The bladder is the urine storage organ of the body. It is a hollow muscular organ located just below your kidney and above your pelvic region, with a tube that links to your vagina or penis (as the case may be) to enable the excretion of urine.
The bladder carries out its function of entering urine by sending signals to the brain through the pelvic nerves that it is time to urinate when it has been filled up with filtered excess fluids and waste products from the kidney. These signals sent are what creates the need for you to urinate.
However, in some situations, the signals may get mixed up and distorted by some factors and this may make you want to pass out urine more frequently and in very little volumes. Often this happens, there may pain in passing out the urine. This can be a sign of “Interstitial Cystitis“.
What is Interstitial Cystitis (IC)?
Interstitial cystitis (IC), also referred to as “Painful Bladder Syndrome“, is a chronic and complex condition that is characterized by the severe inflammation of the muscular layers of the bladder, pelvic, and urinary area, leading to pressure and sharp intense pains in the region when you want to urinate.
IC causes urgent and frequent urination that can be between 40 to 60 times a day all round the clock. This condition mostly happens in women than it does in men. The pains that come with it are often fierce and inconvenient and are more likely to hurt your everyday life.
Interstitial cystitis can affect your lifestyle and lead to certain complications. These complications are mostly in changes in your activities and life, rather than in your health. They include:
There are no tests that can diagnose interstitial cystitis because the condition has no habitual cause, but could be developed from another condition that has a relationship with the kidney, bladder, urethra, pelvis, penial or vaginal region, etc.
IC shares symptoms with other disorders such as urinary tract infections, sexually transmitted disease, kidney stones, bladder cancer, chronic pelvic pain syndrome and chronic prostatitis (inflamed prostate) in men, endometriosis in women, etc. Because of this, tests to rule out other related conditions are done to diagnose IC.
Such tests include:
- Reduction in bladder capacity by the stiffening of the bladder wall.
- Insomnia and disturbance or interruption in sleep.
- Emotional, mental, and physical stress
- Psychological problems such as depression and anxiety.
- Reduced self-esteem, due to the need to avoid social embarrassment as a result of the persistent need to urinate and the probability of accidental leakage.
- Loss of interest in relationships and sexual intimacy.
- Decreased and poor quality of life because the condition interferes with your daily life, work, and social activities.
There is no cure for interstitial cystitis and the treatments are used to relieve the symptoms until the syndrome can go into remission. These treatments are not definitive, but often, people take them in combinations or try various treatments till they can find one which brings them fast relief.
Drugs are to be taken according to your doctor’s prescription. The following can be drugs that can be prescribed:
- Pelvic examination
- Urine tests; urine culture, urinalysis, urine cytology to check infection or cancer.
- Biopsy, to examine a small sample of bladder and urethra tissue.
- Cystoscopy to measure your bladder capacity.
- Postvoid residual urine volume, to measure how much urine remains after urination.
- Prostate fluid culture, to test the presence of infection or cancer.
- Imagery tests (MRI scans, CT scans, X-ray) of the lower abdomen and pelvic region, to check inflammation or presence of other disorders.
II) Injections & Steroids
Injections such as onabotulinumtoxin A can be used to cause bladder muscle paralysis to block out the pains. Also, where you have ulcers in your bladder causing piercing pains, you can relieve the pains and heal them with steroids.
III) Nerve stimulation (Neurostimulation)
This is a process that stimulates nerves by sending small electric shocks that change their working system. The doctor does this by implanting nerve stimulation devices. These stimulations include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, naproxen, etc to relieve inflammation and pains.
- Tricyclic antidepressants such as amitriptyline, imipramine, to relieve bladder pains and relax the bladder.
- Antihistamines such as loratadine, hydroxyzine, to control the urgency and frequency of urination.
- Pentosan polysulfate sodium such as Elmiron, which may aid the repair of the inner bladder walls.
- Cyclosporine, to suppress the immune system from fighting the bladder.
- Medications that are instilled into your bladder through a catheter, popularly dimethyl sulfoxide (DMSO), to relieve inflammation and block pains.
Electrical wires are attached to your lower back or above your pubic area to deliver electric pulses through the skin and stimulate the bladder nerves. This can reduce bladder pains, relax the bladder, strengthen its muscles, and reduce the frequency of urination.
- Transcutaneous Electrical Nerve Stimulation (TENS)
An electric wire is placed on the sacral nerves located between the spinal cord and bladder nerves to send electric pulses to and stimulate the nerves. This can block the pain in the bladder and reduce urine frequency and urgency. It can be a permanently implanted device.
IV) Bladder Training Techniques
These procedures are done by your doctor, developed to help reduce your urine frequency and urgency by lengthening the duration of urination. They include:
This procedure involves injecting fluid into the bladder, thereby slowly stretching it. This can relieve some of the symptoms of IC. The effect lasts for less than 6 months, but a repeat can be done after.
This process involves stretching the bladder with water or gas to increase the capacity of the bladder and interrupt the signals transmitted by the bladder nerves that cause urine frequency and urgency, and pains.
Surgical procedures can be carried out to increase the size of the bladder and heal ulcers. Although these surgeries are rare, they are considered when the symptoms are very chronic and other treatments have failed to relieve them. Some options include:
This involves adding a patch of the intestine to the bladder to increase its size and capacity.
This surgery involves inserting instruments through the urethra to cut away and close up any ulcers in the bladder.
A process that involves interesting instruments through the urethra to burn off and close up all ulcers found in the bladder.
Both resection and fulguration are down through the help of endoscopic instruments that enable the surgeon to monitor the insides of the bladder through a computer while carrying out the surgery.
Alternative medicine is a form of natural remedies that involve the mind, body, and psychological methods of healing. They include:
You are made to relax and numerous thin needles are inserted minimally into your skin at strategic and specific points on your body. These needles enable the flow of life and energy all through your body, easing out stress and causing relief of pains. They boost your body’s natural painkillers and this can block out bladder pains.
II) Guided Imagery
This is often carried out with a psychotherapist. It employs the use of imagery and visualization to help you create a consciousness of healing. Your brain or mind is made to believe that you feel no pains and that you are healed, with the hope that your body will align to the consciousness of your mind. This therapy does not work for everyone.
Lifestyle & Natural Treatment/Remedies
I) Physical Therapy
You can employ the services of a physiotherapist to help to create a routine that can strengthen your pelvic and bladder muscles. Such routines can help you relieve pains and discomfort that arise from muscular abnormalities and tenderness of your pelvic floor, and aid in reducing your rate of urination.
However, the exercises are not meant to be too strenuous or stressful as that can defeat the whole reason, causing flare-ups and increasing urine frequency. Keep the exercises easy and low-impact. Engage in walking, stretching, yoga, tai chi, pilates, low-impact aerobics, etc.
Also, you can try a home routine bladder training.
Try to restrain your bladder by suppressing your urge to urinate a little longer. Use relaxation techniques to curb your urge to urinate such as breathing deeply and slowly, distracting yourself with fun activities such as playing a game, watching a movie, cooking, reading, writing, anything that can keep your mind preoccupied.
Some diets can irritate your bladder. Figure out those diets; foods or beverages and cut back on them especially when you are experiencing severe symptoms of interstitial cystitis.
Some irritants include:
- Sacral Nerve Stimulation (SNS)
Also, quit the intake of nicotine and tobacco in the form of cigarettes. Smoking can irritate the bladder and worsen the pains. Hard drugs and substances can also contribute to chronic bladder pains.
III) Stress Reduction
Manage your stress level because it can trigger pains in your bladder. You can go for psychotherapy to relieve the stress; meditate, visualize, and biofeedback. Do anything that helps to ease out and relax. Stretch, watch a movie, read a book, talk to friends, laugh, listen to music, etc.
Do not wear clothes that put pressure on your abdomen and pelvic region. Avoid belts, wear loose clothes.
- Carbonated drinks
- Caffeine of any kind
- Citrus fruits
- Food and drinks containing a high level of vitamin C
- Artificial sweeteners
- Acidic food or drinks
- Pickled foods
- Alcohol, etc.
The signs of interstitial cystitis are often similar to that of urinary tract infection (UTI), but in IC, there is no sign of an infection. However, if a person suffering from IC gets a urinary tract infection, the symptoms become more severe.
The symptoms of IC varies in different people. The signs are likely to change every day or week. They might linger for weeks, months, or years, and can even disappear on their own without treatment.
The signs can be worsened by triggers that may include pressure on your pelvic area or bladder caused by sitting for a long duration, exercising, running, etc, menstruation, physical and/or mental stress, some foods and drinks, sexual activities, etc.The symptoms of interstitial cystitis include:
- The urgent need to urinate almost every minute or two, or even after you just finished urinating.
- Persistent and frequent urination all through the day and night.
- Accidental leakage of urine because bladder and urethra can become irritated to a certain level and give way for urine to come rushing out.
- White urinating may come as a little sting, or as a severe burning sensation.
- Pressure, chronic pains, and discomfort in the pelvis.
- Painful burning sensation in the vagina, vulva, or the area between the vagina and anus in women.
- Painful burning sensation in the penis, scrotum, testicles, or the area between the penis and the anus in men.
- Stringent piercing pains and discomfort in your urethra, pelvis, and lower back and abdomen.
- Pressure and pains in your bladder that increases as it fills up and reduces after you urinate.
- Pains during and after sexual activities.
The symptoms often vary. Some may have symptom-free periods, while others have consistent signs all through the period of the condition. The pains and discomforts may be infrequent or persistent.
The exact cause of interstitial cystitis is not clear. However, it is said that certain conditions can lead to the syndrome and some factors are most likely to contribute to the initiation of IC. They include:
- A defect or leak in the epithelium (the protective lining) of the bladder irritating the bladder wall.
- Chronic pain disorders such as fibromyalgia (muscle pains) or irritable bowel syndrome(IBS).
- Inflammation or hypersensitivity of the pelvic nerves that causes them to release mixed up signals.
- Weakened muscles of the pelvic floor.
- Vulvodynia, a burning sensation and pain in the vulva, not caused by an infection.
- Nerve damage making your brain to misinterpret signals, making your bladder feel pains from excretion that does not hurt.
- Bladder or bladder tissue damage, probably from toxins or chemicals in your urine.
- Overstretched bladder due to holding urine for a long period.
- Bladder lining trauma usually from surgery.
- Bladder ulcers.
- Trauma to the spinal cord.
- Bacterial infections
- Autoimmune reaction and attacks on the bladder.
People who are most like to be affected by interstitial cystitis are:
- People from 30 years and above.
Which specialist should I see if I have Interstitial cystitis?
Consult with a urologist, a specialist who treats urogenital disorders.
Do probiotics help with interstitial cystitis?
Some patients with interstitial cystitis (IC) have found probiotic drugs helpful in relieving bladder pains.
What happens if interstitial cystitis goes untreated?
IC is a bladder and urinary disorder that has symptoms identical to urinary tract infection but it is not caused by an infection or bacteria. Leaving IC untreated may not lead to any other medical condition, but has a huge negative effect and impact on the quality of life.
What is the difference between Urinary Tract Infection and Interstitial Cystitis?
The symptoms of UTI and IC are often similar, so the best way to differentiate them is from a urine culture test. There is a presence of bacteria in UTI. If you have severe symptoms with bladder, pelvic, and urinary tract pains and inflammation and there is no presence of bacteria in your urine, it is most likely that you have IC.
Can IC go into remission?
Yes, interstitial cystitis can go into remission. Going into remission means the symptoms can reduce and become milder over some time and at a point, disappear. The treatments for IC are used to step down the symptoms and if these symptoms are successfully controlled, they can go into remission.