top of page

Interstitial Cystitis

Interstitial Cystitis: Understanding and Managing Chronic Bladder Pain

​

Interstitial cystitis (IC) is a chronic bladder condition characterized by damage to the protective lining of the bladder. This condition can lead to symptoms such as urinary frequency, urgency, and pain in the pelvic area, which may vary from mild to severe and from occasional to constant. Approximately 90% of individuals diagnosed with IC are women.

 

Causes of Interstitial Cystitis

 

The exact cause of IC is not fully understood, but several potential factors may contribute, including:

​

  • Urinary Substances: Irritants in the urine that damage the bladder lining.

  • Defective Bladder Epithelium: A compromised bladder lining that allows irritants to penetrate and cause inflammation.

  • Nerve Sensitization: Changes in bladder nerve pathways that amplify pain signals.

  • Chemical Release: Histamine or other inflammatory chemicals released by immune cells.

  • Autoimmune Response: The body’s immune system attacking bladder tissue.

  • Chronic Infection: Persistent bladder infections, although often misdiagnosed as IC if cultures are negative. I will always check either PCR or Next Gen Sequencing (NGS) tests before making a diagnosis of IC.

 

These factors may interact, compounding the symptoms and severity of the condition.

 

Diagnosing Interstitial Cystitis

 

Diagnosing IC involves a comprehensive evaluation, including:

​

  • Medical History and Physical Examination: Reviewing symptoms and medical history, including past urinary issues.

  • Urinalysis: Testing for infections or other abnormalities. I will always check either PCR or Next Gen Sequencing (NGS) tests before making a diagnosis of IC. I feel many women are misdiagnosed with IC when in reality they have recurrent UTI, embedded UTI, biofilms, or chronic bacterial cystitis.

  • Cystoscopy: Using a camera to examine the bladder for inflammation, ulcers, or other abnormalities.

  • Urodynamic Testing: Measuring bladder pressure and function during filling and emptying, with signs such as low bladder capacity and pain during filling often indicative of IC.

  • Potassium Sensitivity Test: Comparing bladder response to potassium solution and water, although this test is less commonly performed due to patient discomfort. This test is not specific and can cause a great deal of discomfort so I do not perform this test.

 

Treatment Options for Interstitial Cystitis

 

Although there is no cure for IC, various treatments can help manage symptoms effectively:

 

Lifestyle and Dietary Modifications

​

  • Acid-Base Balance: Managing the pH of urine can alleviate symptoms. Over-the-counter supplements like Preliefcan help.

  • Dietary Adjustments: Avoiding bladder irritants such as caffeine, alcohol, spicy foods, and artificial sweeteners.

  • Stress Management: Techniques like yoga, mindfulness, or counseling can reduce symptom severity.

 

Medications

​

  • Oral Pentosan Polysulfate (Elmiron): This medication may restore the bladder lining and reduce inflammation. However, it is associated with potential side effects, including maculopathy, and its labeling was updated in 2020 to include this warning.

  • Dimethyl Sulfoxide (DMSO): Administered directly into the bladder via catheter, this treatment reduces inflammation, pain, and oxidative damage.

  • Antihistamines (Hydroxyzine): These reduce inflammation and improve sleep by alleviating nighttime symptoms.

  • Tricyclic Antidepressants (Amitriptyline): These medications provide pain relief, reduce bladder spasms, and modulate nerve pain. Side effects may include sedation, constipation, and weight gain.

  • Heparin Instillation: Delivered via catheter, this treatment helps repair the bladder’s protective lining. Side effects are rare.

 

Other Therapies

​

  • Bladder Training: Gradually increasing the interval between urinations to improve bladder capacity.

  • Physical Therapy: Pelvic floor therapy to alleviate muscle tension contributing to symptoms.

  • Neuromodulation: Devices like sacral nerve stimulators can help regulate bladder nerve signals and reduce pain and urgency.

 

Finding Relief

 

Living with IC can be challenging, but effective symptom management is possible with the right care plan. At PeeDoc, we specialize in personalized treatment approaches, working closely with you to address your unique needs and improve your quality of life.

 

Take Control of Your Bladder Health

 

Don’t let IC disrupt your life. Contact PeeDoc today to schedule a consultation and explore your options for relief and better bladder health.

bottom of page