Doctor's Notes on Interstitial Cystitis
Interstitial cystitis (IC) is inflammation of the bladder without any infectious cause. Signs and symptoms may vary in individuals, but usually one or more of the following may be present: urinary frequency and/or urgency, urinary incontinence, pain (lower back, abdomen, urethra, pelvic, and/or perineal areas), depression, and sleep problems. Some people have increased severity of symptoms after exposure to food and drinks like tomatoes, spices, high-acidic foods, chocolate, alcohol, or stressful situations. Men may have pain in the scrotum, testicles, or penis and painful orgasms; women may have pain in the vulva or vagina and painful intercourse -- pain can increase during her periods.
The cause(s) of IC are not known, but there are theories. They include autoimmune, hereditary, mast cell abnormalities (these cells are associated with inflammation development), defective bladder epithelial cells, and nerves that carry information to and from the bladder. Some researchers suggest the cause may be an undetected infectious agent.
What Are the Treatments for Interstitial Cystitis?
Unfortunately, there is no one simple treatment; most patients may need to try multiple treatments, often in combination that range from physical therapy to surgery. The general categories of treatments are as follows:
- Physical therapy: pain reduction
- Oral medications
- Nerve stimulation (by an electronic device)
- TENS (transcutaneous electrical nerve stimulation)
- Sacral nerve stimulation
- Bladder distension (stretching the bladder with water pressure)
- Direct instillation of medications into the bladder by a catheter
- Various combinations of drugs like a local anesthetic mixed with sodium bicarbonate and heparin
- Using urethral access, fulguration (burning) off small ulcers on the bladder internal surface
- Removal of ulcers by cutting them out
- Bladder augmentation (increasing bladder capacity with adding a section of the patient's intestine to the bladder)
Your urologist can help determine the best therapies for your condition.
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Frequent UrinationHaving to urinate more than eight times a day or waking up to go to the bathroom more than once a night is considered frequent urination. Symptoms include urgency, frequency, hesitancy, dribbling, straining, hematuria, and urinary incontinence. Treatment of frequent urination depends upon the underlying cause.
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.