Interstitial Cystitis - Symptoms, causes, treatment

Interstitial Cystitis Symptoms​

Interstitial cystitis (IC), also called painful bladder syndrome, is a continuing condition that produces pain and other symptoms related to the bladder. Possible symptoms can range from mild to severe and flaring-up randomly. Common symptoms include:

• Pelvic Pain
• Frequent Urination
• Urgency to Urinate
• Pain during Urination
• Pain during Sexual Activity
• Bladder Pressure
• Pain Relief after Urination

Interstitial Cystitis Treatment​

There is no known cure for interstitial cystitis, the treatment is purely for management of the symptoms. There are, however, ways of managing these conditions by altering lifestyle, taking drugs and undergoing certain treatments.

Lifestyle & Dietary Changes

• Avoid Trigger Foods
• Stay Hydrated
• Pelvic Floor Exercises
• Bladder Training
• Manage Stress

Medications

• Oral Medications
• Bladder Instillations

Medical Procedures

• Bladder Distension
• Nerve Stimulation
• Botox Injections
• Surgery

Interstitial Cystitis Causes​

The cause of such condition is not well understood but is assumed to be due to factors that cause inflammation and impaired function of the bladder. Some possible causes include:

• Bladder Lining Defects
• Autoimmune Reaction
• Nerve Dysfunction
• Mast Cell Activation
• Chronic Infections or Inflammation
• Genetic & Hormonal Factors
• Pelvic Floor Dysfunction

Interstitial Cystitis Diagnosis​

It is necessary to understand that there is no one single test that can be used to diagnose interstitial cystitis. However, antiviral drugs to cure the disease do exist while doctors perform differentiation diagnosis to eliminate other diseases.

• Medical History & Symptom Review
• Physical Exam
• Urine Tests
• Cystoscopy
• Potassium Sensitivity Test
• Bladder Biopsy
• Urodynamic Testing

Interstitial Cystitis and Pregnancy​

Pregnancy is influencing interstitial cystitis (IC) in various ways. Some women are relieved of their symptoms as other see their condition aggravated by hormonal changes and pressure on the bladder.

Effects of Pregnancy on IC

• Relief of the symptoms – some women stated that the inflammation was reduced possibly due to increase levels of progesterone since it has an anti-inflammatory effect.
• Worsened symptoms – Some others have increased pressure in the bladder; the pressure to urinate frequently or feel pain because of the uterus size.
• Flare-ups – Sometimes one feels stressed and this can cause flare-ups, hormonal changes – This is because some individuals go through hormonal changes and these may cause flare-ups in the affected area, changes in diet, and stress.

Interstitial Cystitis Flare-up Relief​

It is also to be noted that flare-ups can occur due to stress, diet, hormonal changes, or issues of some other nature. There are also measures that can be taken to ease the discomfort upon the onset of an interstitial cystitis flare:

Dietary Adjustments

• Pass more water so that urine does not irritate the bladder as this may lead to the formation of cysts.
• Avoid trigger foods such as:

Caffeine (coffee, tea, soda)

Spicy foods

Acidic foods (tomatoes, citrus fruits)

Artificial sweeteners

Alcohol and carbonated drinks

Chocolate

• Eating certain foods that do not irritate the bladder such as pears, melons, rice, potatoes, plain yogurt, lean proteins.

Pain Management

• Heat – Finally, apply heat on the lower abdomen by either using a heating pad or warm compress.
• Do cool therapy – There are times when use of ice telescopic may reduce the severity of the pain experienced by an individual.
• Pelvic floor relaxation – It is recommended to strengthen pelvic floor muscles that may be loose through contraction and flexibility exercises or breathing exercises.

Bladder Care

• Drinking ½ teaspoon of baking soda with a glass of water – This solution is used to neutralize the urine acidity if the patient tolerates it.
• One must empty his bladder whenever it feels that it is full since this can cause the bladder to be irritated.

Medications (Use under the advice of the physician)

• Acetaminophen (Tylenol) – For pain relief.
• Anti-inflammatory medications (e.g., hydroxyzine) – Should be taken to decrease inflammatory reactions.
• Urinary analgesics (for example, Phenazopyridine or Azo) – Pain and urgency can be relieved by their help (do not use it for more than several days).

Stress Reduction

• When in pain, one should try to practice deep breathing, meditation, or yoga to calm the muscles and decrease pain.
• It is recommended to take a warm bath to ease muscles and any pain that is present.

Gentle Exercise

• A few examples of beneficial activities to be performed at intervals are walking, stretching, or any other movement that aids in blood circulation and alleviation of tensions.
• In general, one should abstain from any activities that are likely to trigger the worsening of the symptoms.

Interstitial Cystitis Pain Management​

In managing IC pain, one has to change their lifestyle, take medicine, and undergo some therapies. Below are some ways through which pain can be managed:

Home Remedies

• Heat Therapy– One should apply heat that include a heating pad or warm compress to the lower abdomen to relieve muscle tension and pain.
• Cold Therapy – Some patients prefer applying an ice pack in order to reduce sensitivity of the affected area.
• Baking Soda Bath – Consuming a solution prepared by dissolving ½ teaspoon of baking soda in water may also help in decreasing the acidity of the urine (if not compromised).
• Epsom salt baths – The warm water mixed with Epsom salt should help relax the muscular pull in the areas of the pelvis and assist with the pain.

Dietary Adjustments

• Do not use stimulants such as coffee, alcoholic beverages, chili spices, sour fruits, chocolates, sorbitols, and soda drinks.
• Diet changes, consume foods that are beneficial to the bladder which include pears, melons, rice, oats, potatoes, lean proteins among others.
• He advised the patients should drink more water to dilute the urine so that it does not constitute a source of discomfort to them.

Medications (It is advised that one consults a doctor for the usage of the following)

• Acetaminophen (Tylenol) – For mild pain relief.
• Tricyclic Antidepressants (e.g., Amitriptyline) – It is prescribed to decrease the affected bladder nerves sensitivity.
• Antihistamines (e.g., Hydroxyzine) – Reduce inflammation and bladder irritation.
• Urinary Analgesics (e.g., Phenazopyridine, Azo) – Provide short-term pain relief.
• It is done by instilling medications such as DMSO, Lidocaine and Heparin into the bladder under the supervision of a doctor.

Pelvic Floor Therapy

• There are a couple of useful stretches which are able to minimize the tension in the pelvic area and ease the pain in the bladder.
• If the muscles of the pelvic region are tight, it may be advised to take up physical therapy.

Nerve Stimulation

• TENS (Transcutaneous electrical stimulation) – An electrical stimulation that is used to diminish pain impulses.
• Interstim – A therapy used to apply signal to nerves in the leg thus helping to ease bladder pain.

Stress Reduction

• Yoga, meditation and deep breathing practices have the potential of reducing stress leading to flare-ups.
• Support in form of counselling groups could prove useful in order to address the emotional issues arising from injection use.

Interstitial Cystitis Specialist​

• Dr. Rajiv Yadav, Artemis Hospital, Gurgaon
• Dr. Gagan Gautam, Medanta-The Medicity, Gurgaon
• Dr. Vikram Sharma, Fortis Memorial Research Institute, Gurgaon
• Dr. Anupam Bhargava, Max Hospital, Saket

Interstitial Cystitis Prognosis​

The symptoms of IC can be controlled successfully through lifestyle adjustments, drug, and non-pharmacological interventions. Its prognosis also depends with each individual in terms of symptoms manifested and response to applied treatment plan.

Factors Influencing Prognosis

• Trigger management – Steer clear of food, stress, and lifestyle triggers to minimize flare-ups.\
• Treatment adherence – Adhering to an individualized treatment plan enhances long-term success.
• Coexisting conditions – IC occasionally coexists with fibromyalgia, irritable bowel syndrome (IBS), and pelvic pain disorders, which can impact symptom management.