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Interstitial Cystitis – Overview

February 3, 2021
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"Interstitial cystitis, also known as IC or painful bladder syndrome, is a clinical diagnosis given to someone who experiences discomfort that is perceived to be related to the bladder and is associated with other urinary symptoms, such as frequency and urgency. The symptoms must be present a minimum of six weeks and have no other identifiable cause such as a urinary tract infection. The estimated prevalence of IC is between 2.7 and 6% of US adult females. This roughly translates between three and 8 million women over the age of 18. It is generally accepted that IC affects women more often, with a ratio of approximately five to one. The symptoms of IC tend to wax and wane and will often disappear over time. This may be related to the hormonal changes associated with aging, as it is much more common for IC to be diagnosed in a woman's twenties and very uncommon for a woman to first experience IC in the fifth decade or later in life.

Interstitial cystitis symptoms are similar to that of a bladder infection, including frequency, urgency, and bladder pain. The main differences are that tests are negative for urinary tract infection and antibiotics do not improve symptoms. Most people with IC will note that acidic foods aggravate their symptoms, and things like menstruation and stress can often cause a flare of symptoms. Interstitial cystitis causes are not known, although there are several theories. One theory is that there is a defect in the bladder lining. Another theory is that there is some type of inflammatory or allergic process in the bladder. And another theory is that there is an abnormality in pain receptors, as IC is associated with irritable bowel syndrome and fibromyalgia. Interstitial cystitis medications and treatments are aimed at the symptoms. There is only one FDA approved medication for interstitial cystitis called Elmiron or pentosan polysulfate.

This medication does have side effects of hair loss and impaired vision. Other treatments may be recommended by a physician include bladder installations or insertion of medication directly into the bladder, hydro distension or overstretching of the bladder that can cause temporary nerve damage and alleviate pain. Lastly, there is a small percent of IC patients who have ulcers, and often these ulcers can be fulgurated to improve symptoms. Interstitial cystitis treatment at home is focused around the interstitial cystitis diet that can be summarized by avoiding the four C's: caffeine, citrus, carbonated drinks and excessive doses of vitamin C. Supplements for interstitial cystitis typically neutralize the acids. The main complication of interstitial cystitis is impairment and quality of life, although medication that is taken for interstitial cystitis may also have side effects of those medications as a complication."

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