Facts and Treatment for Interstitial Cystitis


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Are you are someone you know suffering from pelvic pain? Do you feel that you are always running to the restroom because you have the urge to urinate or urinate frequently? If you answered yes to any of these questions, you may be suffering from a disease known as interstitial cystitis (IC). Before you panic, you should know that this disease is treatable, and you are not the only one suffering from it.

Throughout the course of this paper, you will learn everything you need to know about IC. First, we will talk about diagnosing the disease, what causes IC, medical conditions associated with IC, the various types of oral medications, and medications that are introduced into the bladder. In the second half of the paper, you will learn about the male with IC, surgery and the patient, sex, conservative therapies, and support.

To begin, what exactly is interstitial cystitis? It is a disease of the urinary bladder marked by inflammation and ulceration (interstitial cystitis means inflammation (cystitis) within (interstitial) the bladder wall). (Robert Moldwin). This is not a disease that can be detected by blood or urine. The only way that this disease is able to be recognized is by the symptoms that you are experiencing. A person with IC usually experiences symptoms between 30-50 years old, although it can occur earlier in life. It is said that 90% of IC patients tend to be women. (ICA)

You're probably thinking to yourself, "Do I have interstitial cystitis"? Your doctor can make the ultimate decision of whether or not you have IC. Providing a medical history will help eliminate and bring about possibilities. Tests will also be used to help determine the decision some of which include: a urinalysis, a urine culture, urine cytology, a pelvic ultra sound, and an urodynamic evaluation (Moldwin).

No one really knows what causes interstitial cystitis. Researchers have identified the causes by the complaints that the patients provide (ICA). Patients that have IC are said to have abnormalities on the bladder surface, abnormalities of the bladder's blood supply, undiagnosed microorganisms, and autoimmunity (ICA).

Today, there are many medical conditions that are associated with interstitial cystitis. In a 1997 study by Alagiri, Chottiner, Ratner, Slade, et al, described the following seen in IC patients: allergies 40.6, irritable bowel syndrome 25.4, and skin sensitivity 22.6 (Moldwin). Other conditions associated with IC include vulvodynia, pelvic floor dysfunction, fibromyalgia, urethral syndrome, and urinary tract infection (UTI) (WHC).

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Although just because you have one of these medical conditions, it doesn't mean you have IC.

Next, there are is treatment out there to help you if you are diagnosed with IC. For instance, oral medications will help to improve your symptoms when used correctly. Does this mean that you aren't going to feel any pain at all? The answer is no. Patients will experience less pain and will feel more comfortable throughout the day. There are many medications out there to help with the pain of an IC patient. Some of the medications are thought to coat the bladder surface which includes Pentosan Polysulfate Sodium (Elmiron). This is a new medicine and has been proven to help improve the symptoms in 35-40% of patients (Moldwin). Other medications include antidepressants, selective serotonin reuptake inhibitors (SSRIs), antihistamines, antiseizure medications, non-steroidal anti-inflammatory medications (NSAIDs), immunosuppressants, muscle relaxants, narcotic therapy, urinary anesthetics, anticholinergic therapy, l-arginine, calcium channel blockers, and alpha-blockers (Moldwin).

Along with oral medications, there is a more advanced treatment of medications, which is introduced directly into the bladder. This is known as intravesical therapy or intravesical instillation ("vesical" means bladder) (WHC). These medications are instilled into the bladder using a catheter, usually on a weekly basis for varying durations--usually between twenty to thirty minutes, if possible (WHC). So you are probably wondering if this treatment is right for you. This is not something that should just be used as an initial treatment rather than taking medications daily, or rather yet, when all other therapies don't happen to work. The only person who can decide whether this is right for you is your doctor. The positive outcomes with intravesical therapy include: few side effects, direct approach to the bladder, and patients start feeling better right after treatment is finished.

If you a male, you're probably wondering how and if interstitial cystitis affects you any differently from women. The only thing different is that it is hard to diagnosis and treat than it is with women. Many doctors think of IC as a "female illness," and overlook the possibility of IC in male patients (Moldwin). Another thing difficult with men is that they have other problems and symptoms that are similar to IC. For example, to make the problem of IC in a male patient even harder, it is possible to have two problems at the same time, such as IC and a prostate that's obstructing that flow of urine (Moldwin). A few medical problems that mimic IC include: the prostate gland, prostate cancer, and bladder cancer.

The next thing that we will discuss is the different forms of surgical care that is available to people with IC. Minimally invasive procedures are frequently performed right in the doctor's office. This type of procedure has less pain and faster recovery time. There are various types are procedures that one can receive some of which include: urethral dilatation, bladder hydrodistention under anesthesia, surgical management of the hunner's ulcer, resectoscopes, laser therapy, neurostimulation, and interstim therapy (Moldwin). There are also invasive surgical procedures, which are open surgery. The only time a patient would get this type of procedure is if everything else fails. Rather than being performed in the doctor's office, they are performed in the hospital. The patient will require five to ten days in the hospital afterwards. This surgery is like taking your old bladder out and replacing it with a new one. Everything is removed except for the base (called the trigone) and the uretha, while a segment of intestine is then reshaped and attached to the remaining base to create a new larger bladder (Moldwin). This sounds like a great idea right? Well it is unfortunate that many people have not seen results and feel no relief of pain of receiving such a tremendous surgery. When it comes down to making the decision of which treatment to choose, many doctors would choose for their patients to receive minimally invasive procedures due to their outcome.

Next, you're probably pondering if sexual intercourse has any impact when it comes to IC. Unfortunately, IC patients often steer clear of intercourse due to the pain. This can be a very hard thing for people to deal with since it can lead couples to break up and even drift apart. If you are in a relationship, you need to sit down with your partner and explain to them the situation and what you are going through. There are many reasons why you can develop dyspareunia (pain with sexual intercourse) (ICA). The two basic groups are entry dyspareunia, which is pain that occurs at the opening of the vagina. Some of the problems that can cause this pain are: atrophic vaginitis, vaginitis, herpes or other lesions on the vulva, vulvodynia, and infection within the glands of the vulva. The second group is known as deep dyspareunia. Some of the pain may be cause by vaginal infections or lesions, severe dryness of the vaginal lining, bladder pain, pain from other pelvic abnormalities, and pain from the pelvic floor muscles. There are a few things that you can do to help deal with sex and IC which include: talking to your partner, don't focus on vaginal penetration, watch out for effects of medication of orgasm, go slow, use lots of lubrication, be in control, find the right position for yourself, go one step at a time, avoid intercourse during flares, take advantage of remissions, take a warm bath after sex, avoid urinary tract infections, avoid using the diaphragm for contraception, use vaginal dilators/biofeedback, and read more about the subject (ICA).

There are also things that you can do for yourself to help improve your symptoms of IC. For instance, over 50% of people that have changed their diet have had an influence on their symptoms (Moldin). Each food varies by each individual, and once you find which food cause the symptoms, then you will know which ones to eliminate. Some foods that have been proven to worsen the symptoms of IC include: citrus fruits, caffeinated beverages, chocolate, alcoholic beverages, carbonated beverages, sour cream, salad dressing, nuts, and many others (Moldwin). Also, fluid intake is very important when it comes to IC patients. Taking in more fluid than normal is recommended. Other things that you can do to help with your symptoms are physical therapy and acupuncture. Both of these can help with the symptoms of the urge to urinate and frequently.

Last, many people with IC tend to not talk about it with others and are embarrassed about it. It tends to be overlooked, misunderstood, and often misdiagnosed by many people today. What do you have to hide? There are many individuals out there just like you looking for support. Some areas for support are publications for IC patients (where they are able to keep up to date), local support groups, telephone support, internet support, and regional and national educational meetings. Don't just sit around and feel helpless...get out there and talk to others that have the same problem as you!

In conclusion, now you know a little bit more about interstitial cystitis and how it affects the human body. If you are anyone you know has IC you will be able to talk to them about diagnosing the disease, what causes IC, medical conditions associated with IC, the various types of oral medications, medications that are introduced into the bladder, the male with IC, surgery and the patient, sex, conservative therapies, and support. I know that may sound like a lot of information, but think about it, you may be able to help someone else...or even yourself!

References

Interstitial Cystitis Association. ICA. "Interstitial Cystitis." 2002. Retrieved April 4,

2006. http://www.ichelp.com/.

Moldwin, Robert. The Interstitial Cystitis. New Harbinger Publications, Inc. 2000.

Womens Health Channel. WHC. Interstitial Cystitis." 1998-2006. Retrieved April 4,

2006. http://www.womenshealthchannel.com/interstitialcystitis/diagnosis.shtml.


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