagina.
• Frequent urination; urgent or frequent need to urinate.
• Nocturia or need to urinate many times at night.
• Bladder cannot expand even after it is filled with urine.
• Decreased bladder capacity; bladder is unable to hold much urine.
• Bladder wall may become stiff or scarred (red and sore). Recurrent irritation of bladder wall causes pinpoint bleeding.
• Feeling of pressure around the bladder increases tremendously when the bladder is full.
• Random swelling of the abdomen.
• Pain and discomfort during sexual intercourse.

Treatment for Interstitial Cystitis

Doctors generally suggest a healthy diet, free from spices, tomatoes, caffeine and citrus beverages. Evidence has shown that IC patients can get considerable relief by avoiding these food items. Drinking and eating food products that contain artificial sweeteners and alcohol should also be avoided, as intake of these foods intensify IC symptoms. When it comes to oral medication, heparinoid (elmiron) is the most commonly prescribed medicine to treat this condition. This medicine helps to repair and restore the tissues in the bladder. Antidepressants like elavil also help to block and decrease bladder spasms. Generally, people diagnosed with severe interstitial cystitis are given heparinoid for about 2 years to improve their condition. Patients with mild symptoms of IC are given painkillers like aspirin and ibuprofen to reduce their discomfort. Drugs such as pyridium and prodium can relieve IC symptoms (urgency to urinate and urinary pain).

Non-surgical Treatment

If oral medications fail to provide relief to the patient, then other modes of treatment, such as non-surgical procedures are used. These procedures are, in most cases, effective and help reduce pain and increase the capacity of the bladder. The following non-surgical procedures are performed:

Bladder Instillations: Bladder instillation or bladder wash is a procedure that involves filling the bladder with a therapeutic solution using a catheter (a narrow tube). A rescue solution which is a mixture of lidocaine, heparin and a topical anesthetic is the most commonly prescribed solution to fill the bladder. The solution is held for some time, ranging from a few seconds to several minutes, before allowing it to drain through the catheter. This method of treatment gives desirable results, as it reduces pain and anxiety of the patient to a great extent. For the treatment to be effective and to achieve long lasting relief, the procedure needs to be performed several times.

Hydrodistention (Stretching of Bladder): In this procedure, water is filled in the bladder. As a result, the bladder expands considerably, which can be quite painful. Hence, general anesthesia is administered to the patient before starting this procedure. This form of treatment can help improve IC symptoms and increase bladder capacity.

Surgical Treatment

Surgical procedures are used, when IC patients do not respond to conservative treatments. If the pain does not recede, doctors recommend surgery. However, patients should discuss all the possible risks and complications with the doctor prior to the surgery. The following bladder surgeries may relieve IC symptoms:

Augmentation: This involves enlarging the bladder by introducing a section of the small intestine in the bladder. The treatment removes inflamed, ulcerated, and scarred sections of the bladder.

Cystectomy: In this procedure the bladder is completely removed to get rid of IC symptoms. Once the the doctor removes the bladder, different methods are used to provide a new route for urine output.

Doctors are still unable to determine the causes of interstitial cystitis; hence, there are no guidelines to prevent this disease. However, occurrence of this condition can be greatly reduced by limiting the intake of foods and drinks mentioned above.