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Gary Bellman, M.D., F.R.C.S.
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Interstitial Cystitis: Learn About Treatment and Symptoms

By: Dr. Gary Bellman on August 21, 2014, 4:36 pm

What is interstitial cystitis/bladder pain syndrome (IC/BPS)?
Interstitial cystitis is a chronic pain condition that affects the bladder.  Many experts now call it bladder pain syndrome (BPS).  Symptoms of IC/BPS include:

• Pain or discomfort believed to be related to the bladder, which often gets worse as the bladder fills.

• Feeling like you need to urinate right away (urgency), often (frequency), or both. Most people urinate between 4-7 times a day.  Yet with IC, the bladder may hold less urine.  People with severe IC urinate as often as 30 times a day.

• Pain, pressure, or tenderness in the pelvic area and/or genitals.

• Pain during sexual intercourse, or pain during ejaculation for men.

• Ulcers and/or bleeding in the bladder.
 
 
The symptoms of IC vary from person to person and can change over time. Women's symptoms often get worse during their menstrual periods.  Some people with IC feel only mild discomfort.  While others have severe pain and symptoms.

IC can greatly affect a person's quality of life.  Severe cases of IC can keep people from going to work or school and being socially active.  It can affect a person's sex life and relationships.
 


What are the causes of IC?
No one knows what causes IC.  The following factors may play a role:

• A defect in the bladder wall that allows substances in the urine to irritate the bladder.

• A specific type of cell that releases histamine (chemical released during an allergic reaction) and other chemicals, which lead to symptoms of IC.

• Something in the urine that damages the bladder.

• Changes in the nerves that carry bladder sensations, making normal events, such as bladder filling, painful.

• The body's immune system attacks the bladder.

 

Many women with IC have other conditions, such as irritable bowel syndrome and fibromyalgia.  Allergies also are common in people with IC.  Learning about these conditions also might provide clues on the cause of IC.

 

How can I tell if I have IC?
No single test can tell if you have IC, which can make it hard to diagnose.  Your doctor will ask you lots of questions about your symptoms.  Your doctor also will need to rule out other health problems that may be causing your symptoms, such as:

• Urinary tract infection (UTI)

• Bladder cancer

• Endometriosis

• Sexually transmitted infections (STIs)

• Kidney stones

 
Some tests used to help rule out other health problems that can cause bladder pain include:
 
• Urine test. Your doctor will insert a catheter, which is a thin tube, to drain urine. Or you may be asked to give a urine sample using the "clean catch" method.  For a clean catch, you will wash your genital area before collecting urine midstream in a sterile container. Your urine will be looked at under a microscope or sent to a lab to see if you have germs that cause UTIs or STIs.

• Cystoscopy with or without bladder distention. Your doctor may use a cystoscope, which is a thin tube with a tiny camera, to see inside the bladder.  Further testing may include slowly stretching the bladder, called bladder distention, by filling it with liquid.  This helps the doctor get a better look inside the bladder.  The doctor can look for signs of cancer, bladder stones, or other problems.  It can show whether your bladder wall is swollen, thick, or stiff and can measure how much urine the bladder can hold. It can also find bleeding or ulcers in the bladder. This test is often done as an outpatient surgery.

• Biopsy. A biopsy is when a tissue sample is removed and looked at under a microscope. Samples of the bladder and urethra may be removed during cystoscopy.  A biopsy helps your doctor rule out bladder cancer.

 

Researchers are working on developing new tests to help diagnose IC.


 
Is there a cure for IC?
Doctors have not yet found a cure for IC. They cannot predict who will respond best to the different treatment options. Sometimes, symptoms may go away for no reason or after a change in diet or treatment.  Even when symptoms do go away, they may return after days, weeks, months, or years.

What are the different types of treatments?
There are treatments available to help ease the symptoms of IC.  Doctors usually start with a conservative approach, and progress to other therapies as needed.  Although no one treatment helps everyone, over time many women are able to find a treatment plan that helps them to feel better. Some of these include:

 
Self-help strategies. Some people with IC nfind relief with self-care methods, such as:

• Bladder retraining-- This helps the bladder hold more urine before signaling the urge to urinate.

• Dietary changes

• Wearing loose clothing

• Quitting smoking

• Reducing stress — Stress cannot cause IC, but it can trigger flare-ups.

• Pelvic exercises — A doctor or physical therapist can teach you how to do these.

• Low-impact physical activity, such as stretching and walking

 

A prescription medicine called pentosan polysulfate sodium (Elmiron) can help ease symptoms in about one-third of patients.  Because Elmiron has not been tested in pregnant women, it's not recommended for use during pregnancy, except in severe cases.  Other oral medicines for IC/BPS include:

• Amitriptyline, (an antidepressant that can help increase bladder capacity and block pain

• Antihistamines


Can consuming certain foods and drinks bring on symptoms or make them worse?
Studies have not proven a link between diet and IC.  Yet, some people find that that their symptoms begin or get worse after consuming certain foods or drinks, such as:

• Alcohol

• Tomatoes

• Spices

• Chocolate

• Caffeinated and citrus drinks

• High-acid foods

•Caffeinated and citrus drinks

•Artificial sweeteners

 


 If you decide to avoid certain foods or drinks, make sure that your meals are still well-balanced and healthy.


For an appointment or consultation with Dr. Gary Bellman,
please contact the office or call 818-912-1899




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