8/30/2019

Interstitial Cystitis

Interstitial cystitis is a chronic inflammatory disease of the bladder, with very painful and distressing symptoms. It may at first resemble a bacterial infection, but antibiotics have no effect on it, and the test of urine is sterile.

The characteristic symptoms are pain, urgency and urinary frequency. (with a difficulty of increasing urination as the disease progresses) The pain may be intensified when the bladder is full, and lighter when it is empty. It often occurs in the pelvic or abdominal region. It extends up to the lower back, and can also be felt in the groin and thighs. In women, pain can be in the vagina and in men in the penis, testicles, scrotum and perineum. Note that 90% of patients with interstitial cystitis are women. For against, you can find the disease in children, although the diagnosis can be given to a patient under 18 years.

Surgical or other reasons not known


Symptoms may begin spontaneously without apparent reason or start after an operation, especially in women after a hysterectomy or other gynecologic intervention after childbirth or after a severe bacterial infection of the bladder.

Interstitial cystitis and urinary tract infections


In the early stages of the disease, symptoms may appear and resolve for themselves. It is essential to perform a urine culture to distinguish them from bacterial cystitis. To complicate matters, patients may have urinary tract infections in addition to interstitial cystitis. An infection can greatly aggravate the symptoms of IC and should be treated with an appropriate antibiotic. But the symptoms of CI do not, on the contrary, they may gradually worsen, and the speed at which this happens varies tremendously from one patient to another. Some symptoms will grow very slowly over the years while for others it may progress to an advanced stage in a short time with the resultant fibrous bladder and a minimum capacity.

Interstitial cystitis pain


The pain may be felt as burning, in the form of spasms in the bladder or around or stabbed in the vagina with a sensation of pressure. It may be constant or intermittent. It also radiates throughout the pelvic region including the stomach, intestines, due to inflammation of the pelvic nerves.

Difficulty in urinating in Interstitial cystitis


Some patients have difficulty urinating or completely emptying their bladder. Women sometimes have leakage of urine after leaving the toilet, and are afraid of becoming incontinent, but that is not normally the case. The problem can be solved by taking more time to ensure that the bladder is emptied or using underneath protectors and there are usually only a few drops of urine flowing. Alternating between a surge and a reduction of symptoms is characteristic of interstitial cystitis. Many women (pre-menopausal) find that their symptoms worsen before and during menstruation, probably due to hormonal changes that affect the cells of the bladder. Sex may be painful for patients and for some, completely impossible what may make marriage more difficult. Many of them have an exacerbation of their symptoms as a result of physical or emotionally stressful events.

Interstitial cystitis causes


Despite considerable research, the cause of interstitial cystitis remains unknown. Several hypotheses have been advanced as an impaired immune system related to allergy, a neurodegenerative disease, a bacterial or viral and even environmental factors (eg food). The theories differ and much research has been done in recent years, but no response has been found so far.

Interstitial cystitis treatments


Once a diagnosis has been established, the physician has the task to explain to patients the various treatments that may alleviate the symptoms. Despite all the research done to date, we still do not know how to cure the disease. Treatment outcomes may differ from one patient to another. That is why we need to try several treatments before deciding which is most effective. This is another reason to suspect that the IC can be multifactorial. The treatment of IC can be done with various drugs, by instillation and distention of the bladder, stimulation of nerves or surgery. Treatment can be hampered by exacerbations and remissions of symptoms that are characteristic to interstitial cystitis. It is therefore difficult to say whether the improvement was caused by a drug or simply a spontaneous remission.

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