Interstitial cystitis is a condition affecting the bladder that is caused by inflammation.
Both men and women can be affected, but approximately 90 percent of the time, women develop the condition.
- It is unknown why women are more often affected.
- The usual age of onset is 20 to 50 years.
It is not known what causes this condition. However, it is thought that multiple factors might play a role. For example, the lining that protects the bladder may have a defect that allows some of urine’s toxic substances to cause irritation. While unproven, it is theorized that heredity, an allergy, an autoimmune reaction, or an infection might contribute.
The symptoms vary and are often different for different patients. Over time, it is possible for the presentation of symptoms to change. In some cases, something may trigger a type of flare, causing the symptoms to worsen for a period of time. Triggers might include prolonged sitting, exercise, menstruation, stress, and sexual activity. The symptoms can include:
- Pelvic pain
- Pain between the anus and vagina, or anus and scrotum
- Chronic pelvic pain
- Frequent urination
- Painful intercourse
- An urgent and persistent need to urinate
- Discomfort as the bladder fills (this is generally alleviated after urination)
There are several treatment options that may be explored. Patients may require a combination of methods to get the most relief. Dietary changes are often recommended first, and the goal is to eliminate foods that might irritate the bladder to reduce pain and help to decrease the urination-related symptoms. Such foods may include:
- Carbonated beverages
- Artificial sweeteners
- Spicy foods
- Cranberry juice
- Monosodium glutamate
Bladder distension is another option. The patient is anesthetized and then either fluids or gas are used to essentially stretch the bladder walls. The fluids or gas will overfill the bladder. It is not fully understood why this provides relief for some patients. It is thought that it may improve the bladder’s ability to hold more urine. Another theory is that it interferes with the pain signals in the bladder that are sent by the nerves. It is possible for symptoms to be increased for up to three weeks. Bladder infection and blood in the urine are also considerations.
Bladder instillation involves introducing a liquid medicine into the bladder via the use of a catheter. Dimethyl sulfoxide is usually tried first. The fluid is held in the bladder for up to 15 minutes and then the patient will be asked to urinate to remove the liquid medication. This treatment is administered for six to eight weeks at one to two-week intervals. The purpose is to alleviate urination frequency, urgency, pain, and nocturia. The potential side effects depend on the medication used and may include discomfort during urination or increased urination urgency or frequency.
Pentosan polysulfate is an oral medication that doctors might prescribe. It works to protect the bladder wall lining from the urine’s toxic substances. Hydroxyzine, a type of antihistamine, can also be considered. It works to decrease how much histamine the bladder wall produces. To reduce bladder spasms and block pain, doctors may prescribe amitriptyline, a type of tricyclic antidepressant
A thorough overview of the patient’s condition, symptoms and medical history are necessary to determine candidacy for all treatment options.