A bladder condition caused by chronic inflammation, interstitial cystitis leads to difficulties with urination.
Causes, incidence, and risk factors
Interstitial cystitis (IC) is an inflammation (irritation with increased presence of immune cells) of the tissues of the bladder wall, with no known infectious (bacterial, viral, or fungal) cause. The condition is identified through a diagnosis of exclusion. There are about 10-30 cases per 100,000 people. Women are 10 times more likely to be affected than men. The condition is more common in Jewish women and is rare in African-Americans. IC generally occurs during the third or fourth decades of life. For the average person with interstitial cystitis, there is a 4-year delay between the time the first symptoms occur and the diagnosis. This demonstrates both the difficulty of diagnosis and how infrequently this condition is suspected.
Signs and tests
Diagnosis is made by ruling out other causes. Urine analysis, urine culture, and urine cytology tests are essential. Usually, cystoscopy (endoscopy of bladder) and bladder biopsy are performed. The characteristic finding of interstitial cystitis during cystoscopy is pinpoint bleeding (hemorrhage) in the lining of the bladder.
Video urodynamics may also be performed.
Treatment
There are no standard or consistently effective treatments for interstitial cystitis. Results vary from individual to individual. As long as the cause of IC is unknown, treatment is based on trial and error until relief is found.
Some of the treatments that have been tried include:
Dilation of the bladder with fluid (hydrodistention) Oral medications:
Elmiron (coats bladder like Pepto-Bismol) Opiates (Nalmefene) Psychiatric medications like Elavil or Vistarul (may have a pain-relieving effect, also helpful for psychiatric conditions like depression which often accompany this disorder) Intravesical therapy (instillation into the bladder) of medications such as dimethyl sulfoxide, heparin, clorpactin, lidocaine, doxorubicin, or BCG vaccine Surgery, ranging from cystoscopic manipulation to cystectomy (removal of the bladder)
Support groups
A support group may help you deal with symptoms of this disorder and learn about treatments that have worked for others.
Interstitial Cystitis Association (ICA) - www.ichelp.com
Interstitial Cystitis Network (ICN) - www.ic-network.com
Expectations (prognosis)
Treatment results vary. Some people respond well to simple treatments. Others may require extensive treatments or surgery to relieve symptoms.
Complications
Chronic pain that may cause a change in lifestyle Emotional trauma High costs associated with frequent medical visits Chronic depression (and accompanying suicidal thoughts)
Adverse effects of treatments (depending on the treatment)
Calling your health care provider
Call your health care provider if you have symptoms suggestive of interstitial cystitis. Be sure to mention that you suspect this disorder. It is not well-recognized nor is it easily diagnosed.