Interstitial Cystitis

Interstitial Cystitis: Overview

Alternative Names: IC, Painful Bladder Syndrome, PBS, Bladder Pain Syndrome, BPS, Hypersensitive Bladder Syndrome

Interstitial Cystitis (IC) refers to an uncomfortable and annoying inflammatory condition of the bladder.  The classic symptoms include urinary frequency and pain above the pubic region.  The interstitial cystitis patient has a small capacity, irritated bladder.  Urgency and pain intensity can vary greatly from patient to patient.  No one is certain of the cause.

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Interstitial cystitis patients often have other chronic conditions as well, such as allergies, irritable bowel syndrome, and sensitive skin.

Incidence

Approximately 5 to 9 times as many women than men are affected, and approximately one third of women who suffer chronic pelvic pain are found to have interstitial cystitis.

Diagnosis and Tests

As with urethral syndrome, many other more common urologic problems are diagnosed incorrectly before the proper diagnosis is made.  Interstitial cystitis must be diagnosed with the use of the cystoscope, an instrument which can directly visualize the interior of the bladder.

Treatment and Prevention

While there are numerous treatments for IC there is no outright cure.  Medical treatments for interstitial cystitis have included overstretching of the bladder with water, instillation of a dilute silver nitrate solution into the bladder, and steroid use.  Currently, treatments for interstitial cystitis are aimed at relieving symptoms rather than achieving a cure.  For patients with only mild symptoms, nonprescription aspirin or ibuprofen may be enough to relieve bladder discomfort.

For some people, the pain and other negative effects of the condition may be aggravated by a variety of foods.  The list can be very long but some of the commonly mentioned ones include tomatoes, spices, chocolate, caffeinated and citrus beverages, high-acid foods and artificial sweeteners.  In order to determine which (if any) of these foods may be aggravating your symptoms, you might try eliminating all of these foods for a week or two, and then reintroducing them one by one, at weekly intervals.  You may then be able to tell which ones cause you problems.

Prognosis

IC begins gradually and becomes progressively worse.  Symptoms may go away for a period of time (remission), but usually return.  A survey in 1998 found that among people with interstitial cystitis:

  • 40% were unable to work
  • 27% were unable to have sex due to pain
  • 27% had marriage breakdown
  • 55% contemplated suicide
  • 12% had attempted suicide

Signs, symptoms & indicators of Interstitial Cystitis:

Symptoms - Reproductive - General

(Severe) vulvar pain

Vestibulitis may sometimes be part of bladder and/or urethral inflammation as seen in the interstitial cystitis or urethral syndrome.  The lining of both vagina and bladder arise from the same tissue during fetal development and thus when one becomes inflamed, the inflammation may spread to the adjoined areas.

Symptoms - Urinary

Counter-indicators
Counter-indicators

Risk factors for Interstitial Cystitis:

Personal Background

Caucasian ethnicity

For reasons unknown, 90% of interstitial cystitis cases occur among Caucasians.

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Interstitial Cystitis suggests the following may be present:

Autoimmune

Lupus, SLE (Systemic Lupus Erythematosus)

Interstitial cystitis patients have been found to be 30 times more likely to have systemic lupus erythematosus.

Digestion

IBS (Irritable Bowel Syndrome)

Interstitial cystitis often occurs alongside Irritable Bowel Syndrome.  In fact, several studies suggest that interstitial cystitis patients are 100 times more likely to have irritable bowel syndrome than those without.

Interstitial Cystitis could instead be:

Infections

Urinary Tract Infection (UTI)

Interstitial cystitis and urinary tract infections have similar symptoms, but interstitial cystitis tests negative for bacteria.

Recommendations for Interstitial Cystitis:

Amino Acid / Protein

L-Arginine

Arginine, 3gm per day in divided doses on an ongoing basis, can reduce symptoms.  In some people with herpes, the arginine may need to be offset with lysine.  The body also uses arginine to make nitric oxide, which helps to relax smooth muscles like those found in blood vessels and the bladder.  Based on this known mechanism, arginine has been proposed as a treatment for various conditions that may be caused by limited blood flow.  Some researchers theorize that arginine's effects on nitric oxide synthesis might help relax the bladder, making it a useful treatment for IC.

Animal-based

Heparin

Sublingual heparin (1000 units daily) has helped some people; at this dose there is no chance of anticoagulant consequences.

Diet

Alkalizing Agents/Diet

A book written by a urologist, Larrian Guillespie, MD called You Don't Have to Live With Cystitis (1985) details a fundamentally dietary approach to interstitial cystitis.  She discusses alkalizing the diet, and avoiding aspartates.

Many people also find that certain foods increase their symptoms.  The most frequently cited offenders are coffee, chocolate, ethanol, carbonated drinks, citrus fruits and tomatoes.  Although there are broad guidelines that most IC patients can follow, discovering which particular foods may cause you problems requires perseverance.  Many IC patients report that restricting their diet is an effective form of treatment and believe that it is worth the effort.  Some IC patients report that they have the least trouble with rice, potatoes, pasta, vegetables, meat and chicken.

Alcohol Avoidance

Avoiding alcoholic beverages may help reduce symptom frequency.

Habits

Tobacco Avoidance

In people who have already been diagnosed with interstitial cystitis, symptoms may be less likely to flare up if the patient stops smoking cigarettes.

Mineral

MSM (Methyl Sulfonyl Methane)

Stacy J.  Childs, MD, of the University of Alabama, Tuscaloosa, recently described 6 patients with interstitial cystitis who benefited from MSM.

Skin

DMSO Topically

A common and useful treatment for interstitial cystitis is the instillation of DMSO into the bladder.  This is a medical procedure, not one to be done at home.

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Weak or unproven link: may be a sign or symptom of; may increase risk of; may suggest; is very occasionally misdiagnosed as
Weak or unproven link:
may be a sign or symptom of; may increase risk of; may suggest; is very occasionally misdiagnosed as
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