Excruciating Interstitial Cystitis

Interstitial cystitis (IC) is a chronic pain condition that affects the bladder. Many experts now call it bladder pain syndrome (BPS). Interstitial cystitis can have a long-lasting adverse effect on your quality of life. The symptoms vary from case to case and even in the same individual. People may experience mild discomfort, pressure, tenderness, or intense pain in the bladder and pelvic area and an urgent need to urinate, a frequent need to urinate, or a combination of these. Pain may change in intensity as the bladder fills with urine or as it empties. Interstitial cystitis can affect children and men, most of those affected are women. Women’s symptoms often get worse during menstruation. They may sometimes experience pain during vaginal intercourse.

The cause of IC/BPS is unknown, though several theories have been put forward (these include autoimmune theory, nerve theory, mast cell theory, leaky lining theory, infection theory and a theory of production of a toxic substance in the urine). Other theories are neurologic, allergic, genetic and stress-psychological. IC patients may have a substance in the urine that inhibits the growth of cells in the bladder epithelium. The majority of IC/BPS patients struggle with a damaged urothelium, or bladder lining. When the surface glycosaminoglycan (GAG) layer is damaged (via a urinary tract infection (UTI), excessive consumption of coffee or sodas, traumatic injury, etc.), urinary chemicals can “leak” into surrounding tissues, causing pain, inflammation, and urinary symptoms. Oral medications like pentosan polysulfate and medications that are placed directly into the bladder via a catheter sometimes work to repair and rebuild this damaged/wounded lining, allowing for a reduction in symptoms.

bladder pain syndrome
The diagnosis of IC/PBS in the general population is based on the presence of pain related to the bladder, usually accompanied by frequency and urgency of urination and the absence of other diseases that could cause the symptoms. Diagnostic tests that help rule out other diseases include urinalysis, urine culture, and cystoscopy, biopsy of the bladder wall and urethra, and distention of the bladder under anesthesia. Also, to examine this disease in some patients, gene expression study of urine sediment can be of great non invasive help. The Hunner lesions (bladder ulcer cells) show a distinct gene signature for inflammation which is same to the results of micro array analysis of bladder biopsies. As an alternative to bladder biopsies, micro array technology helps to examine the cells which are shed into the urine. The treatments of IC include medications, a proper diet, surgery, pelvic floor treatments and bladder distention.

Excruciating Interstitial Cystitis
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