Interstitial Cystitis by Mary PreFontaine, RPh, FAAFM
Interstitial cystitis (IC), also known as painful bladder syndrome, is a condition in which the tissues of the bladder wall become inflamed or damaged. Symptoms of IC are very similar to those of a urinary tract infection and as a result are often misdiagnosed. Early on, IC typically occurs in “flares” with occurrence and symptoms being sporadic (leading to a misdiagnosis of a UTI); however over time symptoms can become consistent and unbearable. Most commonly patients will notice pain/discomfort during urination and intercourse, urinary frequency and urgency and urinary discomfort. Untreated, IC can lead to scarring or stiffening of the bladder walls and an inability to hold much fluid in the bladder. IC typically occurs in women but has the potential to occur in men as well.
The exact cause of IC is not yet known, however inflammation clearly plays a role. Some contributing factors include chemicals in the urine aggravating damaged tissue in the bladder, auto-immune responses such as mast cell activation and histamine release, low estrogen levels and previous bladder damage. Patients with IC begin experiencing symptoms for no apparent reason or they may start following surgery, particularly hysterectomy and gynecological surgeries in women.
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Treatment options are available for interstitial cystitis
A great place to start is by looking at diet and lifestyle. Many women say their symptoms abate when they follow an alkalizing, low-inflammatory diet by avoiding certain trigger substances. website information . Here are some primary “triggers” to avoid:
- Coffee for both the acidity and caffeine
- Tea, even decaffeinated, due to acidity.
- Cranberry and other acidic fruit juices. Remember this is not an UTI.
- Diet soda for acidity, caffeine, and the artificial sweetners.
- Tomatoes and other acidic foods
- Artificial foods, dyes and flavorings.
- Foods that promote yeast, especially refined sugars.
- Gluten which promotes inflammation in many patients.
The association with low estrogen and IC has been noted clinically and in the literature. Many physicians will try vaginal hormone replacement containing estrogens to control IC symptoms.
Although there is no accepted cure for IC, the main goal of current treatment is to alleviate symptoms. Unfortunately there is not one medication that can be given to every patient that will relieve all symptoms, so patients may receive a “cocktail” (a concoction of various medications). These cocktails are administered intravesically, into the bladder, through a catheter; this is known as a bladder instillation.
Instillations can contain combinations of the following medications:
Heparin: aid in bladder restoration
Lidocaine: local anesthetic for pain
Sodium bicarbonate: enhance anesthetic penetration into mucous tissue
Rimso-50 (DMSO): anti-inflammatory
Dexamethasone: anti-inflammatory corticosteroid
Triamcinolone: anti-inflammatory corticosteroid