Interstitial cystitis is a long-term (chronic) inflammation of the bladder wall.
Cystitis – interstitial; IC
Causes, incidence, 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 isoften misdiagnosed as a urinary tract infection. Patientscan 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.
Common symptoms of interstitial cystitis include:
- Pain during intercourse
- Pelvic pain
- Urinary discomfort
- Urinary frequency (up to 60 times a day in severe cases)
- Urinary urgency
Many people who have long-terminterstitial cystitisare also depressed because of the pain and changes to their lifestyle.
Signs and tests
The diagnosis is made by ruling out other causes. Tests include:
- Bladder biopsy
- Cystoscopy (telescopic examination of the bladder)
- Urine culture
- Urine cytology
- Video urodynamics (shows how much urine must be in the bladder before you feel the need to urinate)
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 you find relief.
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.
Other medicines may include:
- Narcoticpainkillers for severe pain
- Tricyclic antidepressants such as amitriptyline to relieve pain and urinary frequency
- Vistaril (hydroxyzine pamoate), an antihistamine that causes sedation, helps reduce urinary frequency
Other therapies that may be tried include:
- Over-filling the bladder with fluid while under general anesthesia(bladder hydrodistention)
- Bladder training (using relaxation techniques to train the bladder to go only at specific times)
- Medicinesplaced 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)
Some patients find that changes in their diet can help 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
- Artificial sweeteners
- Citrus juices
- Cranberry juice (Note: Although cranberry juice is often recommended for urinary tract infections, it can make IC symptoms worse.)
- Fava and lima beans
- Meats that are cured, processed, smoked, canned, aged, or that contain nitrites
- Most fruits except blueberries, honeydew melon, and pears
- Nuts except almonds, cashews, and pine nuts
- Rye bread
- Seasonings that contain MSG
- Sour cream
- Sourdough bread
Experts suggest that you do not stop eating all of these foods at one time. Instead, try eliminating one at a time to see if that helps relieve your symptoms.
For additional information and support, see interstitial cystitis support groups.
Treatment results vary. Some people respond well to simple treatments and dietary changes. Others may require extensive treatments or surgery.
Calling your health care provider
Call your health care provider if you have symptoms of interstitial cystitis. Be sure to mention that you suspect this disorder. It is not well recognized or easily diagnosed.
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Cody JD, Nabi G, Dublin N, McClinton S, Neal DE, Pickard R, Yong SM. Urinary diversion and bladder reconstruction/replacement using intestinal segments for intractable incontinence or following cystectomy. Cochrane Database Syst Rev. 2012;2:CD003306. DOI: 10.1002/14651858.CD003306.pub2.