How to manage your painful bladder syndrome
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Interstitial cystitis — or IC (sometimes referred to as painful bladder syndrome) — is a chronic, yet treatable, condition of the bladder that affects both women and men. If you think you have IC, it may seem like no one understands what you're going through. Remember, you're not alone. Your doctor can help with treatment for your IC.
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To better understand interstitial cystitis (IC), it's helpful to have some knowledge of the urinary system and what might cause IC. Here's a short overview.
The urinary system is composed of various organs, tubes, muscles, and nerves that work together to create, store, and carry urine.
The kidneys produce urine, a fluid containing irritating substances and natural waste products. From each kidney, the urine flows through a long thin tube called the ureter. From the ureters, the urine travels to the bladder.
The bladder is an organ located in the pelvic area. It is a muscular sac responsible for storing and emptying urine. Since the bladder may store urine for several hours, it has a protective lining to shield its wall from the irritating waste products of the kidneys. This protective mucous lining is called the glycosaminoglycans (GAG) layer.
This layer is supposed to act as a barrier to keep the irritating substances of the urine away from the bladder wall.
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What Causes Interstitial Cystitis?
No one is 100% sure of what causes IC, but experts who study IC do have several theories to help explain why some people develop IC and others don't.
Some evidence points to irritating substances in the urine or damage to nerve cells along the bladder wall. Other evidence suggests that IC is caused by the body's own natural defense system turning on itself. Chronic pain in the bladder may also be aggravated by allergies. In some patients, symptoms may get worse when certain foods are eaten. Some experts also believe that the bladder's GAG layer has become thinned or is absent. A damaged GAG layer may allow irritating substances in the urine to aggravate the bladder wall and cause inflammation and pain.
Medical experts believe that many causes could actually be working together, resulting in the same set of painful symptoms common in IC. Fortunately, there's a growing awareness of IC.
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What are the symptoms of Intersitial Cystitis?
- You feel unexplained pain or pressure in the urethra, the vagina, the area above the pubic bone, the inside of the thighs, the lower abdomen, the lower back, the groin area, or any combination of these areas
- You feel pain during or after sexual intercourse.
- You have frequent, sometimes painful, urination. (Normally, people urinate an average of 6 to 7 times per day. Patients with IC urinate an average of 16 times per day.)
- You wake up one or more times at night to urinate.
- You feel the urge to urinate, sometimes even after you've emptied your bladder.
- You have unresolved symptoms of a urinary tract infection (UTI) that have not responded to antibiotic therapy.
- Your symptoms come and go — flare-ups may be associated with menstruation, certain foods, allergies, and stress.
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Misdiagnosis is Common
Although more and more doctors are gaining awareness of interstitial cystitis (IC), this condition may often be undiagnosed for a long time. And it 's not uncommon for someone with IC to see several doctors, over the course of many years, before they are actually diagnosed with the condition. That's why it's important to find a doctor who is familiar with IC. Urologists and obstetrician/gynecologists (OB/GYNs) are 2 types of specialists who tend to be most familiar with the diagnosis and treatment due to their specialized clinical experience.
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Other Conditions
Because the symtpoms of IC can be similar to other conditions, it's possible for it to be mistaken for something else. As a result, sometimes patients who have IC receive inappropriate treatment. Also, because it's possible to have IC in addition to another medical condition, such as endometriosis, understanding and communicating all of your symptoms to your doctor is important. Your doctor may evaluate you for other conditions.
IC is a chronic condition of the bladder that's characterized by urinary urgency, frequency, and pelvic pain. As mentioned, IC has many symptoms that are in common with other conditions, such as: Chronic Pelvic Pain (CPP), Recurrent Urinary Tract Infections (UTIs), Endometriosis, Overactive Bladder (OAB), and Vulvodynia.
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Diagnosis of Interstitial Cystitis
Unfortunately, there is no single test to determine whether or not a person has interstitial cystitis (IC). But, by working with your doctor, it is possible to get the right diagnosis. Your doctor must first rule out other conditions that may be causing your symptoms, including bladder cancer. To do that, there are a few things your doctor may explore.
- Review Your Medical History
Information about your medical history may provide important insights into what may be causing your symptoms. Some typical things your doctor will ask about are any medications you're currently taking, any allergies you may have, and any medical problems or conditions you may have.
- Explain and Track Your Current Symptoms
It's very important to communicate the symptoms you are currently experiencing to your doctor, along with their severity and when they flare up. An easy and helpful way to track your symptoms is to keep a symptom journal and to share it with your doctor.
- Conduct Diagnostic Tests
Several diagnostic tests may be used to help your doctor identify the exact cause of your symptoms. Here are some that your doctor may conduct:
- – Urinalysis and urine culture:
These tests can detect and identify the most common bacteria that infect the urine and that may cause symptoms similar to those of IC. Organisms such as chlamydia, however, cannot be detected through these methods, so a negative culture does not rule out all types of infection. After a clean urine sample is collected, it is tested.
White and red blood cells and bacteria in the urine may indicate an infection of the urinary tract, which can be treated with an antibiotic. But if urine is sterile for weeks or months while symptoms persist, the doctor may consider a diagnosis of IC.
- – Other diagnostic tests may include cystoscopy and urodynamics.
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Treating Interstitial Cystitis
If you do, in fact, have interstitial cystitis (IC) or think you might have IC, it's important to know that it's a treatable medical condition. Your doctor can help you manage your symptoms and find the IC treatment that's right for you. Although there is no known cure for IC, there may be other treatment options that may bring relief—some more invasive than others. Talk to your doctor about the treatment options best for you.
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Lifestyle and Diet Changes
In addition to traditionally prescribed treatments for IC, some IC patients may find that they experience some degree of temporary symptom relief by making certain IC diet and lifestyle changes.
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