Interstitial Cystitis

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1 Interstitial Cystitis Introduction Interstitial cystitis, or IC, is a chronic problem where the bladder wall can become inflamed and irritated. It is much more common in women than in men. Some doctors use the term painful bladder syndrome, or PBS, to describe interstitial cystitis. This is because the condition often causes bladder pain, as well as an urgent need to pee often. The condition may also be referred to by doctors as IC/PBS for short. This reference summary will help you understand IC, including symptoms and causes. It also covers the diagnosis and treatment of this condition. The Urinary Tract Your bladder is a part of the urinary tract. The urinary tract is made up of organs that make and release urine. These organs include the: Kidneys Ureters Bladder Urethra The body has two kidneys. The kidneys filter blood and make a liquid waste called urine. Urine passes from each kidney into the bladder through a long tube called a ureter. Kidneys Ureters Bladder Urethra Your bladder is a hollow organ in the lower abdomen. The bladder stores urine until it passes out of the body. When a person goes to the bathroom, urine leaves the bladder and travels outside of the body through a shorter tube called the urethra. 1

2 Symptoms There are three main symptoms of IC: Strong urges to pee Needing to pee more often than normal, also known as frequency Pain Urgency is the feeling that you need to pee right away. Urgency is normal if you haven t gone to the bathroom for a few hours or if you have been drinking a lot of fluids. You may have a problem if you get strong urges to pee before your bladder is full. Needing to pee more often than normal is another symptom of IC. This is especially true if you are urinating more than 8 times a day. If you drink large amounts of fluid or take diuretics, the need to pee more often is normal. Frequency is a sign of a problem when you aren t drinking a lot of fluid or taking diuretics. Diuretics are also known as water pills. They are medications that make the body produce more urine. The third main symptom of IC is pain. Pain is more than just a feeling of discomfort when you need to go. You may have a problem if you feel burning or sharp pain in your bladder or urethra. Not everyone has all three symptoms. Some people have only pain. Others may have no pain but have strong urges to pee and pee often. Women with IC often experience worse symptoms during their periods. They may also feel pain during sexual intercourse. If you have any of these symptoms, check with your healthcare provider. The symptoms may be caused by other diseases, infections, medications, diet and/or lifestyle. For example, drinking lots of water may cause you to pee more often. Causes Doctors do not know what causes IC. It is thought that people with IC have bladders that are more sensitive to urine. Substances in urine can irritate the bladder lining. Diet may play a role in interstitial cystitis. Certain foods can irritate the bladder, such as caffeine and citrus products. 2

3 Lifestyle choices may cause a frequent and urgent need to pee. Wearing tight clothing can put pressure on the abdomen and increase the need to pee. Smoking may have the same effect because nicotine causes the bladder to contract, or squeeze together. It can also lead to bladder cancer. Other factors that are thought to cause or worsen IC symptoms include: Allergic reaction Autoimmune reaction Genetics, or inherited traits Infection An autoimmune reaction is when the body recognizes its own cells or tissues as foreign and attacks them. While doctors do not know what causes IC, they do know some risk factors. Risk factors increase a person s chances of getting a disease. People at higher risk of IC include: Women People in their 40s People with other chronic pain disorders, such as irritable bowel syndrome Diagnosis Other diseases can cause symptoms similar to those of IC. Doctors diagnose a patient with IC after ruling out other diseases such as: Medication side effects Bladder cancer Bowel disorders Endometriosis Infection Endometriosis is when tissue that normally lines the uterus, or womb, appears in other places outside of the uterus. In order to rule out other causes, your healthcare provider may order some tests. There is no single test that can diagnose IC. This section explains some of the tests that may be used. 3

4 Your healthcare provider may ask you to keep track of your symptoms in a diary. The diary can help you keep track of how much you drink and how much you pee. A pelvic exam may be done for women to check the health of the reproductive organs. Sometimes problems with the reproductive organs can cause bladder symptoms. Your urine may be tested by the lab. The lab checks the urine for infections, blood, cancer cells, and other signs of disease. Blood tests may also be ordered. A potassium sensitivity test uses two different solutions that are placed in the bladder. One is water and the other is potassium chloride. People with normal bladders can t tell a difference between the two solutions. People with IC may have more pain or urgency with the potassium solution. A cystoscopy is another possible test. During a cystoscopy, your doctor uses a thin, lighted tube called a cystoscope to look directly into your bladder. Your doctor can remove samples of abnormal tissue with a cystoscope. This is called a biopsy. A pathologist examines the tissue under a microscope. A biopsy checks for cancer and other rare causes of bladder symptoms. Treatment IC cannot be cured. However, treatments often help most people feel better. No one treatment for IC has been found that works for everyone. Your healthcare provider will work with you to find a treatment that meets your needs. Treatment for mild IC may include: Physical therapy Reducing stress Retraining your bladder to hold more urine 4

5 Diet and lifestyle changes may also help treat mild IC. Many people find relief by eliminating foods that can irritate the bladder, such as caffeine and citrus products. Some people also feel better by avoiding clothes that are tight on the abdomen or by quitting smoking. A procedure that stretches the bladder may also help with IC. During this procedure, the bladder is stretched by filling it with liquid or gas. Medications may also help. Medications that may be used to treat symptoms include: Ibuprofen, to reduce inflammation and relieve pain Certain antidepressants, to help your bladder relax and block pain Antihistamines, to reduce urgency and frequency A special medication called Elmiron may be prescribed to treat bladder pain and discomfort. It is currently the only oral medication approved specifically for interstitial cystitis. Liquid medicines placed in the bladder may also be used. If these treatments do not help, your healthcare provider may recommend nerve stimulation. This treatment sends mild electrical pulses to the nerves that control the bladder. It helps relieve the symptoms for some patients. Rarely, surgery may also be considered for severe IC that does not improve with other treatments. Summary Interstitial cystitis, or IC, is a chronic problem in which the bladder wall can become inflamed and irritated. It is much more common in women than in men. Some doctors have started using the term painful bladder syndrome, or PBS, to describe interstitial cystitis. This is because the condition often causes bladder pain, as well as a need to pee urgently and frequently. The condition may also be called IC/PBS for short, or simply IC. 5

6 Doctors do not know what causes IC. It is thought that people with IC have bladders that are more sensitive to urine. Substances in the urine can irritate the bladder lining. IC is diagnosed if other causes of your symptoms are ruled out. No one treatment for IC has been found that works for everyone. Your healthcare provider will work with you to find a treatment that meets your needs. 6

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