Key Points About Interstitial Cystitis
Interstitial cystitis is an inflamed or irritated bladder wall.
The cause of IC is unknown and it does not get better with antibiotics.
There is no best way to diagnose IC. A variety of tests may be needed. Urine tests will be done and imaging tests may be used to look at the different parts of the urinary tract and make sure everything is normal. Tissue samples may be removed from the bladder and examined under a microscope to see if cancer or other abnormal cells are present.
Treatments are aimed at easing symptoms. A variety of procedures, medicines, and lifestyle changes may be advised.
What Is Interstitial Cystitis/painful Bladder Syndrome
Interstitial cystitis/painful bladder syndrome is a common condition that usually affects women in their 40s. It is a condition that results in recurring discomfort or pain in your bladder and the surrounding pelvic region. The symptoms can vary from person to person and even in the same individual.
This condition is thought to occur in around one in fifty women. Around a quarter of people with this condition will have actually had some symptoms since they were children.
How Is It Diagnosed
Thereâs no test for interstitial cystitis. If you go to your doctor complaining about bladder pain along with frequency and the urgency to pee, the next step is to rule out what else it could be.
Both men and women would first need to rule out urinary tract infections, bladder cancer, sexually transmitted diseases, and kidney stones.
In women, endometriosis is another possibility. For men, IC can be mistaken for an inflamed prostate or chronic pelvic pain syndrome.
These tests can rule out other conditions:
- Urinalysis and urine culture. Youâll be asked to pee in a cup. Itâll be sent to a lab to check for infection.
- Postvoid residual urine volume. Using an ultrasound, this test measures the amount of pee that remains in your bladder after you go to the bathroom.
- Cystoscopy. A thin tube with a camera is used to see the inside of the bladder and urethra. This is usually done only if there is blood in your pee or if treatment doesnât help.
- Bladder and urethra biopsy. A small piece of tissue is taken and tested. This is usually done during cystoscopy.
- Bladder stretching. Your bladder is filled with liquid or gas to stretch it out. Youâll be asleep under anesthesia. Sometimes this is also used as a treatment. This is done with a cystoscopy.
- Prostate fluid culture . Your doctor will need to press on your prostate and milk a sample to test. This is not commonly done.
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What Is Painful Bladder Syndrome
Painful Bladder Syndrome
Painful bladder syndrome is a condition that causes bladder pain, pressure, or discomfort. Some people feel the need to urinate frequently or rush to get to the bathroom. The symptoms range from mild to severe and can happen sometimes or all the time. PBS is not caused by an infection, but it can feel like a urinary tract infection or UTI. Painful bladder syndrome is also referred to as bladder pain syndrome and interstitial cystitis. In the past, doctors thought PBS was rare and difficult to treat. We now know that PBS affects many women and men and treatments are helpful.
What causes PBS?
No one knows for sure, but we think PBS happens when the inner lining of the bladder is not working properly. This means that nerves in the wall of the bladder become hypersensitive so the normal feeling of the bladder filling can be painful. There may also be inflammation or allergic reaction responses in the bladder. Some people report developing PBS after an injury to the bladder such as a severe bladder infection or major trauma, but this is not always the case. PBS is more common in people who have irritable bowel syndrome, fibromyalgia, chronic fatigue syndrome, or other chronic pain conditions. It is not clear why these problems happen together.
What are the symptoms of PBS?
How is PBS diagnosed?
Do I need a cystoscopy?
How is PBS treated?
Simple changes to diet or routines can help some people with bladder pain. Steps might include
How Is Interstitial Cystitis Treated/managed
There is no cure for interstitial cystitis. Treatment and management is aimed at finding relief and achieving remission for each person.
- Hydro distension : this procedure is performed under anaesthesia. Relief from symptoms occurs in approximately half of patients. If the procedure is successful, relief can be obtained for weeks or even months. If successful, the procedure can be repeated.
- Instilled medications these are medications inserted into the bladder. The solution is held in the bladder for 10-15mins. The medication installed is Dimythyl Sulfoxide and is administered once a week for approximately 6 weeks. DMSO is known to reduce inflammation in the bladder and block or reduce pain. Other medications include: Heparin , Clorpactin or Bacillus Calmette-Guerin .
A new instillation called iAluril is now available. Ialuril works by helping to repair the damage layer in the bladder thereby restoring the bladders protective coating and therefore relieving symptoms. This is administered directly into the bladder through a catheter. The catheter is then removed and you are instructed to leave the solution in your bladder for ½ hour before urinating normally. Treatment is initially weekly for 4 weeks then once every 2 weeks for the second month then monthly until symptoms settle.
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What Are The Symptoms Of Interstitial Cystitis / Painful Bladder Syndrome
The key symptoms of Interstitial Cystitis / Painful Bladder Syndrome are pain, frequency of urination and urgency . The pain or sensation of bladder discomfort/pressure in IC / PBS is felt classically as the bladder fills with urine and is usually relieved by urination. The sensation of bladder discomfort drives the need to urinate and results in frequency of urination, usually both day and night. Symptoms can begin gradually or suddenly and with no apparent reason. In mild forms of IC / PBS or in the early stages of IC / PBS, symptoms may occur as transient attacks known as flares which may be mistaken for urinary tract infections. It is therefore important to have a urine culture to help distinguish these symptoms from a bacterial urine infection.
How Do You Know If You Have Ic
IC can be diagnosed with a proper history and physical from a urologist. It is first important to rule out an infection. Sometimes the urologist will feel it is appropriate to do other tests regarding bladder function and to rule out other causes for the symptoms described above. One test called a cystoscopy is when a camera is placed inside your bladder. The difference between IC and painful bladder syndrome is that the cystoscopy will show Hunners ulcers on the bladder in IC and the cystoscopy is normal in Painful Bladder Syndrome.
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My Interstitial Cystitis Story
About 17 years ago I found myself having strange symptoms after a few urinary tract infections in a short period of time. I think it was something like two in one month, meaning two separate rounds of antibiotics within 30 days or so.
After the infections were “gone” my symptoms were not. For the next year I noticed an increasingly sensitive bladder, meaning I felt the urgency to urinate a lot more frequently during the day, and even more at night, which was a pretty foreign experience for a 21-year-old who was used to sleeping like a rock.
That started a long decade of chronic pain and poor sleep . While IC is bad during the day, it’s even worse at night. Eating a trigger food during the day sometime meant a sleepless night or 10+ trips to the bathroom.
The discomfort grew over time. On the worst days I’d be up all night not able to sleep because I constantly felt stinging in my bladder and that I had to pee. It made no difference if I had gone 10, 4, or even 2 minutes ago. Even the smallest amount of urine would irritate my bladder leaving me unable to fall asleep or get restful sleep, period. Occasionally I’d go into my doctor to see if I had another UTI, but they’d always come back clean, a dead giveaway of interstitial cystitis or painful bladder syndrome. A condition that according to the internet “can’t be cured”…
What Is The Outlook
You may need to try different treatments until you have relief of your symptoms. It is important to know that none of the treatments usually works right away. It can often take weeks to even months before you notice an improvement in your symptoms. Even with successful treatment, your IC/PBS may not be completely cured.
However, most patients can have significant relief of their symptoms and lead a normal life with the right treatment. You may find that you still experience some symptoms, however, and may find that you constantly have to pass urine more frequently. It is likely that you will always have to avoid certain types of food that have made your symptoms worse in the past.
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What Are The Symptoms Of Interstitial Cystitis/painful Bladder Syndrome
It is common to experience mild discomfort, pressure, tenderness or intense pain in your bladder and pelvic area. These symptoms often persist for many weeks. The intensity of your symptoms can often fluctuate and so be different on different days. Some days your symptoms are likely to be more severe than on other days.
In addition to this pain, you are likely to have symptoms such as needing to pass urine more frequently and/or pain on passing urine. You may also find that you are not able to hold on to urine for as long as you used to. Such symptoms will have lasted for more than six weeks and not have been found to be due to another cause such as infection.
You may feel pain when having sexual intercourse. IC/PBS can affect the way you exercise and sleep and can cause a great deal of distress. Without treatment, IC/PBS symptoms make it hard to get through your day or even to be able to work. This can really affect not only your life but also your relationship with your partner.
Some people with IC/PBS have other conditions such as irritable bowel syndrome, fibromyalgia, chronic fatigue syndrome and other pain syndromes.
Why Choose Cooper To Diagnose And Treat Interstitial Cystitis
Cooper University Health Care has a comprehensive urogynecology program that is on the forefront of care for interstitial cystitis in women. Our team of fellowship-trained urogynecologists offers a full range of todays most advanced diagnostic and treatment services, provided in a caring, sensitive manner.
- We teach the next generation of urogynecologists through a respected fellowship programtestament to the high level of clinical expertise available here
- Our urogynecologists conduct leading-edge research, giving you access to the latest knowledge and advances in treating IC in women
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What Are The Risks If Interstitial Cystitis Is Left Untreated
If left untreated, bladder pain syndrome may cause the wall of the bladder to stiffen, causing a long-term decrease in bladder capacity. Pain with intercourse can negatively impact your sex life and romantic relationships, and pain and frequent need to urinate can cause major disruptions in your sleep schedule and everyday routine.
What Happens When You See A Gp
BPS can have similar symptoms to long-term or frequent UTIs, so the GP may give you a urine test to check for a UTI.
Standard urine tests used in GP surgeries and hospitals may not pick up all infections of the bladder. You may be prescribed antibiotics to see if they help.
A GP may also suggest simple treatments such as:
- keeping a food diary and avoiding foods and drinks that make your symptoms worse
- stopping smoking chemicals in tobacco can irritate your bladder
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What Are The Causes Of Painful Bladder Syndrome
The precise cause of interstitial cystitis is not known, but many cases are contributed to by a break in the bladders protective lining which allows harmful substances found in urine to leak through and cause irritation to the wall of the bladder. IC may also be caused by a faulty nervous system response which sends pain signals to the brain for functions which are not ordinarily painful. You may be more likely to have painful bladder syndrome if it has affected another member of your family, and you could also be at a higher risk if you have recently suffered an infection of the bladder.
How I Reversed My Interstitial Cystitis
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I’m surprised that in my 11 years of blogging, I haven’t told you this story yet. It took me some time to come to terms with my own internalized story with ‘invisible’ pain, and to really own my experience instead of minimizing and pretending it didn’t happen. For too long I associated pain with weakness, but now I realize how much stronger the pain has made me.
I was 21 when I first started experiencing symptoms of interstitial cystitis or painful bladder syndrome. I was new to chronic pain, and had no idea the long ride I was in for…
Also, it’s important to note my interstitial cystitis did not occur in a vacuum, I had digestive issues too, which you can read about here
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Should I Limit The Amount Of Fluids I Drink
No. Many people with bladder pain syndrome think they should drink less to relieve pain and reduce the number of times they go to the bathroom. But you need fluids, especially water, for good health. Getting enough fluids helps keep your kidneys and bladder healthy, prevent urinary tract infections, and prevent constipation, which may make your symptoms worse.9
How Is Painful Bladder Syndrome Diagnosed
Your doctor will begin by getting a detailed description of your symptoms and medical history and performing a physical exam of the pelvic region. A urine test may be performed to rule out urinary tract infection.
A cystoscopy may be performed. A cystoscopy is a diagnostic procedure in which a slender tube with a camera is inserted through the urethra to examine the inside lining of the bladder. During this procedure, your doctor may inject liquid into the bladder to test its capacity, or remove tissue to examine for signs of bladder cancer.
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Mayo Clinic Q And A: How To Treat Painful Bladder Syndrome
DEAR MAYO CLINIC: I am a 45-year-old woman with urinary challenges, including feeling the frequent urge to empty my bladder. My primary doctor said I might have interstitial cystitis and suggested I see a urogynecologist. Could you explain this condition? What are my treatment options, and will I recover?
ANSWER: Cystitis is the medical term for inflammation of the bladder. Most of the time, the inflammation is caused by an infection. But interstitial cystitis, also called painful bladder syndrome, is different. It is a disease that causes pressure or pain in the bladder and pelvis that is associated with trying to hold urine.
Symptoms can range from mild burning or discomfort to severe pain and a persistent, urgent need to urinate. Interstitial cystitis is a chronic condition that can be difficult to treat, which is why your primary care provider suggested a urogynecologist.
A urogynecologist is a specialist who cares for women with pelvic floor disorders. This includes bladder leakage, pelvic organ prolapse and pelvic pain.
Unlike other forms of cystitis, researchers don’t know the exact reason for interstitial cystitis. But many theories exist regarding its cause.
Some researchers believe that people with interstitial cystitis have a defect in the protective lining, or epithelium, of their bladder. A leak in the epithelium may allow substances in urine to irritate the bladder wall, causing pain.
What Are The Symptoms
These vary from person to person with IC. They can change every day or week or linger for months or years. They might even go away without any treatment.
- Bladder pressure and pain that gets worse as your bladder fills up.
- Pain in your lower tummy, lower back, pelvis, or urethra
- For women, pain in the vulva, , or the area behind the
- For men, pain in the scrotum, testicles, , or the area behind the scrotum
- The need to pee often
- The feeling you need to pee right now, even right after you go
- For women, pain during sex
- For men, pain during or after sex
The bladder pain people feel with IC can range from a dull ache to piercing pain. Peeing may feel like just a little sting, or it can feel like serious burning.
About 5% to 10% of people with the condition get ulcers in their bladder.
Things that might make symptoms worse:
- Some foods or drinks
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Symptoms Of Interstitial Cystitis
The symptoms of interstitial cystitis and painful bladder syndrome are pretty straightforward in that they often mimic those symptoms of a bladder infection, but without the infection:
- Bladder pressure
- Bladder fullness
As I look back on what my own symptoms and pain felt like, I’d describe it simply like this: remember when you were a kid and you’d skin your knee real bad? Then your parents or the school nurse would wash it out with an antibacterial solution that stung like crazy?! That’s what IC pain felt like to me, a constant stinging and burning feeling whenever a tiny bit of urine touched my bladder wall. This constant stinging discomfort left me constantly headed to the bathroom to relive the pain. But the problem is your body is always producing urine! It’s like a slow drip of pain all day long that becomes much worse at night because that’s when urine becomes more concentrated and acidic causing more irritation to the bladder wall.