What is interstitial cystitis (IC)?
IC is a chronic inflammatory condition of the bladder wall, which frequently goes undiagnosed. Although the cause is unknown and no treatment is uniformly effective for everyone, many treatments are available and the vast majority of patients obtain relief.
What are the symptoms of IC?
Symptoms include bladder pain, urinary urgency, day and night frequency (up to 60 times per day), suprapubic (lower abdominal) or perineal (area between the vagina and anus), pain and pressure, and painful sexual intercourse. Women’s symptoms often get worse during menstruation.
Are there different types of IC?
Most IC experts agree that IC appears to be a multifactoral syndrome rather than a single disease and may have more than one cause. The cause(s) and symptoms of IC may vary from patient to patient. There are currently considered to be two types of IC:
- Non-ulcerative IC
- Ulcerative IC (Hunner’s patches or ulcers)
Many researchers and clinicians have questioned the usefulness of this classification, since the vast majority (about 90%) of cases do not involve ulcers, and their presence or absence does not influence treatment options.
How do I know if I have IC?
You may suspect IC if:
- You feel unexplained pain and pressure in the urethra, the vagina, the area above the pubic bone, the inside of the thighs, the lower abdomen, the lower back, or the groin area, in any combination.
- You urinate frequently (normally, people urinate an average of 6-7 times per day, IC patients average about 16 times per day, and some urinate as often as 60 times per day)
- You are unable to hold a lot of urine
- You wake more than once a night to urinate
- You may feel the urge to urinate, sometimes even after you’ve emptied your bladder
- Your symptoms flare up with sexual intercourse, menstruation, certain foods, allergies, or stress
- Your symptoms come and go
Because IC symptoms are similar to those of other disorders of the urinary system and because there is no definitive test to identify IC, doctors must rule out other conditions before considering a diagnosis
of interstitial cystitis.
How common is IC, and whom does it affect?
Originally, IC was thought to be a rare disease affecting mostly postmenopausal women. Now, it is clear that IC can affect any age group, and men and children as well. A recent study found that the prevalence of interstitial cystitis in the U.S. is over 700,000. More than 90% of those affected are women.
How is IC treated?
At this time there is no cure for IC nor is there an effective treatment which works for everyone. However, a vast majority of IC patients are helped by one or more of the following treatments:
Elmiron®: Elmiron received FDA approval in 1996. It is the only oral medication approved specifically for use in IC. It is believed to work by repairing a thin or damaged bladder lining.
Antidepressants: Tricyclic antidepressants such as Elavil® (amitriptyline) have been shown to help with both the pain and frequency of IC. In IC, these medications are used for their anti-pain properties, not as treatment for depression.
Other Oral Medications: These include anti-inflammatory agents, antispasmodics, bladder analgesics, antihistamines, and muscle relaxants.
Bladder Distention: The bladder is stretched by filling it with water under general anesthesia. This is also a diagnostic procedure for IC.
Intravesicle Therapy: The bladder is filled with a solution that must be held for varying times, usually 10-30 minutes, before being emptied.
Diet: Eliminating certain foods (acidic, spicy) may decrease the severity of IC symptoms. Also, drinking coffee or tea, and alcoholic beverages may aggravate IC.
Smoking: Many patients feel that smoking makes their symptoms worse. Because smoking is the major known cause of bladder cancer, one of the best things smokers can do for their bladder is to quit.
Self-Help: Self-help techniques can improve the quality of life and reduce the incidence and severity of flare-ups. These include changes in diet, stress reduction, visualization, biofeedback, bladder retraining
and exercise, among others.
Electronic Nerve Stimulators:
- Transcutaneous Electrical Nerve Stimulation (TENS): This device, which is worn externally, relieves bladder pain in some people.
- Sacral Nerve Stimulation Implants: These surgically implanted devices are approved for use in treating urinary incontinence, urgency and frequency.
Surgery: For a small minority of patients whose symptoms are severe and who do not respond to other IC treatments, bladder surgery may be considered.
Where can I get more information?
Interstitial Cysititis Association (ICA)
Phone: 1-800-HELP-ICA (1-800-435-7422)
Web site: www.ichelp.com
Interstitial Cystitis Network
Web site: www.ic-network.com
National Bladder Foundation
Phone: 1-877-BLADDER (1-877-252-3337)
Web site: www.bladder.org