Interstitial Cystitis

TYPES

• Non-ulcerative: A type where ulcerative lesions are absent.
• Ulcerative: Patients with IC of this type have Hunner’s ulcers. Hunner’s ulcers are red ulcerative patches on the bladder surface surrounded by mucous. Only 5-10% of IC patients have this type.

SYMPTOMS

Symptoms change every day and linger for months and even years. Common symptoms are:

• Bladder pressure and pain that worsens when the bladder gets filled
• Pelvic, and urethral pain (from dull to piercing pain)
• Pain in the vulva, vagina, and the area behind the vagina (for women)
• Pain in the scrotum or the area behind, testicles, and penis (for men)
• The need to pee frequently and urgently (more than eight times daily)
• The feeling that you need to pee even right after you go
• Pain during sex (for women)
• Pain during orgasm or after sex (men)
• Burning sensation when peeing
• accidental leakage of urine

Some factors that make the symptoms worse:

• Some food and drinks: high-acid foods, caffeinated beverages, MSG, food with artificial sweeteners
• Mental and physical stress
• Period

DIAGNOSIS

A simple urinalysis cannot identify interstitial cystitis. There is no definitive diagnosis for the condition. Doctors make a diagnosis by exclusion. IC shares the same symptoms with other bladder disorders. These include urinary tract infections, bladder cancer, chronic prostatitis, STD, bladder stones, kidney disease, multiple sclerosis, chronic pelvic pain syndrome, and endometriosis. Doctors have to perform tests (urine test, pelvic exam, biopsy, etc.) to rule them first. Once confirmed that your symptoms are not caused by any other disorders/diseases, your doctor may diagnose you with IC.

To know if you have an ulcerative IC, the doctor may need to perform Cystoscopy, in which the doctor will use a special tool to look at the inside of your bladder. The doctor will also require you to keep a bladder diary, note the volume of fluids you drink, how many times you pee, and the amount of your urine.

TREATMENT

Lifestyle changes: cut down stress, slowly retrain your bladder, do low-impact exercise, quit smoking, control water intake, and avoid food triggers

Common food triggers:

• High-acid foods
• Citrus fruits
• Tomatoes
• Chocolate
• Caffeinated drinks
• Alcohol
• Spicy foods
• Artificial sweeteners

For severe IC, talk to your doctor. Your doctor may recommend drugs that can relax your pelvic muscles, and relieve symptoms such as:

• Painkillers: amitriptyline, gabapentin, and pregabalin
• Antihistamine: hydroxyzine, loratadine, and cetirizine
• Pentosan (repairs the bladder lining)
• Dimethyl sulfoxide (placed with a catheter)
• Steroids (for ulcerative type)

Surgeries and therapies may be needed for rare and severe cases.